Upcoming Review of Medical Records

Date: 07/08/22

Superior HealthPlan is requesting your cooperation by providing access to specific member medical records to facilitate a Risk Adjustment chart review that will take place in August. Risk Adjustment is the payment methodology used by the Centers for Medicare and Medicaid Services (CMS) and Health and Human Services (HHS) for Superior HealthPlan STAR+PLUS Medicare-Medicaid (MMP), Ambetter from Superior HealthPlan and Wellcare By Allwell (HMO and HMO DSNP) members. 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 the accurate levels of specificity.

Change Healthcare and CIOX Health have been engaged by Superior to retrieve medical records selected as part of this chart review. Please know that any information or records shared with Change Healthcare and CIOX Health during this review will be confidential and in accordance with all applicable state and federal laws regarding the confidentiality of patient records including current HIPAA requirements. Superior appreciates your cooperation with this medical record review and will work with you to minimize disruptions in member care activities.

Providers will have the option to submit medical records via secure email, fax, FedEx, remote Electronic Medical Record (EMR) download, or onsite scanning performed by a Change Healthcare medical record technician.

Please anticipate a call or fax from Change Healthcare or CIOX Health to schedule the medical record retrieval in August.

For questions, please contact Superior’s Risk Adjustment and Quality Rating Systems Operations at SuperiorHealthPlanRiskAdjustment@SuperiorHealthPlan.com.