Annual Medical Record Data Collection for Quality Reporting Begins Feb. 1, 2016

Posted December 31, 2015 

Blue Cross and Blue Shield of Illinois (BCBSIL) collects performance data using specifications published by the National Committee for Quality Assurance (NCQA) for Healthcare Effectiveness Data and Information Set (HEDIS®) and by the U.S. Department of Health and Human Services (HHS) for the Quality Rating System (QRS). HEDIS is the most widely used and nationally accepted effectiveness of care measurement available and HHS requires reporting of QRS measures. These activities are considered health care operations under the Health Information Portability and Accountability Act (HIPAA) Privacy Rule, and patient authorization for release of information is not required. 

To meet these requirements, BCBSIL will be collecting medical records using internal resources and leveraging independently contracted third party vendors, such as Enterprise Consulting Solutions, Inc. (ECS), HealthPort Technologies, LLC and IOD Incorporated. If you receive a request for medical records, we encourage you to reply within 7 to 10 business days.

BCBSIL or one of the vendors referenced above may be contacting your office or facility in January or February 2016 to identify a key contact person and to ascertain which data collection method your office or facility prefers (fax, secure email, or onsite). Appointments for onsite visits will be scheduled with your staff, if applicable. You will then receive a letter outlining the information that is being requested, and the medical record request list with members’ names and the identified measures that will be reviewed. If you have any questions about medical record requests, please contact the BCBSIL HEDIS Department at 312-653-5005.

HEDIS is a registered trademark of NCQA.

Enterprise Consulting Solutions, Inc. (ECS), HealthPort Technologies, LLC and IOD Incorporated are independent third party vendors that are solely responsible for the products or services they offer. BCBSIL makes no endorsement, representations or warranties regarding any products or services offered by independent third party vendors. If you have any questions regarding the services they offer, you should contact the vendor(s) directly.