Join us for an Online Clinical Data Exchange for Quality and Risk Adjustment Webinar
Online Clinical Data Exchange for Quality and Risk Adjustment Webinar
Use the links below to register for sessions covering the Medical Attachments, CQV and CERA tools. Select a session date and time:
Medical Attachments for Quality and Risk Adjustment Purposes
You can now receive and respond to quality and risk adjustment medical record requests electronically via Availity’s Medical Attachments tool. Learn more about Electronic Quality and Risk Adjustment Medical Records Requests.
Clinical Quality Validation (CQV) Tool
Comply with Healthcare Effectiveness Data and Information Set (HEDIS®) measures using Availity’s new Clinical Quality Validation Tool. By using CQV you may document your patients’ care and assessments electronically, while closing quality HEDIS gaps. CQV also helps support the Centers for Medicare & Medicaid (CMS) STAR rating for Blue Cross Medicare Advantage (HMO)SM and Blue Cross Medicare Advantage (PPO)SM plans. Learn more about CQV.
Claim Encounter Reconciliation Application (CERA)
CERA helps you respond to BCBSTX if potential risk adjustment gaps are identified based on claims data for members with commercial and on/off-exchange health plans. Learn more about CERA.
Availity users have access to many other tools and resources. Visit the BCBSMT provider website to learn more about online options. Providers who are not Availity users are encouraged to register with Availity.com and complete the online application, at no charge.
At this time, electronic medical record request and submission process are not available for medical record requests resulting from utilization review activities or the claims adjudication process.
Availity® is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSMT. BCBSMT makes no endorsement, representations or warranties regarding any products or services provided by third-party vendors such as Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.