Enrollee Records Clause Samples
The Enrollee Records clause establishes the requirements for maintaining, storing, and providing access to records related to individuals enrolled in a program or service. Typically, this clause outlines what types of records must be kept, such as enrollment forms, attendance logs, or performance data, and specifies how long these records should be retained and who may access them. Its core practical function is to ensure that accurate and complete documentation is available for compliance, auditing, or dispute resolution purposes, thereby promoting transparency and accountability.
Enrollee Records. DVHA and its IGA partners shall guard the confidentiality and privacy of individually identifiable health information contained in enrollee records in a manner consistent with 45 CFR parts 160 and 164 (Health Insurance Portability and Accountability Act) to the extent that these requirements are applicable. Specific requirements include the following: policies and procedures for protecting enrollee information; procedures for authorizing access to enrollee information; physical security procedures; and information system security procedures. Enrollee records must include all recipient information required for utilization review as specified in 42 CFR 456.
Enrollee Records. A. The contractor is responsible for a complete long-term care record for each enrollee.
B. The contractor must use procedures that promote the development of a centralized, comprehensive long-term care record for enrollees. The contractor must ensure, with written consent of the enrollee or their representative, all providers involved in the enrollee's care have access to the enrollee's record for the purpose of providing care.
C. The contractor must maintain an enrollee records system, which is consistent with professional standards and permits the prompt retrieval of information. Each record must include timely and accurately documented information and must be readily available to all appropriate and authorized practitioners involved in the integration and coordination of care.
D. The contractor will ensure all subcontracted long term care providers-properly document the care provided to enrollees.
E. The contractor will ensure enrollee record information is accessible only to authorized persons in accordance with written consent or an executed authorization granted by the enrollee or the enrollee's representative and with all applicable federal and state laws, rules and regulations.
F. The contractor must disclose enrollee records, including enrollee and caregiver identifying information, to the department and Agency. It is the department and Agency's obligation to oversee the performance or to conduct assessment, investigation, or evaluation of this contract. Not withstanding provisions to the contrary, release of material to the department and Agency will not be construed as public disclosure of confidential information.
G. All records must contain documentation that the member was provided written information concerning the member's rights regarding advanced directives, and whether or not the member has executed an advance directive. The contractor shall not, as a condition of treatment, require the member to execute or waive an advance directive in accordance with Section 765.110, F.S. The contractor must comply with the requirements of 42 CFR 422.128 for maintaining written policies and procedures for advance directives.
Enrollee Records. DVHA and its member departments shall guard the confidentiality and privacy of individually identifiable health information contained in enrollee records in a manner consistent with 45 CFR parts 160 and 164 (Health Insurance Portability and Accountability Act) to the extent that these requirements are applicable. Specific requirements include the following: policies and procedures for protecting enrollee information; procedures for authorizing access to enrollee information; physical security procedures; and information system security procedures.” Enrollee records must include all recipient information required for utilization review as specified in 42 CFR 456.
Enrollee Records. A. The contractor is responsible for assuring that there is a complete long-term care record for each enrollee.
B. The contractor must use procedures that promote the development of a centralized, comprehensive medical and long-term care record for enrollees. The contractor must ensure, with written consent of the enrollee, all providers involved in the enrollees care have access to the enrollee's record for the purpose of providing care. C. The contractor must maintain an enrollee records system which is consistent with professional standards and which permits the prompt retrieval of information. Each record must include timely information accurately documented and must be readily available to all appropriate and authorized practitioners involved in the integration and coordination of care.
Enrollee Records. The OVHA shall ensure (and require its subcontracted Departments to ensure) that each enrollee served under the Global Commitment to Health Waiver has a comprehensive medical record. The OVHA and its subcontracted Departments shall ensure compliance with all State and Federal legal requirements as they pertain to medical records and in particular, to confidentiality of records. At a minimum, all medical records shall: • Be maintained in a manner that is current, detailed, and organized such that it permits effective patient care and quality review as documented in the Minimum Standards and Clinical Care Audit; • Include sufficient information to identify the patient, date of encounter and pertinent information which documents the type and frequency of services provided; • Include an annual review of treatment and service plan determinations (as appropriate and applicable); and • Describe the enrollee’s diagnosis and appropriateness of the treatments/services, the course and results of the treatment/services, and shall illustrate how the provider facilitates continuity and coordination of care as evidenced by:
Enrollee Records. Physician shall maintain the usual and customary records, in accordance with all applicable federal and state statutory and regulatory requirements, for each enrollee in the same manner as for other patients of Physician. Each enrollee's medical record shall be opened upon the enrollee's first visit to Physician, and all enrollees' medical records shall be completed in a timely fashion, be legible, and fully document billed services.