Annually, we conduct an Ambulatory Medical Record Review (AMRR) of participating providers in our Illinois Health Maintenance Organization (HMO) network.* To support this important aspect of patient care, a random sample of providers are audited to validate that the medical records received have met all medical record documentation requirements.

After the review is completed, providers may receive a request to sign an attestation form and return it to the Quality Management team if there were medical record requirements missing from their documentation. The attestation form is the provider’s acknowledgement that they have reviewed the medical record indicators and will implement procedures to ensure adherence going forward.

Please note that the provider’s signature is required, and no others will be accepted on the attestation form. As a reminder, a valid email address for both the provider and the office should be confirmed when submitting the form to ensure that the Quality Management team can respond to the correct staff.

Go to the Cigna for Health Care Professionals website (CignaforHCP.com) to view the full set of documentation standards for Medical Record Reviews.

If you have any questions about the AMRR process for participating providers in the Illinois HMO network, please send an email to the dedicated email box at DedicatedAMRRMailbox@Cigna.com.

*Illinois Administrative Code Title 77, Section 240.90, outlines the HMO Provider Site Medical Record Requirement. The citation states that health care providers contracted by a health maintenance organization (HMO) are required to maintain specific medical record documentation in the active record for each enrollee who receives health care services.