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Medical Record Review

Provider Administrative Policy

Commercial Managed Care
Policy Date
December 2002
Reviewed/May 2008
Provider Type(s)
All Providers  


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, the Medical Quality Management Department may initiate a study or perform a review that requires medical record audits of Blue Cross of Idaho members’ charts. Physician offices will be given adequate notice of any scheduled medical record reviews.

Physician office staff is asked to assist with the Quality Improvement Program (QIP) process by providing copies of medical records or providing access to charts for on-site review of records.

Policy History

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