Billing Manual for Community Care Network Providers

The member has the right to request an accounting of disclosures of his/herinformation by writing a letter to the privacy officer at Community Care.The privacy officer or his/her designee will review the member request and willrespond in 30 days.If the information requested by the member is not on site, Community Care willretrieve the information within 60 days.If needed Community Care may extend the retrieval an additional 30 days provided;that the member is sent a written statement with the reasons for delay and a date bywhich we will have the information.Community Care will only have one such extension of time for each request.If granted, Community Care will release to the member an accounting of his/herdisclosed protected health information.The privacy officer or his/her designee will oversee the process to account fordisclosures of protected health information.This granted request for an accounting of protected health information will berecorded in the Member Request to an Accounting of Protected Health InformationLog, which will be maintained by the privacy officer or his/her designee.The privacy officer or his/her designee will notify the manager of the file room tohave the member’s chart pulled. The following will be included in the accounting ofdisclosures:• The date of the disclosure.• A brief description of the information that was released.• A statement on the purpose of the disclosure or a copy of the signedauthorization.• The name of a person or provider who requested this information. (CommunityCare reserves the right to deny the request for an accounting of disclosure ofinformation if divulging the name of the person who received information could bedetrimental to the member or the person to whom the information was disclosed.)• A brief statement of Community Care’s policy on Disclosure of Information.• If there was more than one authorized release of information during therequested time period then, the frequency, periodicity, or number of thedisclosures made is included.• If the information was for, or in anticipation of, a civil, criminal, or administrativeaction or proceeding, Community Care will not release the information.• A flag will be placed in PsychConsult to notify employees that the member askedfor an accounting of disclosures.Once this information has been compiled, the information will be mailed in anenvelope marked “Confidential” to the address that the member specifies.Each year the first request for the accounting of information is free. After this,Community Care may charge a reasonable fee for preparing the information, as long asmembers are notified.Community Care Provider Manual | 1-888-251-CCBH | © 2012 All Rights Reserved | Page 156