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Respond Electronically to Medical Record Requests for Quality and Risk Adjustment, and Soon Claims, via Availity® Provider Portal

Posted August 30, 2019

Currently, the Medical Attachments application within the Availity portal allows you to electronically respond to quality and risk adjustment medical record requests from Blue Cross and Blue Shield of Illinois (BCBSIL). After Oct. 1, 2019, you will also be able to use this optional application to electronically respond to medical record requests from BCBSIL to more efficiently support claims processing.  

Submitting requested medical record information online is easy. Once logged into the Availity portal, medical record requests from BCBSIL will display in the Notification Center. You may then respond by uploading and submitting documentation using the Medical Attachments application. You may also track and audit your submissions within the Medical Attachment application.  

You must be a registered Availity user to receive and respond to these requests online using the Medical Attachments application. To enable this feature, practice administrators must first log into Availity, select Enrollment Center, then choose Medical Attachments Setup and enter the required data. Administrators are encouraged to complete this online setup now to ensure your organization is ready to receive new medical record requests for claims processing, once this new feature is implemented.  

We are excited to offer more payer­provider solutions within your daily Availity workflow. Integrating this new electronic medical records submission capability has the potential to reduce in-person visits to retrieve medical records and administrative challenges associated with mailing or faxing paper submissions. (Mailing and faxing medical records remain options for all participating providers.)  

Continue to watch our News and Updates for upcoming online training sessions and other educational resources. If you have questions, contact our Provider Education Consultants at PECS@bcbsil.com  

Not registered with Availity? Go to availity.com  and complete the online application, at no charge. For more information, refer to Availity Portal Attachments Tools – Getting Started Guide.    

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.  

Providing requested medical records is not a guarantee of payment of benefits. Payment of benefits is subject to several factors, including, but not limited to, eligibility at the time of service, payment of premiums/contributions, amounts allowable for services, supporting medical documentation, and other terms, conditions, limitations, and exclusions set forth in the member’s policy certificate and/or benefits booklet and or summary plan description. Regardless of any preauthorization or benefit determination, the final decision regarding any treatment or service is between the patient and their health care provider.