Billing Manual for Community Care Network Providers

The medical director or his/her designee will request a description of the purpose forthe requested information from the business associate.All requests for de-identified information will be recorded in the Request for DeidentifiedInformation log.Each request will be reviewed individually.For each request, Community Care will determine how this information will be deidentified.If Community Care is able to reduce the amount of information requested while stillmeeting a business associate’s request, we will do so.Community Care will develop a code to de-identify this information (HIPAA164.514(c). This code will be unique with each request for information. This code willnot be released to the business associate, and each code will be kept in the Requestfor De-identified Information Log. Only the medical director or his/her designee willhave access to this log.The medical director will present the request for information to the OutcomesCommittee for final approval.When the privacy officer receives the decision from the Outcomes Committee; theywill notify the requestor in writing, confirming if the requested information will bereleased, the manner in which it will be released, and how the information will be deidentified.If Community Care did not grant the request for information, a briefexplanation of the reason will be given instead.Once this has all occurred, the member will be contacted by Community Care to seeif he/she would like to participate in any active clinical research activity. CommunityCare is required to receive the member’s authorization prior to the release of anyinformation to a business associate for research purposes. If the member agrees toparticipate in the study and once the signed authorization is received from themember, the information will be released to the business associate conducting theresearch.If the member declines to take part of this study, his/her coverage will not beterminated with his/her refusal to participate.Collecting and Using Member Identifiable InformationCommunity Care collects and uses only the minimum necessary member identifiabledata and information routinely in the performance of our work. Community Careemployees are required to sign a “Statement of Confidentiality” when hired, agreeing tobe bound by Community Care’s strict confidentiality policies and procedures and allfederal and state laws.Community Care considers the following as member identifiable information, but it is notlimited to that listed below. This information used alone or in any combination mayidentify the member (HIPAA 164.512(b)(2)(i).NameAddress (es)Zip CodeCommunity Care Provider Manual | 1-888-251-CCBH | © 2012 All Rights Reserved | Page 136