HPSM conducts an annual clinical record review to search for documented ICD-10 diagnoses that may not have been reported to the Centers for Medicare and Medicaid Services (CMS). The 2024 requests for medical records from providers began in August with the expectation that all records will be collected by December 31st.
Because record retrieval can be a burden on providers, we will consolidate requests when possible. In many cases, providers choose to streamline their ongoing record collection process by granting us access to their electronic health record (EHR) for HPSM members. This enables us to handle record retrievals individually. To grant us EHR access for HPSM members, contact our contracted medical record collection vendor at 1-866-243-6057 or 1-855-216-9420.
The following details will help you respond to requests:
- HPSM partners with Optum. They have acquired Episource, which specializes in the record retrieval process, so you may get a record request from them rather than HPSM.
- Records requested will be from January 1st, 2023 to the present.
- CMS is requesting these records as part of their risk and quality review, so we appreciate your prompt response.
If your office needs assistance with these requests, email Ingrid Cornejo, Revenue Data Operation Project Specialist.