Retrieval Services

• Digital retrieval involves accessing records through electronic systems such as EMRs, APIs or secure file transfers.
• Manual retrieval relies on methods like fax, mail or on-site collection.  

Digital methods are typically faster, more scalable and streamlined for providers.

Learn best practices for efficient medical record retrieval

Medical record retrieval is critical for risk adjustment programs, quality measurements and HEDIS® scores because it helps attain accurate member health profiles and risk reimbursement.  

Digital retrieval is faster, more efficient and less demanding on providers. It also supports the industrywide drive toward interoperability in healthcare.

• Digital adoption: Our team focuses on recruiting high-volume providers to the program to continually expand electronic contribution.
• Interoperability: EMR connections are made via FHIR integration or remote automation, and digital connections via APIs and aggregators. Optum can intake multiple formats (PDF, CCD, CCDA, FHIR, HL7) and convert them for coding and abstraction.
• Targeted network expansion: We work with clients to identify provider recruitment targets and with technical teams to test connections. We provide continual recruitment updates and electronic conversion progress.  

The full range of retrieval methods health plans should seek out includes:

• EMR data aggregators
• Fast Healthcare Interoperability Resources (FHIR)
• Field agents
• Interoperability network
• Provider portal
• Remote automation
• Remote EMR access
• Secure email, fax and mail
• Secure file transfer  

A digital-first retrieval approach delivers quicker, more efficient chart retrieval. The Optum approach delivers the following benefits:

• Active digital adoption efforts to influence use of digital retrieval methods including integration of APIs and RPA
• Access to major EMRs and interoperability networks
• Broad national coverage access to 1.5M providers, including over 375,000 using digital methods
• Intelligent workflows that leverage AI and NLP with team oversight at key decision points
• Multimodal retrieval including digital, remote access, onsite, secure provider portal, manual and HIH management  

See our best practices for efficient medical record retrieval

With Optum, health plans can gain transparency and support via a client service team and client-facing portal.

Organizations have greater visibility, control and flexibility throughout the retrieval process thanks to:

• Actionable insights
• Client-determined cadence for delivery of records and reporting
• Real-time status reports  

Health plans should focus on a few key strategies:

1. Adopt a digital-first retrieval approach to help reduce administrative burden.
2. Minimize manual chart requests so providers aren’t overwhelmed by high volumes of requests.
3. Enable interoperability and direct EMR integration to improve engagement, which supports sharing records seamlessly without repeated outreach.
4. Use a multimodal approach that aligns with provider preferences, combined with analytics-driven routing, to reduce friction and encourage ongoing participation.  

Learn about best practices for reducing provider abrasion