smorgan@hne.com<\/a>.<\/p>\nThank you for your cooperation and for your efforts to provide excellent care to your patients.<\/p>\n
Sincerely,
\nStephne Morgan, CPC, CPMA, CRC
\nRisk Adjustment Supervisor<\/p>\n
Confidentiality<\/strong>
\nHealth New England has entered a BAA<\/em> with Change Healthcare, in accordance with the privacy regulation of HIPAA<\/em>. This agreement allows this vendor to perform activities involving the use or disclosure of individually identifiable health information on behalf of Health New England. In addition, it only permits this vendor to use the information as permitted under the agreement. The regulations promulgated under HIPAA<\/em> are the federal rules that govern the privacy of an enrollee\u2019s protected health information (PHI) and establish requirements for the use and disclosure of PHI by physicians\/health care professionals and health plans in connection with their health care operations\u2019 activities. HIPAA<\/em> allows a covered entity to disclose PHI to another covered entity for the health care operations of the entity receiving the information, without an enrollee’s authorization or consent, under certain circumstances.<\/p>\nUnder this provision, you are permitted to disclose PHI to this vendor as a Health New England business associate when requested for purposes such as:<\/p>\n
\n- Quality assessment.<\/li>\n
- Disease management, case management and care coordination.<\/li>\n
- Evaluating health plan performance.<\/li>\n
- Accreditation, certification, licensing, and credentialing activities.<\/li>\n<\/ul>\n
<\/p>\n
In adopting this regulation under HIPAA<\/em>, the Department of Health and Human Services (DHHS) explicitly recognized in the preamble to the HIPAA<\/em> privacy regulations that health plans may need to obtain PHI from physicians and other health care professionals for the plans\u2019 quality-related activities, accreditation, and performance measures. The Department of Health and Human Services confirmed that the provision was intended to allow information to flow from one covered entity to another for activities important to providing quality and effective health care.<\/p>\nA signed consent form from the member is not required under the HIPAA<\/em> privacy rule for you to release the requested information to Health New England or to Change Healthcare, who is acting on our behalf.<\/p>\n","protected":false},"excerpt":{"rendered":"Health New England has initiated a program to better serve our members \u2014 your patients \u2014 with a process that more accurately reports their health status and clinical risk profile. As part of our annual risk adjustment process, we will be conducting reviews of our members\u2019 medical records. This review ensures that all ICD-10 codes […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[92],"tags":[165,166],"class_list":["post-7968","post","type-post","status-publish","format-standard","hentry","category-provider-newsletter","tag-medical-record-retrieval-program","tag-risk-adjustment"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-24w","_links":{"self":[{"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/7968","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=7968"}],"version-history":[{"count":5,"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/7968\/revisions"}],"predecessor-version":[{"id":7974,"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/7968\/revisions\/7974"}],"wp:attachment":[{"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=7968"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=7968"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=7968"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}