ExchangeDocumentationMedium impact
2025 QHP Risk Adjustment Data Validation Project
Blue Cross Blue Shield of Vermont·VT·Provider News
Effective date
Jul 1, 2026
We identified it
Jul 1, 2026
Summary
Blue Cross VT is conducting the 2025 QHP Risk Adjustment Data Validation (RADV) project in partnership with Reveleer to retrieve medical records for 2025 claims identified by CMS. Providers will receive outreach requests starting in July 2026 and must respond promptly with requested medical records to support the validation process.
Action Required
By July 31, 2026: Establish a process to receive and track medical record requests from Reveleer related to the RADV project. Designate staff responsible for responding to RADV requests. When requests are received, billing and clinical teams must promptly retrieve and submit the requested medical records following Reveleer's instructions. Delayed or non-responsive submissions may impact risk adjustment reconciliation. For questions, contact Blue Cross VT QHP Risk Adjustment Department at RiskAdjustment@bcbsvt.com or (802) 371-3540.