Member Record Clause Samples
The Member Record clause establishes the requirement for maintaining accurate and up-to-date records of each member within an organization or association. Typically, this clause outlines what information must be recorded, such as names, contact details, membership status, and any changes to these details over time. By specifying the process and responsibility for updating member information, the clause ensures that the organization can effectively communicate with its members and comply with legal or regulatory obligations. Its core function is to provide a clear framework for record-keeping, thereby reducing administrative errors and supporting organizational transparency.
Member Record. The MCO shall develop and maintain a complete member record as specified in Article XIII.A.10., Contents of Member Records, for each person enrolled. A complete and accurate account of all care management activities shall be documented by IDT staff and included in the member’s record. The MCO shall document all billable case management activities within a case note within the timeframe(s) defined in a MCO policy approved by DHS.
Member Record. The PO shall develop and maintain a complete member record as specified in Article XIII.A.9, Contents of Member Records for each member enrolled. A complete and accurate account of all care management activities shall be documented by IDT staff and included in the member’s record. The PO shall document all billable case management activities within a case note within the timeframe(s) defined in a PO policy approved by DHS.
Member Record. The IHCP shall develop and maintain a complete member record in accordance with MCO policy and procedures as specified in Article XII.A.8, Contents of Member Records, for each member. A complete and accurate account of all care management activities shall be documented by IDT staff and included in the member’s record. The IHCP shall document all billable case management activities within a case note within the timeframe(s) defined in a MCO policy approved by DHS.
Member Record. The IHCP shall develop and maintain a complete member record in accordance with Department approved policy and procedures as specified in Article XII.A.8, Contents of Member Records, for each member. A complete and accurate account of all care management activities shall be documented by IDT staff and included in the member’s record. The IHCP shall document all billable case management activities within a case note within the timeframe(s) defined in a MCO policy approved by DHS. Member Safety and Risk The IHCP shall follow the MCO’s DHS-approved policies and procedures regarding member safety and risk. IHCP staff and other appropriate individuals shall be informed of these policies on an ongoing basis. The purpose of these policies and procedures is to balance member needs for safety, protection, good physical health and freedom from accidents, with over-all quality of life and individual choice and freedom. These policies and procedures shall identify: How IDT staff will assess and respond to risk factors affecting members’ health and safety; Guidelines for use by IDT staff in balancing member rights with member safety through a process of ongoing negotiation and joint problem solving; Criteria for use by IDT staff to identify risk, including vulnerable/high risk members as defined in Article IV, section H. Training for all IDT staff in identifying risk and coordinating care; Guidelines, trainings, and tools to assist IDT staff in identifying and mitigating risk with all members and/or their legal decision maker; Training and guidance for all IDT staff that identified concerns and risks that require mitigation but a member chooses not to prioritize is reviewed with the member at least every three months, and documented in the members record as identified in the MCP; Protocols for use by IDT staff to identify, implement and document appropriate, individualized monitoring and safeguards to address and mitigate potential concerns and assure the health and safety of members including those identified as vulnerable/high risk as defined in Article IV, section H. At a minimum these protocols must include:
Member Record. The PO shall develop and maintain a complete member record as specified in
Member Record. Medical Group and Medical Group Providers shall establish and maintain an accurate medical record, for each Member with whom Medical Group Providers have an encounter that, at a minimum, shall include such information about the Member and a description of all services rendered to the Member as dictated by generally accepted medical and surgical practices and standards and as required by the Provider Manual (“Medical Record”). Medical Group Provider shall maintain accurate financial books and records, including electronic records, concerning Covered Services provided to each Member, including any charges to and payments received from the Member by Medical Group (“Financial Record”). Medical Group shall maintain the Medical Records and Financial Records for a period of at least ten (10) years after the records cease to be active records. The obligations of Medical Group to maintain and provide access to records under this Part