Billing Manual for Community Care Network Providers

POLICYCommunity Care, our staff and agents, shall protect the confidentiality of all confidentialdata and information to which they have access. “Confidential” information is defined asany information by which the member could be identified. The purpose of this policy isto assure that all data and information obtained by Community Care, and ourrepresentatives, are maintained and used with the degree of confidentiality and securitythat the data and information warrant.PROCEDUREGeneral Confidentiality ProvisionsCommunity Care has designated the privacy officer to oversee company policies andprocedures regarding confidentiality and privacy. The specific functions for which theprivacy officer is responsible include but are not limited to:Annual review of all confidentiality policies.Annual training of Community Care employees on confidentiality.Follow-up to concerns of members or providers regarding confidentiality.The Compliance Department will assist the privacy officer with these responsibilities asrequired and requested.Community Care employees, staff, and volunteers are required to sign CommunityCare’s “Statement of Confidentiality” agreeing to be bound by strict confidentialitypolicies and procedures, including all federal and state laws, and the Health InsurancePortability and Accountability Act of 1996 (HIPAA). Signed “Statements ofConfidentiality” are maintained by Community Care’s Compliance Department.Community Care business associates potentially having access to confidentialinformation are required to sign Community Care’s “Statement of Confidentiality”agreeing to be bound by Community Care’s strict confidentiality policies and proceduresor must conform to equivalent provisions as determined by Community Care staff orlegal counsel.Breach of the “Statement of Confidentiality” or equivalent is grounds forimmediate termination.When Community Care becomes aware of a breach in confidentiality:The privacy officer will alert senior management of the breach.An investigation regarding the breach of the member’s (or provider’s) confidentialitywill be conducted by, or under the direction of, the privacy officer.All necessary staff will be interviewed.Any physical material involved will be reviewed.Community Care Provider Manual | 1-888-251-CCBH | © 2012 All Rights Reserved | Page 171