From now through October, you may receive a call from Health Data Vision, Inc. (HDVI) about reviewing the medical records of your patients with ConnectiCare commercial plans, including plans purchased on Access Health CT, the Connecticut exchange.
HDVI will conduct chart reviews on our behalf as part of the 2015 Benefit Year HHS-RADV (Risk Adjustment Data Validation) review of medical records. As a health plan, we must submit detailed documentation for each patient on an ongoing basis to the U.S. Department of Health and Human Services (HHS).
Starting this year, HHS will select a sample of ConnectiCare member medical records to review and validate that the diagnoses have been submitted according to ICD-9-CM/ICD-10-CM standards and are appropriately documented in patients' medical charts.
HDVI will contact you to arrange a convenient way of obtaining copies of our members' medical records for dates of service in 2015. As our partner and "business associate," as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), HDVI is fully HIPAA compliant and is required to protect, preserve and maintain the confidentiality of any protected health information (PHI) it obtains from clinical records provided by medical practices.
We truly appreciate your help with this medical records review. If you have questions, please call a ConnectiCare provider education and service representative at (860) 409-2468. Notice of the need for these reviews and your required compliance are included in your contractual agreement with ConnectiCare.