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Medicare AdvantageAdministrativeHigh impact

RADV Audit for 2020 Underway

EmblemHealth·Provider News
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

EmblemHealth's vendor Datafied is actively requesting complete medical records from healthcare providers for specific patients with dates of service from Jan 1, 2019 to Dec 31, 2019 as part of a RADV audit for 2020. Additional RADV audits are planned between May 2026 and August 2027, requiring similar medical record submissions.

Action Required

Action needed
Immediately: When contacted by Datafied, respond promptly and submit complete medical records for requested patients with dates of service Jan 1-Dec 31, 2019 using secure delivery methods provided. Medical records staff should notify any third-party medical record vendors now to ensure timely responses. No member authorization required due to existing business associate agreement.

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