Billing Manual for Community Care Network Providers

If the member is denied the right to amend his/her protected health information theprivacy officer, or his/her designee will:Record in the Member Request to Amend Protected Health Information Log that therequest was denied.Send the member a letter including:• The decision.• The reason for the denial.• A description of the appeals process.• The right to, and process for, filing an appeal.• The name, or title, and the telephone number of the contact person for the nextstep.The member has the right to request in writing that Community Care attach astatement to all future releases such as “the member requested this information beamended and Community Care denied the request.”The privacy officer or his/her designee will record in the Member Right to AmendProtected Health Information Log that the member requested a statement similar tothe one above be attached to all future releases of information.The privacy officer or his/her designee will notify the manager of the file room tohave this member’s file pulled.A sticker will be placed on the front of the member’s utilization record that says:“SEE PRIVACY OFFICER BEFORE ANY INFORMATION IS RELEASED TOOUTSIDE SOURCES.” The privacy officer will need to see the information that isrequested before it is sent to ensure that the statement a member requested isincluded with the information.The privacy officer or his/her designee will also write a brief statement to be includedin the member’s file that the member requested to amend his/her protected healthinformation was denied.The member may also request that this statement be included with all futureinformation to be released.If the information the member is requesting to be amended is not the property ofCommunity Care, the member will be referred to the originator of the documents.If the originator of the protected health information is unable to act on the request (forexample, a practitioner who is no longer in practice), and Community Care’s privacyofficer feels the member’s written request is legitimate Community Care will amendthe information in its possession (HIPAA 164.526(a)(2)(i)).Right to an Accounting of Disclosures of Protected Health InformationThe member has the right to request that Community Care provide an accounting ofdisclosures of protected health information made by Community Care in the six years(or shorter time period) prior to the date in which the accounting is requested. (As perthe HIPAA Section 164.528.) Community Care is not required to track disclosuresprior to the implementation of the HIPAA Privacy Regulations.Community Care Provider Manual | 1-888-251-CCBH | © 2012 All Rights Reserved | Page 155