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IMPORTANT: Medical Records Retrieval Project

Date: 02/06/26

Superior HealthPlan is requesting your cooperation in providing access to specific member medical records to facilitate Risk Adjustment and HEDIS® (Healthcare Effectiveness Data and Information Set) chart reviews. Risk Adjustment is the payment methodology used by the Centers for Medicare and Medicaid Services (CMS) and Health and Human Services (HHS) for Wellcare By Allwell, Wellcare By Superior HealthPlan, STAR+PLUS Medicare-Medicaid Plan (MMP), Ambetter Health Solutions and Ambetter from Superior HealthPlan members. HEDIS® is a data set utilized to measure performance on a variety of healthcare indicators. Accrediting bodies as well as federal and state purchasers of health care utilize this data set to evaluate the effectiveness of a health insurance company’s ability to improve health outcomes.

The purpose of these chart reviews is to verify that information reported to Superior, and ultimately to CMS and HHS via claims or encounter data, includes all pertinent diagnosis codes at accurate levels of specificity.

Please Note: Superior has a Business Associate Agreement with both Advantmed and Datavant (formerly CIOX Health). They will be doing outreach on our behalf.

Superior is working with Advantmed and Datavant to retrieve medical records selected as part of this chart review. Any information shared during this review will be kept in the strictest of confidence, in accordance with all applicable state and federal laws regarding the confidentiality of patient records, including current Health Insurance Portability and Accountability Act (HIPAA) requirements. Superior appreciates your cooperation with this medical record review and will work with you to minimize disruptions in member care activities.

You will have the option to submit medical records in the following ways:

  • Secure email
  • Fax
  • FedEx
  • Remote Electronic Medical Record (EMR) download
  • Onsite scanning performed by an Advantmed/Datavant or Superior medical record technician

Please anticipate a call or fax from Advantmed, Datavant, or Superior to schedule the medical record retrieval in the upcoming weeks.

For any questions, please email SHP_RiskAdjustment@SuperiorHealthPlan.com.