Medicare AdvantageAdministrativeMedium impact
CMS RADV Audit, Payment Year 2019: We May Request Medical Records
Florida Blue·FL·Claims & Billing
Effective date
Jul 1, 2025
We identified it
Jun 16, 2026
Summary
CMS is conducting a RADV audit for Florida Blue Medicare Advantage plans focusing on 2018 dates of service. Between July-September 2025, Florida Blue may request medical records from providers with 10 business days to respond and a hard deadline of 45 days from the original request date.
Action Required
Between July-September 2025: Respond to any Florida Blue medical records requests for BlueMedicare HMO/PPO members with 2018 dates of service within 10 business days. All records must include progress notes and be submitted no later than 45 days from original request date. Contact RPMChartProcurement@FloridaBlue.com with questions. Failure to respond timely may impact audit compliance.