ExchangeAdministrativeMedium impact
Commercial Risk Adjustment Call for Records
Florida Blue·FL·Medical Policy
Effective date
Nov 1, 2025
We identified it
Jun 16, 2026
Summary
Florida Blue will be requesting medical records for ACA health plan members from November 2025 through March 2026 to validate clinical conditions for federal risk adjustment. Providers can submit records via five methods including remote EMR access, secure file transfer, fax, email, or mail.
Action Required
Between November 2025 and March 2026: Medical records staff must respond to Florida Blue record requests using one of five approved methods: remote EMR access (contact CommercialROI@BCBSFL.com), secure file transfer, fax to 1-904-301-1671, secure email with 'Secure' in subject line, or mail to P.O. Box 40008, Jacksonville, FL 32203-0008. Establish workflow to handle requests from Florida Blue or their authorized third parties (Sharecare, Datavant, Virtix Health). Contact 1-904-905-2691 for questions.