It’s all about our members: 2021 HEDIS data studies are underway
New data elements required for professional claims

It’s all about our members: 2021 HEDIS data studies are underway

The 2021 HEDIS® medical record retrieval began this month and will continue through May. Blue Cross® Blue Shield® of Arizona (BCBSAZ) has contracted with companies representing BCBSAZ benefit plans to contact network providers and collect data on our behalf.

The information we collect is vitally important. Even more important is the motivation for these proactive data studies: Improved quality of care for our members and your patients.

Your timely response is needed

HEDIS data and HIPAA guidelines Release of this information is permissible under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as the disclosure is part of quality assessment and improvement activities. No specific authorization is required. See 45 CFR 164.506 for more information.

We do our best to obtain needed data from records already available to us, but we might not have everything we need. Upon request, please provide the necessary documentation—including progress notes, specialist notes, radiology reports, and laboratory data—within the specified time frame. The medical records you submit will allow us to validate and demonstrate the quality care you provide to our members.

Data collection methods include fax, mail, and remote electronic medical record (EMR) system access, if available. In light of the limited data-collection time frame, a turnaround time of 3-5 days is requested. It’s critical that you follow the specific instructions included in the request notice about how and where to send the records.

We understand the value of your time, and appreciate your participation.

You’ll find additional information about HEDIS on the secure provider portal at “Population Health > HEDIS.” If you have questions or concerns, contact a HEDIS coordinator at 602-864-5273.

HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).

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Our members can take a digital ID card with them wherever they go with the MyBlue AZSM mobile app.