contracting, per<strong>for</strong>mance evaluation, quality assurance, and quality improvement, isConfidential. However, a practitioner practice group or facility name, status as aparticipant in <strong>Community</strong> <strong>Care</strong>’s network, business address, business telephonenumber, and services offered are not considered confidential when disclosed <strong>for</strong>legitimate business purposes.<strong>Community</strong> <strong>Care</strong>’s business data and in<strong>for</strong>mation, including but not limited tosalaries, policies and procedures, finances, business plans, in<strong>for</strong>mation aboutproviders participating in the network when not being released <strong>for</strong> legitimatebusiness purposes, proposals to potential or current customers, in<strong>for</strong>mationdisclosed to <strong>Community</strong> <strong>Care</strong> in confidence by any third party, and per<strong>for</strong>manceevaluation, quality assurance, and quality improvement data and in<strong>for</strong>mation whereproviders are individually identifiable are Confidential.III.C.1b Keeping In<strong>for</strong>mation ConfidentialFor all <strong>Community</strong> <strong>Care</strong> representatives:• Divulging computer passwords and security system pass codes is prohibited• Divulging access codes and keys with any individual who does not have the rightto such access codes or keys is prohibited.• All computers that have the ability to access confidential data or in<strong>for</strong>mation mustbe protected with a confidential log-in password; turned off or logged off at theend of the workday; and protected with a confidential screen-saver password inthe event that the computer is turned on and logged on while the computer useris away from his or her work area.<strong>Community</strong> <strong>Care</strong>’s agents, contractors (including providers), employees, staff, andvolunteers may not access or view confidential data or in<strong>for</strong>mation unless requiredby their duties or responsibilities <strong>for</strong>, or on behalf of, <strong>Community</strong> <strong>Care</strong>.<strong>Community</strong> <strong>Care</strong>’s agents, contractors (including providers), employees, staff, andvolunteers may not discuss confidential data and in<strong>for</strong>mation in an area whereindividuals, including other <strong>Community</strong> <strong>Care</strong> agents, contractors, employees, staff,and volunteers who do not have the right to know about the in<strong>for</strong>mation, mayoverhear the in<strong>for</strong>mation.All confidential data and in<strong>for</strong>mation must be maintained in a manner that preventsaccess by individuals who do not have a right to access the data and in<strong>for</strong>mation.All physical media, including but not limited to, paper, magnetic and optical, used tostore confidential data and in<strong>for</strong>mation must be stored under a double-lock system.All physical media containing confidential in<strong>for</strong>mation that are still in use by<strong>Community</strong> <strong>Care</strong> agents, contractors (including providers), employees, staff andvolunteers at the end of the day must be locked in that individual’s desk or in anothersecured storage area. All desks or secured storage areas must be in areas withkeyed entry, maintaining a minimum of a dual-key system. All physical mediacontaining confidential in<strong>for</strong>mation that are no longer needed by <strong>Community</strong> <strong>Care</strong>agents, contractors, employees, staff and volunteers must be returned to lockedmaster storage at the end of the day. All electronic media containing confidentialin<strong>for</strong>mation must be password-protected.<strong>Community</strong> <strong>Care</strong> Provider <strong>Manual</strong> | 1-888-251-CCBH | © 2012 All Rights Reserved | Page 68
