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Medical Record Review

Provider Administrative Policy

Care Management
Policy Date
May 2008
Revised/May 2008


Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.


Medical Record Review

On occasion, Blue Cross of Idaho may initiate a study or perform a review that requires medical record audits of Medicare Advantage members’ charts. We will give physician offices adequate notice of any scheduled medical record reviews.

We ask that physician office staff assist with our Quality Improvement Program (QIP) process by providing copies of medical records or providing access to charts for on-site review of records when requested.

Policy History

Date Action Reason
May 2008 Revised Language clarification

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