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PAP615

Confidentiality of Member Records


Provider Administrative Policy

Section
Commercial Managed Care
Policy Date
July 2007
Status/Date
Reviewed/May 2008
Provider Type(s)
All Providers  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.

Policy

Confidentiality of Member Records

It is the responsibility of a provider to safeguard all records and confidential information against any alteration or disclosure prohibited by law.

Providers shall maintain records and information in an accurate, thorough and timely manner. Providers shall ensure members receive timely and unrestricted access to their medical records.

When referring to another physician, providers shall give necessary information to the referred physician. This information includes, but is not limited to, clinical summaries, history and physicals and diagnostic work-ups.

When rendering services directed by a primary care physician (PCP) or other physician, a servicing provider shall submit a report of findings or treatments rendered to the referring provider.

Providers shall request and be given information, as necessary to provide care, from other treating providers regarding previous or ongoing care rendered.

Upon receiving a signed records transfer form, a provider shall facilitate the transfer of a member's medical records to the new provider. Transfer all appropriate medical records to a member's new PCP in a timely manner to ensure continuity of care.


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