Get Inovalon Records Request

Filling out the Inovalon Records Request form is an important step in obtaining reimbursement for provided services. This guide will walk you through the process, ensuring you can complete the form accurately and efficiently.

Follow the steps to complete your Inovalon Records Request.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the date you faxed the reimbursement request to BCBSM (1-800-431-9451). This helps track your submission.
3. Include the completed cover sheet. Ensure all necessary information is filled out for clarity.
4. Provide the chart pull list supplied by Inovalon. This is essential for processing your request.
5. Note that BCBSM only reimburses for BCBSM Medicare Plus Blue individual and group members. Be sure to verify eligibility.
6. Enter the date of Inovalon review to track the progress of your request.
7. Provide your site ID as assigned for identification purposes during processing.
8. Fill in your tax identification number in the designated section.
9. Input the contact person's name and phone number for any follow-ups related to your request.
10. Indicate the number of BCBSM Medicare Plus Blue members identified for review in the specified field.
11. Complete the section for where the check should be issued, including the full name and address.
12. Leave the final sections for BCBSM to complete, including 'Date payment mailed,' 'Check number,' and 'Number of charts being reimbursed.' Be aware that notes can be added if necessary.
13. Once all sections are completed, review the form for accuracy before submission. You can then save changes, download, print, or share the form as needed.

Complete your Inovalon Records Request online today for efficient processing.