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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
If you have multiple files, you can combine them before uploading. Do not exceed 25MB.

Last updated Aug 14, 2025