Change Healthcare to begin Medicare chart reviews
The Centers for Medicare and Medicaid Services (CMS) require all organizations participating in the Medicare Advantage (MA) program to submit complete and accurate diagnostic data to CMS for all beneficiaries enrolled in a MA plan. The diagnostic data submitted is used to predict the relative health risk status of individuals during the next calendar year and must be supported by valid documentation within the patient’s medical record.
Priority Health has partnered with Change Healthcare (formerly Altegra Health) to conduct the review of patient charts on our behalf.
We're sending letters to Medicare providers
The Medicare Risk Adjustment team is sending letters to our Medicare providers, informing them of the upcoming chart review. The letter is accompanied by a packet that includes the steps providers need to take to submit medical records to Change Healthcare. Per the letter, a Change Healthcare representative will follow up with each Priority Health Medicare provider in the coming weeks.
Contact information for Change Healthcare
Providers with questions about this process can contact Change Healthcare directly at 855.767.2650.