Reminder: How to correctly submit requested medical records for claims processing

Occasionally, we request medical records to accurately process a claim for payment. As a reminder, if you receive a request from us to submit medical records, the correct process is outlined below.

Following the above process will ensure your medical records are linked to the appropriate claim right away, whenever possible, and will support a timely resolution and claim payment.

Step 1: Search for your claim:

1. Log into your prism account.
2. Click Claims in the main prism menu, then Medical claims.
3. Search for the claim in question and click the Claim ID.

Step 2a: If the claim is available in prism:

1. From the claim information page, click the Contact Us About This Claim button and select Submit medical records from the available options.
2. Enter the requested information, attach the medical records and click Submit.

Step 2b: If the claim isn’t available in prism:

1. Click General Requests in the main prism menu, then New Request.
2. Under Claims questions, select Pended claims requested medical records.
3. Enter the requested information, attach the medical records and click Submit.

You can find this process and instructions for other prism inquiry submission processes outlined in our Get your questions answered document. We highly recommend saving this document’s URL for quick reference.