III.C.1c Transferring Confidential In<strong>for</strong>mationThe transfer of confidential in<strong>for</strong>mation <strong>for</strong> legitimate business purposes between<strong>Community</strong> <strong>Care</strong>’s agents, contractors (including providers), employees, staff, andvolunteers in their official capacities as representatives of <strong>Community</strong> <strong>Care</strong> isconsidered an internal transfer, even though they may be in different physical locations.The transfer of confidential in<strong>for</strong>mation other than to <strong>Community</strong> <strong>Care</strong>’s agents,contractors, employees, staff, and volunteers in their official capacities asrepresentatives of <strong>Community</strong> <strong>Care</strong> is considered an external transfer and must bemade in accordance with <strong>Community</strong> <strong>Care</strong>’s Authorization to Disclose In<strong>for</strong>mation (SeeSection III.C.6). The internal transfer of all confidential data and in<strong>for</strong>mation must be conducted in amanner that limits potential access by individuals who do not have a right to accessthe data and in<strong>for</strong>mation. When not hand-carried and personally delivered to therecipient, physical media containing confidential data and in<strong>for</strong>mation must beplaced in a sealed envelope marked “Confidential.” Confidential data and in<strong>for</strong>mation sent by facsimile must bear a prominentconfidentiality notice similar to the following: “This facsimile transmission containsconfidential and privileged in<strong>for</strong>mation <strong>for</strong> use only by the intended recipient. Do notread, copy, or disseminate this material unless you are the intended recipient. If youbelieve you have received this message in error, please notify the sender byfacsimile or telephone and destroy this document.” Confidential data and in<strong>for</strong>mation sent by email must be flagged as confidential andbear a confidentiality notice similar to the following within the message: “This emailcontains confidential and privileged in<strong>for</strong>mation <strong>for</strong> use only by the intendedrecipient. Do not read, copy, or disseminate this material unless you are theintended recipient. If you believe you have received this email in error, please notifythe sender by return email, securely delete this file and any electronic or magneticcopies and destroy any paper copies.”III.C.1d Destroying Confidential In<strong>for</strong>mationConfidential data and in<strong>for</strong>mation no longer required <strong>for</strong> legitimate business purposesmust be destroyed in a secure manner. Paper records must be thoroughly shredded.Magnetic files must be deleted in a manner that does not permit the files to beundeleted, <strong>for</strong> example, by re<strong>for</strong>matting a floppy disk using the “secure” <strong>for</strong>mat option.Either optical storage media must have the files securely deleted or, if this is notpossible, the storage media must be destroyed.III.C.1e Committee Oversight of Confidentiality<strong>Community</strong> <strong>Care</strong>’s privacy officer and the Compliance Department are responsible <strong>for</strong>approving and periodically reviewing all policies and procedures related toconfidentiality and <strong>for</strong> identifying, developing and implementing mechanisms to oversee<strong>Community</strong> <strong>Care</strong> Provider <strong>Manual</strong> | 1-888-251-CCBH | © 2012 All Rights Reserved | Page 69
- Page 5 and 6:
APPENDIX A.2. Confidentiality 130AP
- Page 7 and 8:
Clinical Fax by County:Adams 1-866-
- Page 9 and 10:
Outpatient Therapy 1MD OutpatientMe
- Page 11 and 12:
Functional Familytherapy (FFT)Multi
- Page 13 and 14:
Non-Acute PartialHospitalizationNot
- Page 15 and 16:
I.A. Code of EthicsCommunity Care
- Page 17 and 18: esources and evaluated on their pro
- Page 19 and 20: Confidentiality policies including
- Page 21 and 22: Within 30 minutes for urban areas.W
- Page 23 and 24: I.E. Care Management Team“Advocat
- Page 25 and 26: In order to serve special populatio
- Page 27 and 28: Psychiatric Rehabilitation Clubhous
- Page 29 and 30: always be considered in light of th
- Page 31 and 32: Tell their provider everything they
- Page 33 and 34: and calls received on the programs
- Page 35 and 36: II.D.1e EvaluationIndividuals parti
- Page 37 and 38: II.D.2b GoalsThe goals of Community
- Page 39 and 40: II.D.3 Providers’ Role in the Pre
- Page 41 and 42: Community Care has a total of 30 ca
- Page 43 and 44: Department of Health and provide in
- Page 45 and 46: An explanation of the grievance pro
- Page 47 and 48: Upon request, the member will be as
- Page 54 and 55: Notices must be in alternate format
- Page 56 and 57: Community Care is a party to the he
