Provide Records to Support Risk Adjustment Data Validation Audit
AI Summary
Blue Cross and Blue Shield of Texas and their vendor Advantmed will be requesting medical records from Medicare Advantage providers to support the CMS Risk Adjustment Data Validation Audit that began in June 2025. Providers must respond quickly to medical record requests as they are time-sensitive and no patient authorization is required.
Action Required
When received: Respond immediately to medical record requests from Advantmed for CMS-RADV audit. Medical records staff must provide all requested records from the sampled year (2018-2023 dates of service) as quickly as possible. No patient authorization is required. Contact BCBSTX RADV department with questions. Be alert for fraud schemes - verify legitimate requests are from Advantmed/BCBSTX.
Plan Types
Medicare Advantage
States
TX
Specialties
all-specialties