Medicare AdvantageDocumentationHigh impact
Risk Adjustment Data Validation (RADV) and The Department of Health and Human Services (HHS) Medical Records Request
Blue Cross Blue Shield of North Dakota·ND·Provider News
Effective date
Jun 25, 2026
We identified it
Jul 3, 2026
Summary
Blue Cross Blue Shield of North Dakota is participating in a CMS-mandated Risk Adjustment Data Validation (RADV) audit for Medicare Advantage members. Providers will receive medical records requests from Cognisight (in-state) or Virtix Health (out-of-state) vendors and must provide requested records at no charge. All submitted medical records must be fully legible, signed with provider credentials, and dated to meet CMS requirements.
Action Required
Immediately: Providers and billing staff must prepare for incoming medical records requests from Cognisight at (877)271-1657 or Virtix Health at 1-888-405-4426 on behalf of BCBSND. Do NOT submit invoices or charge fees for medical records provided to these vendors. Ensure all medical records submitted are fully legible, dated, and signed by the provider with credentials. If records do not meet these requirements, providers may be asked to provide signed attestation. Designate staff to coordinate record requests and establish a process for timely submission via EMR, secure file transfer, or other approved methods. Update internal workflows to flag that this audit does not apply to North Dakota Medicaid Expansion members. Contact BCBSND Provider Services at 800-368-2312 with questions.