Policy Manual sample

MDT Home Health Care Agency, Inc. 1. The consent must be in writing on an Agency approved release of information form, following HIPAA guidelines. 2. The patient's/client’s consent must be voluntary and informed. 3. The written consent must be signed and dated by the patient/client or guardian and must be current. 4. Any patient/client consent for release of medical records to another must set forth "with specificity" the Agency directed to make the disclosure, the name of the patient/client, the extent or nature of the information to be disclosed, statement of the purpose for which the information is being released, a specific expiration date for the consent and a statement that the consent is subject to revocation at any time (or that the consent expires at a given time and when).A copy of the consent must be kept with the patient's/client’s records. 5. When a decision to release a record has been made, the patient's/client’s record will be reviewed by the Administrator prior to its release. 6. The person authorized to receive the information may be charged a reasonable fee for its provision. 7. Persons allowed access to the patient's/client’s medical record shall not make secondary or additional disclosure to others. Physician Access to the Record Care is provided under the direction of a physician, therefore, it is the Agency's policy to allow the attending physician access to the clinical record. If the patient/client refuses to release necessary information to his/her physician, the Agency will not accept the patient/client for care. When a physician other than the attending physician requests access to the record, a release of information will be obtained from the patient/client. Attorney Access to the Record Requests to release information to attorneys must be made in writing to the Administrator. A signed, dated release of information must be obtained from the patient/client. A charge may be made for any copies of the record given to the attorney. The Administrator may contact legal counsel for a legal opinion and advice regarding these requests. Third Party Payor Access to the Record The Agency will exercise caution in the release of information to patient’s/client insurers. The following guidelines will apply: 1. A completed signed patient/client consent for release of records will be presented by the requesting party. 2. Any disclosure of patient/client records will be noted on the patient's/ client’s permanent record along with a notation of what information or records were disclosed and the date of the disclosure. A copy of the written request for the information release will then be attached to the patient's/client’s permanent record. No secondary or additional disclosure will be made to others. Home Health Agency Policies A-107