Upcoming Chart Retrieval Requests

Each year, CareFirst BlueCross BlueShield, CareFirst BlueChoice, Inc. and their subsidiaries and affiliates (collectively “CareFirst”) must retrieve medical records from our network providers to fulfill various regulatory requirements and audits. This communication contains updated guidance in preparation for the retrievals occurring in calendar year 2024.

We encourage you to distribute this communication to all administrative staff, along with any vendors you’ve contracted with to support medical records.

As a reminder, your contract as a participating provider has language around the provision of requested records to CareFirst at no charge and within 15 days of the request.

We hope by providing you with transparent expectations well in advance of retrieval kick off, you can prepare accordingly and minimize disruption to your already busy staff.

What steps should I take to prepare in the coming weeks?

  • View the 2024 Record Retrieval Calendar.
    Click here to access the calendar and note the various vendors that may reach out on behalf of CareFirst. Very few practices will be impacted by all retrieval efforts.
  • Check that your practice has up to date contact information on file.
    The easier it is to reach you, the fewer calls your practice will receive. Visit the Update your Practice Info page for instructions—we recommend double checking address, phone number, fax number and email.
  • Subscribe to provider communications.
    Use a practice level email address to subscribe here or visit carefirst.com/stayconnected.
  • Review the terms of your contracts with third-party print/copy vendors.
    Ensure they include provisions to meet CareFirst requirements and turnaround times. Remind your vendors not to submit invoices to CareFirst for medical records, as these requests are covered under the terms of your contract with CareFirst.
  • Learn more about the Chart Retrieval process.
    Take 2 minutes to review our Risk Adjustment – Chart Retrieval SHORT.

What should I do if I receive a request for medical records?

  • Provide access to electronic medical records (EMR) to the vendor or use another electronic means for record submission.
    This is the fastest and least expensive option to fulfill chart requests. Instructions will be provided by the vendor when you are first contacted about a request. If remote access or electronic submission is absolutely not possible, an address will also be included for mailed records.
  • Respond in a timely manner - ideally within a week, but no more than 15 days.
    This will eliminate disruptive follow-up calls and requests.

Capturing the clinical information in our member’s health records is critical to our standing as a health plan. As such, CareFirst is tracking provider compliance with requests. Failure to submit requested records will be considered a violation of your contract with CareFirst and may jeopardize your network participation and selection for new initiatives. Repeated noncompliance may result in financial penalties to your practice.

CareFirst recognizes large medical requests can be time and labor intensive to your practices. We are taking steps internally to coordinate requests across initiatives and vendors, make available electronic means of submission, give plenty of advance warning of upcoming initiatives, and more to help you prepare.

As always, thank you for your partnership.

Have a question?

Questions specific to a medical record request should be directed to the vendor. For general questions, you can reach out to Provider Relations at 410-872-3512 or escalatedMRrequests@carefirst.com.

Note: Providers in PCMH or other value-based arrangements can direct questions to their Practice Consultant.