Medical Record Retrieval

Improve risk adjustment and HEDIS® results
while minimizing provider abrasion

a dollar sign icon with arrows

Medical Record Retrieval is part of Cotiviti's
Risk Adjustment solution suite.

Icon of a medical file

Health plans need to acquire, exchange, and share large volumes of clinical data to support appropriate reimbursement and drive quality member care. A successful retrieval solution operates efficiently at scale and allows health plans to conduct outreach in a coordinated, minimally intrusive manner that meets providers where they are.


Read the fact sheet

"Our Cotiviti partnership continues to be outstanding from preparation of the upcoming season to the end of Medical Record Retrieval"

-Cotiviti client, Blue health plan

Cotiviti's Medical Record Retrieval solution offers comprehensive, web-based medical record retrieval, aggregation, indexing, and storage—fulfilling even high-volume record requests with minimal disruption to providers and their office staff.

Cotiviti deploys a range of capabilities to meet providers' preferences for retrieval methods and for accurate record location. Our digital-first approach helps streamline outreach efforts, with a range of tactics to overcome barriers and achieve project completion. Achieve optimal retrieval strategies and achieve stronger results thanks to our long-term expertise, expert processes, and data management on provider preferences and performance.

Medical Record Retrieval also prioritizes interoperability. Plans benefit from high-quality data sourced from a growing network of hospital connections, health information exchanges (HIEs), and EMR vendors. Our strategic digital data partnerships and network management help increase the number of charts captured digitally, obtaining clinical data in the C-CDA r2.1 or FHIR format.

Medical Record Retrieval results

>1.8M

providers in our curated proprietary database

>88%

risk retrieval rate for MA plans

90%

Average HEDIS retrieval rate

 

Medical Record Retrieval benefits

Gain retrieval efficiency and lower provider abrasion with our proprietary record retrieval software and processes, with features that include:

  • Provider insights. Before outreach, we match provider data found within the approved chase with industry data as well as an extensive proprietary database of historical provider data to reflect the most current provider preferences and locations.
  • Configurable retrieval process. We help optimize retrieval and prioritize provider requests with a solution that can configure processes for various modes of retrieval. Our fully integrated scheduling and project management system contains detailed provider information that can be tracked, stored, and managed to determine the optimal method for retrieval.
  • Client-facing platform. Applications accessed via our client retrieval portal allow clients to track requests in real time, view detailed notes and alerts from Cotiviti retrieval agents, and manage post-retrieval project workflows.
  • Ability to scale. Medical Record Retrieval is adaptable to plans of all sizes, available for a variety of different project and plan needs, all with the same high level of support.
  • Range of applications. Medical Record Retrieval can be applied to a wide number of purposes including, but not limited to:
    • HEDIS reporting
    • Star Ratings initiatives
    • Risk adjustment
    • Clinical chart (DRG) review

HEDIS® is a registered trademark of the National Committee for Quality Assurance.

What makes Cotiviti different?

Cotiviti's Medical Record Retrieval solution gives health plans key benefits that differentiate us from the competition:

  • >25 years of industry experience partnering with national and regional health plans
  • Extensive provider dataset and ability to optimize requests with site-grouping and accurate record location
  • Digital-first approach and strong healthcare interoperability expertise
  • Expansive database of provider locations and engagement preferences
  • Technology-driven workflows and configurable processes

Read the fact sheet

Ready to learn more? Talk to one of our sales representatives—fill out the form below to schedule a call.