Highmark Health Options reviews medical records at least annually to confirm consistent evaluation and documentation of medical care provided to its members. The Medical Record Review (MRR) assesses your compliance with multiple standards such as the National Committee for Quality Assurance (NCQA).
The MRR is approved by the Highmark Health Options Health Quality Improvement & Utilization Management Committee to meet state, federal, and regulatory requirements. Examples of these standards include: documentation of continuity and coordination of care, execution of an advanced directive, legibility of written documentation, follow-up visits, and signing and dating of notes.
As a participating provider in the Highmark Health Options network, you are required to comply with the MRR process. Providers will be notified of their results by letter within 45 calendar days of the MRR. Highmark Health Options is not responsible for any costs associated with the review process.
We encourage you to review the Medical Record Review Standards 
. The Medical Record Review Standards have been added to the Health Options website under Providers > Quality Guidelines and Resources. You can print a paper copy of these standards from the website for your records.
Highmark Health Options is committed to ensuring a successful, efficient, and informative review as we assist you in fulfilling this important requirement. If you have questions about your results and what they mean, please contact the Medical Record Integration Team at 412-255-7199.
