Excellus Medical Record Requests

Wednesday, February 07, 2007 at 8:17:40 AM

In changes advised by Exellus Blue Cross/Blue Shield in September 2006, submission of relevant medical records are required, if requested, to facilitate reviews for a number of situations. As a result, any claim United Health Services Hospitals (UHSH) has submitted will not be paid if medical records have been requested, but not yet returned/received. UHSH would like to ask for your cooperation when/if your office receives such a request that the records be returned in a timely manner directly to Excellus. Affected situations: * Services or procedures requiring preauthorization * Services or procedures where a Corporate Medical Policy indicates criteria for medical appropriateness or for services considered cosmetic, experimental or investigational * Quality of care and quality improvement * Medical necessity * Pre-existing conditions * Determination of appropriate level of care * Case management or care coordination Thank you in advance for your anticipated cooperation.

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