EmblemHealth is required to respond to a Contract Level RADV Audit for Payment Year 2019.
Our vendor, Cognisight, Inc., is contacting health care providers who are part of the Risk Adjustment and Data Validation (RADV) audit sample. Cognisight is asking providers to submit the complete medical record for specific patients for dates of service between Jan. 1, 2018, and Dec. 31, 2018.
Providers who have not yet supplied the requested records to Cognisight will also be contacted by an EmblemHealth representative to secure the charts.
Please note that a member authorization is not required to release the medical records based on the business associate agreement between EmblemHealth and Cognisight.
When you receive a request from Cognisight or from EmblemHealth directly, we ask that you respond promptly and submit the required documentation using one of the secure delivery methods detailed in the communication materials.
Providers who work with a vendor to manage medical records are encouraged to notify their service suppliers now so that responses to Cognisight’s requests can be issued timely.
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