ExchangeDocumentationMedium impact
2025 benefit year HHS-RADV Initial Validation Audit begins May 2026
BCBS Michigan·MI·Claims & Billing
Effective date
May 1, 2026
We identified it
Jun 16, 2026
Summary
Blue Cross Blue Shield of Michigan will begin conducting HHS-RADV audits in May 2026 for 2025 benefit year claims, requiring providers to submit complete medical records within 180 days of service dates to validate diagnosis codes. Datavant will mail notification letters to selected provider offices starting June 2026.
Action Required
Starting June 2026: When notification letters arrive from Datavant, medical records staff must promptly submit complete medical records for selected patients within audit deadlines. Ensure all records include provider signatures and credentials within 180 days of service date. If signatures are missing or outside timeframe, prepare signature attestation statements as requested by Blue Cross.