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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

June 2017

ACA Risk Adjustment Data Validation Reminder: Medical Chart Requests


As a reminder, in support of the Affordable Care Act’s Risk Adjustment Data Validation (RADV) program, beginning this month, you may receive a medical chart request from Harvard Pilgrim pertaining to services provided during the 2016 calendar year. Please keep in mind that:

  1. Medical chart requests may be for a regular patient of yours or someone who was only seen once in your office.
  2. Medical charts must have the patient’s name and date of birth, the date of service, the provider’s signature and credentials, and date of the provider’s signature.
  3. Medical charts must be provided within 14 days to meet Harvard Pilgrim’s audit timeline requirements.
  4. Member authorizations are not required.
  5. Medical chart request materials will include contact information for assistance you or your staff may need.

If you have questions regarding a RADV medical chart request, please contact Kathryn Roach, Program Manager, at 617-509-2199.

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PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator