Billing Manual for Community Care Network Providers

When such disclosure to health care personnel, a health care facility, the member’sidentified significant other or the police is required to prevent loss of life or injury tothe member.When authorized by an appropriate and valid court order.When authorized by Community Care’s legal counsel to meet the requirements ofany applicable state or federal law.To report child abuse or neglect.To meet public health reporting requirements.To the Pennsylvania Department of Health, Pennsylvania Department of PublicWelfare and the Pennsylvania Insurance Department for the monitoring of healthcare systems, government programs, and compliance with civil rights laws.To federal officials for intelligence, counterintelligence, or other national securityactivities authorized by law.When required by Protective Services for the President and others.To military command authorities in order to provide medical information about amember serving in the armed forces.When it concerns Workers Compensation.To coroners and medical examiners.Information about inmates of a correctional institution or under the custody of a lawenforcement official may be released to that institution or official.III.C.6b Validity of Authorization to Release Member InformationCommunity Care considers an authorization to release member identifiable informationto be valid only if all of the following are met:The member or member’s legally authorized representative is informed of thespecific information to be released and the purpose(s) of the release in languagewhich he/she can understand.The member or member’s legally authorized representative is informed that theprovision of care or treatment will not be affected by the decision of the member ormember’s legally authorized representative.The authorization is obtained in a manner that complies with applicable laws andregulations.III.C.6c Written and Verbal Authorization for Release of InformationThe authorization to release information should be in writing. However under somecircumstances it may be necessary to obtain authorization verbally. The use of a verbalauthorization should be approved in advance by Community Care’s legal counsel or, ifcircumstances indicate the need for a rapid decision about the acceptability of a verbalauthorization, by a member of Community Care’s senior management. The writtenauthorization must include provision of the following information:The name of the person or entity providing the information.Community Care Provider Manual | 1-888-251-CCBH | © 2012 All Rights Reserved | Page 74