Use DatafiedTM to submit records at no cost
Wellcare will begin collecting medical records starting January 2, 2026. This effort supports Healthcare Effectiveness Data and Information Set (HEDIS) for Measurement Year 2025, focusing on clinical Effectiveness of Care measures.
HEDIS is a nationally recognized set of performance standards used to evaluate the quality of care provided to health plan members.
- Collection period: January 2 – May 30, 2026
- Purpose: To evaluate the quality of care provided to members using national HEDIS standards.
What you need to know
- Who may be selected?
- Physicians and independent practice associations (IPAs) may be randomly selected to submit member medical records during this period.
- Your responsibility
- Per contract terms, physicians and IPAs must submit data when requested for health care operations and quality review.
How to submit records
Datafied is contracted to collect medical records and assist with copying for high-volume provider sites at no cost.
- If you choose to use a different vendor, you will be responsible for the cost.
- Your contact information will be confirmed by phone before the HEDIS packet is sent.
- The packet includes a member list and the specific data needed.
Respond within seven (7) days
Once contacted, you must release the records within 7 business days from the date of the request.
- If you need more time, contact Datafied at 714-666-0951 and provide an estimated delivery date. Contact information is included in the packet.
- If records are not available, or the member was not your patient during the requested time frame, physicians and IPAs must:
- Confirm that they do not see the patient(s) at other locations. If they do, the physician or IPA must indicate this on the Certificate of No Record (CNR) or let the Datafied contact know.
- Complete and return the CNR included in the packet.
- Or contact Datafied at 714-666-0951 to redirect the request.
- Datafied will follow up with your office if requests remain unresolved.
Patient privacy is protected
Datafied maintains the confidentiality of patients’ protected health information (PHI) in accordance with Health Insurance Portability and Accountability Act (HIPAA) privacy regulations.1 To comply with these safeguards2, records are accessed by authorized persons only.
Additional information
If you have questions regarding the information contained in this update, contact 866 999 3945.
1Title 45 Code of Federal Regulations (CFR) §164.506 indicates that the routine authorization form you obtain from your patient is sufficient for disclosures to carry out health care operations. 45 CFR §164.501 defines health care operations to include quality assessment and improvement activities. Datafied follows HIPAA regulations and has procedures to protect the privacy of health information received.
2Providing medical records to Datafied follows all federal and state regulations to safeguard PHI and confidentiality.
This information applies to Physicians and Independent Practice Associations (IPAs).
