Billing Manual for Community Care Network Providers
Billing Manual for Community Care Network Providers
Billing Manual for Community Care Network Providers
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Under some circumstances, it may be necessary to obtain authorization verbally. Theuse of a verbal authorization should be approved in advance by <strong>Community</strong> <strong>Care</strong>’s legalcounsel or, if circumstances indicate a need <strong>for</strong> a rapid decision then by the member of<strong>Community</strong> <strong>Care</strong>’s senior management team. If approved, two representatives of<strong>Community</strong> <strong>Care</strong> must witness the entire process of obtaining verbal authorization torelease in<strong>for</strong>mation.<strong>Community</strong> <strong>Care</strong> considers an authorization to release in<strong>for</strong>mation to be valid only if(HIPAA 164.508(c)):It provides the name of the person (s) providing the in<strong>for</strong>mation.It is in a language the member can understand.There is a purpose <strong>for</strong> the release.The specific in<strong>for</strong>mation to be released (dates of treatment, and the exact type ofin<strong>for</strong>mation to be released, i.e., mental health, drug and alcohol) is described.The member’s full name at the time of treatment and correct identifying in<strong>for</strong>mation,e.g., date of birth and Social Security Number.The individual or entity authorized to receive the in<strong>for</strong>mation is described.The expiration date of the authorization.The signature of the member or the member’s legally authorized representative (Ifthe authorization is signed by a personal representative of the individual, adescription of such representative’s authority to act <strong>for</strong> the individual).The release is obtained in a manner that complies with applicable law andregulations.There is a statement that treatment will not be affected if the member or member’srepresentative refuses to sign the authorization.There is a witness signature.There is a date of expiration <strong>for</strong> the authorization.There is a written statement on the authorization <strong>for</strong>m that once this in<strong>for</strong>mation isreleased to the recipient, this in<strong>for</strong>mation may be subjected to re-disclosure by therecipient and no longer protected by this rule.There is a statement on the authorization <strong>for</strong>m that if this in<strong>for</strong>mation is used ordisclosed pursuant to the authorization, it may be subject to re-disclosure by therecipient and no longer be protected by this rule.There is a statement that the individual has the right to revoke this authorization inwriting, including the exceptions to the right to revoke, and a description of theprocess <strong>for</strong> the individual to revoke the authorization.<strong>Community</strong> <strong>Care</strong> will not release the in<strong>for</strong>mation unless the <strong>for</strong>m is completed.Prior to releasing in<strong>for</strong>mation of previously signed authorization to releasein<strong>for</strong>mation, <strong>Community</strong> <strong>Care</strong> will review all authorization <strong>for</strong>ms that are still in effectto ensure that they are compliant with HIPAA regulations.If a previously signed authorization is compliant with HIPAA regulations <strong>Community</strong><strong>Care</strong> will continue to release the in<strong>for</strong>mation until the authorization expires.If the authorization is not HIPAA compliant, then <strong>Community</strong> <strong>Care</strong> will contact themember within 60 days to obtain a newly signed authorization that con<strong>for</strong>ms to<strong>Community</strong> <strong>Care</strong> Provider <strong>Manual</strong> | 1-888-251-CCBH | © 2012 All Rights Reserved | Page 146