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Medical Record Audit – Request for Medical Records

If you have received a "Medical Record Audit – Request for Medical Records" notification from ATRIO, use this form to submit requested documents. If there were multiple claims in the notification, please submit this form for each claim (one submission per claim).

If you have any questions about this form, please email compliance@atriohp.com

Provider Information
By providing your phone number, you agree and acknowledge that ATRIO may send text messages to your wireless phone number for any purpose. Message and data rates may apply. Message frequency will vary, and you will be able to Opt-out by replying “STOP", assistance can be found by texting "HELP". For more information on how your data will be handled please visit our Privacy Policy
If you have multiple files, you can combine them before uploading. Do not exceed 25MB.
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