Medical Records Requests for 2025

Premera Blue Cross Blue Shield of Alaska frequently asks providers for medical records. This year, your office may get requests from Episource, Datavant (formerly CIOX), or Cotiviti. These requests help our commercial risk adjustment program and HEDIS measures. Here’s a summary of when you can expect requests for each of our programs this year.

Commercial risk adjustment medical records retrieval

When: November 2024 through early April 2025.

Why: Helps ensure that all our customers’ medical conditions documented in their medical records are consistent with diagnoses coded on submitted claims.

How: You’ll receive a phone call about the request, followed by a letter from Episource or Datavant. They’ll review the list of medical records being requested from you and help determine which record submission method works best for you.

The goal is to have all records received within 30 days of your receipt of the record request.

Healthcare Effectiveness Data and Information Set® (HEDIS) measures

When: January through May 2025.

Why: Used across the U.S. healthcare industry, HEDIS is a set of standardized performance measures that help consumers compare healthcare quality. Medical records, in addition to the diagnosis and procedure codes you submit on claims, provide evidence of the quality care you deliver.

How: Cotiviti or Datavant will contact you.

These annual efforts are just one of several ways we collaborate with providers to ensure customers have access to quality, affordable healthcare. We appreciate your past participation and continued support.

Requests for records may occur throughout the year to support risk adjustment and HEDIS.