decisionhealth Newsletters, Coder Pink Sheets - 2019 Issue 4 (April)
Compliance: Follow 6 rules when a provider requests patient records
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Article Overview
This article explains the compliance issues that can arise when one provider requests patient records from another provider. It focuses on HIPAA privacy and security expectations, disclosure verification, minimum-necessary considerations, accounting obligations, and the need to watch for other laws that may restrict release of information. It is aimed at practices, compliance staff, and healthcare administrators who handle routine records requests and want to reduce the risk of privacy violations.
Why This Topic Matters
Routine inter-provider record requests can create HIPAA exposure if a practice discloses information without verifying the requester, limiting the disclosure appropriately, protecting the transmission, or considering other applicable laws. The article is relevant for organizations that manage PHI access and disclosure workflows.
Article Sections
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Introduction
Overview of why provider-to-provider record requests are handled differently from requests made by attorneys. Introduces the general compliance framework for disclosing patient information.
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Six steps to follow when another provider requests records
An ordered discussion of the main privacy and security topics involved in responding to a request from another provider. Covers verification, disclosure scope, secure transmission, accounting obligations, other legal restrictions, and fee-related considerations.
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Resources
Lists supporting reference materials and related guidance sources mentioned by the article.
What You Will Learn
- How HIPAA affects requests for patient records from other providers
- What compliance areas should be reviewed before disclosing PHI
- Why other federal or state laws may still apply to a valid request
- What general operational issues can arise in record transmission and handling
Who Should Read This
- Medical practices
- Compliance officers
- Health information management staff
- Healthcare administrators
- Physician offices
- Privacy and security personnel
Code Ranges Discussed
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