Medical Record Review

A Medical Record Review (MRR) is an evaluation of a member’s record according to:

• Format.
• Documentation.
• Continuity or Coordination of Care.
• Pediatric Preventive Services (if applicable).
• Adult Preventive Services (if applicable).
• Obstetric Preventive Care (if applicable).

The review evaluates criteria such as:

• Availability of essential member biographical information.
• Documentation practices.
• Quality as evidenced by consistent and/or coordinated management of health conditions and oversight of preventive services.