Billing Manual for Community Care Network Providers
Billing Manual for Community Care Network Providers
Billing Manual for Community Care Network Providers
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statute. Each practitioner is in<strong>for</strong>med of the right to review in<strong>for</strong>mation in his/her file throughthe cover letter in the application packages <strong>for</strong> initial credentialing andrecredentialing. A practitioner may obtain a copy of his/her file. The request must be in writing. Credentialing staff will send a copy of a practitioner’s file to him/her within 10business days of receipt of the written request <strong>for</strong> the file. This file when mailed willbe sealed in an envelope marked confidential. NPDB in<strong>for</strong>mation is not included. Peer review in<strong>for</strong>mation is not included. Practitioners are notified by the credentialing staff of any in<strong>for</strong>mation obtained duringcredentialing or recredentialing activities that varies substantially from thein<strong>for</strong>mation provided by the practitioner. Practitioners have the right to correct erroneous in<strong>for</strong>mation. Practitioners may submit any corrections in writing or additional documents to theCredentialing Department. Credentialing staff will document any verbal in<strong>for</strong>mation or corrections provided by apractitioner in the file including the date and signature of the individual who obtainsthe in<strong>for</strong>mation.In<strong>for</strong>ming <strong>Providers</strong> about ConfidentialityThe following policies and procedures are included in <strong>Community</strong> <strong>Care</strong>’s Provider<strong>Manual</strong> and updated as needed:General Confidentiality Provisions.Oversight of Confidentiality Practices.Collecting and Using Member Identifiable In<strong>for</strong>mation.In<strong>for</strong>ming Members about Confidentiality.Ability to Give In<strong>for</strong>med Authorization.Member Access to Utilization Records.Disclosure of In<strong>for</strong>mation.Disclosure of In<strong>for</strong>mation to Employers.Handling of Practitioner Specific In<strong>for</strong>mation.Practitioner Office Confidentiality.Practitioner Office ConfidentialityMember identifiable data and in<strong>for</strong>mation maintained in paper-based or removablecomputer storage media must be maintained under lock and key, either in lockedcabinets or in a locked area.Member-identifiable data and in<strong>for</strong>mation includes, but is not limited to, medicalrecords, appointment books, patient reminder cards, correspondence, laboratory<strong>Community</strong> <strong>Care</strong> Provider <strong>Manual</strong> | 1-888-251-CCBH | © 2012 All Rights Reserved | Page 151