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Medicare AdvantageAdministrativeMedium impact

Episource Conducting Medical Record Requests

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

Summary

EmblemHealth and ConnectiCare are partnering with Episource to conduct medical record reviews throughout the year to ensure proper ICD-10 coding for Medicare and NY State of Health/Access Health CT plans. When providers receive medical record requests from Episource, they must respond promptly with the requested documentation as required by their provider agreements.

Action Required

Action needed
Immediately: Establish workflow to respond promptly to medical record requests from Episource. Train staff to recognize Episource requests and follow their specific instructions for submitting documentation. Ensure compliance with participating provider agreement requirements for chart reviews.

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