- Page 58 and 59: The following sections provide info
- Page 60 and 61: members, practitioners are asked to
- Page 62 and 63: Accreditation of Healthcare Organiz
- Page 64 and 65: III.B.4 Facility ReassessmentFacili
- Page 66 and 67: present relevant information, and t
- Page 70 and 71: the implementation and application
- Page 72 and 73: III.C.4 Ability to Give Informed Au
- Page 74 and 75: When such disclosure to health care
- Page 76 and 77: Practitioners are informed of the r
- Page 78 and 79: Medication(s) that have been prescr
- Page 80 and 81: III.E. Clinical Practice Guidelines
- Page 82 and 83: Community Care has developed a plan
- Page 84 and 85: eing served and uses strategies to
- Page 86 and 87: dialogue and intervention may occur
- Page 88 and 89: For any questions about providing s
- Page 90 and 91: If you, as a Community Care provide
- Page 92 and 93: When the precertification is for se
- Page 94 and 95: ORA member expresses a readiness fo
- Page 96 and 97: IV.E.3 Transition of Care to anothe
- Page 98 and 99: Billing ManualCommunity Care Behavi
- Page 100 and 101: Even though an authorization may be
- Page 102 and 103: Timely File requests are to be mail
- Page 104 and 105: Provide an alternative to the use o
- Page 106 and 107: Required Claim FieldsIn the followi
- Page 108 and 109: 24C EMG Not required24D Procedure C
- Page 110 and 111: 17 Discharge Status Required forINP
- Page 112 and 113: 67a-q Diag. Code Required68 Unlabel
- Page 114 and 115: • Explanation of Benefits (EOB) i
- Page 116 and 117: Many of the services covered by Com
- Page 118 and 119:
Community Care Behavioral Health Or
- Page 120 and 121:
Community Care Procedure Code: The
- Page 122 and 123:
C/FST: Consumer/Family Satisfaction
- Page 124 and 125:
Medicaid/Medical Assistance identif
- Page 126 and 127:
APPENDICESAPPENDIX A.1. Fraud, Wast
- Page 128 and 129:
. The provider will also receive a
- Page 130 and 131:
APPENDIX A.2. ConfidentialityPOLICY
- Page 132 and 133:
A Facility or group practice name,
- Page 134 and 135:
Confidential data and information s
- Page 136 and 137:
The medical director or his/her des
- Page 138 and 139:
The privacy officer will review the
- Page 140 and 141:
collection and use of member identi
- Page 142 and 143:
Protection of information disclosed
- Page 144 and 145:
If a member is granted access to re
- Page 146 and 147:
Under some circumstances, it may be
- Page 148 and 149:
164.504(e)(ii)(A)).They will take a
- Page 150 and 151:
must verify that the member has sig
- Page 152 and 153:
esults, billing records, and treatm
- Page 154 and 155:
equestor destroy the information, o
- Page 156 and 157:
The member has the right to request
- Page 158 and 159:
Policy on Release of Information Re
- Page 160 and 161:
y the written authorization of the
- Page 162 and 163:
If minor consents to treatment or c
- Page 164 and 165:
Current patients or clients or the
- Page 166 and 167:
If the client has given written aut
- Page 168 and 169:
Confidentiality policies pursuant t
- Page 170 and 171:
“Statement of Confidentiality”
- Page 172 and 173:
Findings will be reported to senior
- Page 174 and 175:
information and by signing this sta
- Page 176 and 177:
Community Care has identified circu
- Page 178 and 179:
NameAddress (es)Zip CodeDiagnosis (
- Page 180 and 181:
Community Care has the right to den
- Page 182 and 183:
Member identifiable information may
- Page 184 and 185:
Community Care extends all reasonab
- Page 186 and 187:
For research purposes.On behavioral
- Page 188 and 189:
See the policy on Transition of Pri
- Page 190 and 191:
Community Care does not collect inf
- Page 192 and 193:
The request must be in writing. Cre
- Page 194 and 195:
All statements to the media includi
- Page 196 and 197:
• The name, or title, and the tel
- Page 198 and 199:
APPENDIX A.4. Significant Member In
- Page 200 and 201:
Orientation and ongoing provider ed
- Page 202 and 203:
CONSENT FOR RELEASE OF INFORMATIONM
- Page 204 and 205:
Authorization for the Release of Dr
- Page 206 and 207:
___________________________________
- Page 208 and 209:
APPENDIX C.1. Priority PopulationsM
- Page 210 and 211:
Second priority is associated with
- Page 212 and 213:
3. Secondary Data - OMHSAS will dev
- Page 214 and 215:
BEHAVIORAL HEALTH MANAGED CARE ORGA
- Page 216 and 217:
APPENDIX E.1. Companion Guide for N