Revision: Blue Cross Blue Shield of North Dakota is Partnering with Optum/Episource 

Applies to our Commercial line of business only

We are notifying our provider community that due to the recent cyber-attack to Change HealthCare our partnering vendor, we are moving forward with collection of medical records for the accuracy and integrity of encounter data submitted to the Department of Health and Human Services (HHS) for the Affordable Care Act (ACA) with Optum/Episource (is an Optum/United vendor). The ACA mandates health plans to review medical records along with claims to Episource ensure accuracy of coding practice.

To help us continue with these reviews, BCBSND has contracted with Episource to collect medical records for services performed in your office in 2023. Due to the increased security needs we may be re-requesting records that may have already been sent to Change Healthcare, because we have disconnected our data exchange with them. Episource will be requesting records through the Spring of 2024. Episource will contact your office to schedule medical record retrieval. They will also collaborate with you to determine the best approach for your office and staff.

Providers are permitted to disclose protected health information (PHI) to health plans without authorization from the patient when both the provider and health plan had a relationship with the patient and the information relates to that relationship. Episource contracts with BCBSND as a Business Associate which is covered by the Health Insurance Portability and Accountability Act (HIPAA). Episource is ethically and legally bound to protect the privacy of any PHI it gathers from clinical records provided by the hospital or medical practice.

We appreciate your cooperation in extending Episource your professional courtesy and assistance in completing these requests.

Records submission options:

• Fax: 1-833-589-0806
• Traceable mail: Episource 500 W. 190th Street, 4th Floor Suite 400, Gardena, CA 90248.
• Email to: records@episource.com
  • To protect ePHI, please use encrypted email.
• Electronic Medical Records: submitted via SFTP-Provider Portal or Remote Download.
• Onsite retrieval: Contact an Episource Representative to schedule.

Questions?
Please contact an Episource Representative regarding questions or to schedule your preferred retrieval method at 1-866-243-6057 or 1-855-216-9420.