BCBS TexasMedium ImpactAdministrative
Provide Records to Support Quality Care for Medicare Advantage Members
Published January 12, 2026Effective January 1, 2026
AI Summary
Blue Cross Blue Shield of Texas will request medical records from Medicare Advantage providers from January through June 2026 for HEDIS quality measures and risk adjustment reviews. Providers must promptly respond to record requests from BCBSTX or their vendor Advantmed without requiring patient authorization.
Action Required
January-June 2026: All clinical and billing staff must promptly respond to medical record requests from BCBSTX or Advantmed by fax or phone. Ensure complete and accurate records are provided for chronic conditions (diabetes, high blood pressure), transitional care, and risk adjustment chart reviews. No patient authorization is required under HIPAA health care operations.
Plan Types
Medicare Advantage
States
TX
Specialties
all-specialties