Help Close Gaps in Care for Group Medicare Advantage Members

December 6, 2022

If we need medical records for Blue Cross Group Medicare Advantage (PPO)SM members, you will receive requests from Blue Cross and Blue Shield of Montana (BCBSMT) or our vendor, Change Healthcare, as part of the Blue Cross and Blue Shield (BCBS) National Coordination of Care program. Please respond quickly to our requests, including requests related to risk adjustment gaps and Healthcare Effectiveness Data and Information Set (HEDIS®) measures. Learn more.

In addition, you may receive requests from EXL Health for select inpatient, diagnosis-related claims. Learn more.

Change Healthcare is an independent company that provides administrative services to BCBSMT.

EXL Health and EquiClaim, a Change Healthcare Solution, are independent companies that have contracted with BCBSMT to provide medical claim audits for members with coverage through BCBSMT. BCBSMT makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them.