Helpful reminders for our providers regarding post-pay DRG clinical validation reviews and Apixio

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) would like to share a few important reminders and tips to support smoother medical records exchange and communication of findings during reviews conducted in collaboration with our vendor, Apixio. Please note, there are no changes to the current post-pay DRG clinical validation review process.

Key reminders for providers

• Update points of contact
  Providers should update their designated points of contact by emailing ProviderSupport@apixio.com directly.

• Log in to the MFY Portal regularly
  Providers are encouraged to log in to the MFY portal periodically to:

  • View medical record review (MRR) requests
  • Upload required documentation
  • Review results and status updates

• Submit medical records promptly
  Timely submission of medical records is essential to avoid complete denial or recoupment of paid claims.

• Clarify newborn claims
  If a request pertains to a newborn claim, please submit the appropriate records and clarify the nature of the request.

  • Note: Some newborn claims may appear in a Correction status within the Provider Portal, as the parent’s name may be listed on the initial request. For questions regarding corrections, please contact ProviderSupport@apixio.com.

Following the release of this communication, Apixio will send follow-up emails to our providers with key reminders and a request to update their points of contact. We ask providers to share this message with the relevant stakeholders within their organizations to ensure timely awareness and appropriate action.

Please note that Apixio currently remains the primary brand and vendor point of contact for our post-pay DRG clinical validation review process. Providers will continue to receive email communications from an Apixio email address.

However, Machinify and Apixio are now part of the same organization and are in the process of merging and streamlining operations for DRG reviews. As part of this transition, you will soon notice updates in communications, such as branding, logos, and email addresses, reflecting the Machinify name.

It is important to note that the Provider Portal URL and its functionality will remain unchanged, so the provider experience is expected to remain seamless from an end-user perspective.