Providers can now receive and respond to medical record requests for postpay audit via Change Healthcare’s Assurance Attach Assist module
Starting 9/1/2020, Empire BlueCross BlueShield (“Empire”) will launch the use of Change Healthcare’s Medical Attachment functionality for electronic communications as an additional digital option. This new functionality allows providers to upload medical records and itemized bill documents electronically instead of through traditional paper communications. This functionality can improve communications and increase transparency for medical record requests and will not otherwise impact the audit program.
Important facts regarding this change:
- This change only affects providers who use Assurance Reimbursement Management™ from Change Healthcare and have opted in to using the Attach Assist functionality.
- The new functionality is only for medical record requests for postpay claims for the Payment Integrity Quality Claims Review (Provider Audit) department only.
- There will be no duplicate requests (either paper or electronic). If you opt to use this method, paper requests for medical records will not be sent.
- In Assurance Reimbursement Management™, requests for additional documentation will be displayed to the user on the History tab of the claim. Assurance will be configured such that these requests drive workflow to ensure they are brought to the user’s attention.
- The original letter, historically sent via paper, is accessible as a PDF electronic copy in the provider’s downloads folder in Assurance for review. The letter content is exactly the same as it was in paper format.
- Each request letter (first, second and final attempt) will have a timeframe for responding to the request. After the timeframe has passed for that letter, you will not be able to respond to that letter. If you wish to upload medical records after the response time has expired, please refer to the Change Healthcare training referenced below.
- Providers can respond to the request by uploading records in Assurance Attach Assist. The attachments are received in almost real time and are delivered electronically to the payer’s systems through secure means. Records can be accessed through a hyperlink in Assurance Attach Assist for the particular claim the record is associated.
- The following is out of scope or not impacted:
- Vendor requests for medical records on behalf of the payer
- Providers who do not use Assurance Reimbursement Management™ Attach Assist from Change Healthcare or have not configured Attach Assist within Assurance Reimbursement Management™
- The request timing of request letter and the verbiage in the request letter
- The Program Integrity Special Investigations Unit postpay review is not included at this time.
Training is available on the Change Healthcare Connect Center at: https://rcmknowledgecenter.changehealthcare.com/learn.
Can I start using the functionality earlier?
Yes, you can. If you chose to opt in earlier, please ensure you are configured within Assurance Reimbursement Management™. Reach out to your Provider Solutions contact or request early access via email at dl-Prod-ChangeHealthcare-Provider-Support@anthem.com .
For additional information, see our Change Healthcare Medical Attachment Functionality FAQ.
September 2020 Empire Provider News