HIPAA T/F
Behavioral Health Associates are required to verify the identity and authority of all individuals receiving PHI
TRUE
What is minimally needed to verify HIPAA for an adult member on an outbound call?
When does a written ROI expire?
What information are CM's limited to sharing with providers?
SUD information
Is it ok to ask for a member who has a Google phone or robo call system?
Yes, but do not disclose any PHI. As for the member by their first name and state your name and the client friendly name.
False
What is minimally necessary to verify HIPAA for an adult member on an inbound call>
Confirmation of the member's first and last name and 2 additional identifiers.
Where is the best place for an associate to check to see if there is an ROI on file?
CIRS
Which providers can a CM call for engagement?
Any provider as long as the member has an established relationship with the provider and has seen them in the last 90 days or a provider that is listed on their discharge plan, or ONN providers that the member gives consent to call.
What information can you leave on an identified member voicemail that cannot be left on an unidentified voicemail or with a non-member?
The purpose of the call.
False
What is minimally necessary for HIPAA verification of a minor member on an outbound call?
Verification of parents first and last name, verification of the member's first and last name and 2 identifiers.
It is ok to speak with a representative if my co-worker has added them to the member representative tile?
False, CIRS should be checked first.
Which disclaimers do associates have to give to providers?
Call recording disclaimer.
What client information can be shared when completing a provider search?
No PHI can be shared.
SPP associates to share program information with the parents/guardians of minors in all states after HIPAA has been verified
True
What is minimally necessary for HIPAA verification of a minor member on an inbound call?
Verification of the parent/guardian's first and last name, verification of the member's first and last name, 2 additional identifiers.
When can associates share information with a step-parent or grandparent?
When there is an ROI on file or if the step-parent or grandparent is the policyholder.
What information is needed on an outbound call to a provider for HIPAA verification?
Ensure that the correct office has been reached, obtain the name of the person you are speaking with.
What client information can an associate leave on a provider's voicemail if the provider has a confidential voicemail and their name is stated?
An associate can share minimally necessary member information including the member's name, date of birth, and a brief reason for the call without mentioning a specific condition or treatment.
The auditor has to complete the e-form for all confirmed or suspected HIPAA violations.
False
What is needed to discuss SUD information with a third party?
Written ROI
When does a verbal ROI expire?
When revoked by the member or after the issue has been resolved.
What information is needed for HIPAA verification from an inbound call from a provider?
Verification of the provider's first and last name, address and phone number of provider and the name of the practice. Providers must also provide the member's first and last name and 2 identifiers.
What information can an associate leave on a provider's voicemail when there is no confidentiality disclaimer or the provider's name is not stated on the mailbox?
Associates can leave their names, title (do not include program name), health plan name, return phone number and hours of availability.