Medicare chart reviews starting soon

Starting in the coming weeks, Change Healthcare, formerly known as Altegra Health, will conduct the review of Medicare Advantage plan member charts on our behalf. This chart audit process was developed to ensure the accuracy and completeness of the diagnostic data submitted to The Centers for Medicare and Medicaid Services (CMS).

CMS requires all organizations participating in the Medicare Advantage (MA) program to submit complete and accurate diagnostic data to CMS for all beneficiaries enrolled in an MA plan. This diagnostic data 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.

We appreciate your cooperation with this project and in extending Change Healthcare your professional courtesy and assistance. 

Record copy reimbursement

Our contracts state, "At the request of Priority Health, Physician shall provide Priority Health with copies of such requested medical and billing records within a reasonable time from the date of request and in exchange for payment equal to $.25 per page."

Confidentiality

Change Healthcare is bound to protect the confidentiality of any protected health information (PHI) it gathers from clinical records provided by hospitals and medical practices. A Change Healthcare representative will follow-up with you in the coming weeks about patient medical records. The Change Healthcare staff will be able to work with your electronic records on site, if you prefer.

Questions?

If you have any questions regarding any portion of this process, you may contact the Change Healthcare Provider Relations Department at 855.767.2650.