12/18/2024
Texas Medicaid providers may receive a request from Blue Cross and Blue Shield of Texas from February through June 2025 to collect data for Healthcare Effectiveness Data and Information Set (HEDIS®) measures. The data you provide helps us gather information on the quality of our members’ care and their health outcomes.
How you can help: BCBSTX may contact you by fax or phone to provide details about the records needed and how you can return them to us. When requested, please promptly provide complete and accurate records.
Patient authorization isn’t required to release these records, as their collection and review is considered a component of health care operations under the Health Insurance Portability and Accountability Act of 1996.
The data we’re seeking: We collect data related to chronic conditions such as diabetes and high blood pressure, and transitional care.
Please contact our Texas Medicaid Quality Improvement Department via email TX_Medicaid_QI@bcbstx.com.
Other records requests: We also request medical records throughout the year for risk adjustment, focusing on chart reviews and the accuracy of risk-adjustable codes submitted to the Centers for Medicare & Medicaid Services.
HEDIS is a registered trademark of NCQA.