Medicare AdvantageAdministrativeMedium impact
Medical Record Requests for Contract Level (Medicare) Payment Year 2019 RADV Audit
EmblemHealth·Reimbursement
We identified it
Jun 20, 2026
Summary
EmblemHealth is conducting a Medicare RADV audit for 2019 payment year and requires providers to submit complete medical records for specific patients with dates of service from Jan 1, 2018 to Dec 31, 2018. Their vendor Cognisight will be contacting providers directly to request these records, and prompt response is required using secure delivery methods.
Action Required
Immediately: When contacted by Cognisight or EmblemHealth, respond promptly with complete medical records for requested patients with dates of service Jan 1, 2018 - Dec 31, 2018. Use only the secure delivery methods specified in their communication. If using a vendor for medical records management, notify them now to ensure timely responses. No member authorization is required due to existing business associate agreement.