HNS Policy

  1. Records Retention
    Complete patient health care records (including billing and payment information, such as EOBs) shall be maintained for a minimum of 10 years from last date of service OR, if the patient is a minor, for 10 years after the minor patient reaches age 19. Once the patient reaches 19 and is still under care, the provider should retain the patient health care record for 10 years from the last date of service.


  2. Confidentiality of Health Care Records
    Providers have legislative, professional and ethical obligations to protect patient confidentiality and the information included in the clinical record. It is essential that the confidentiality of that information be safeguarded and shared only as necessary to protect the interests of the patient.


    Providers will:

    1. Ensure the privacy and security of the patient's health care information in a manner consistent with the state and federal laws.

    2. Develop and implement practices that protect confidentiality of information and data.

    3. Ensure that health care records are stored and archived in a secure environment.

    4. Ensure that those accessing (or seeking to access) health care records have the authority to access it.

    5. Unless otherwise required by law, ensure that patient-specific health information is only released to:

    1. The individual to whom the information relates;

    2. HNS or health care plan contracted with HNS to perform health care delivery, payment, administration and/or management functions on their behalf;

    3. A third party only if specific authorization is obtained from the individual to whom the information relates;

    4. Except as otherwise provided by law, providers will make member's patient-specific health information available to the member for inspection or copying.


  3. Back-up/Recovery
    If electronic records are utilized, there shall be appropriate back-up and recovery procedures in place. Recovery procedures should be tested at least annually to assure recovery is possible within a reasonable period of time.


  4. Records Availability
    Clinical records shall be organized and stored in a manner that allows for immediate access and easy retrieval.


    Clinical records shall be stored in a secure manner that allows access only by authorized personnel.


  5. Requests for Records
    Copies of clinical records and associated financial records for patients whose insurance plan contracts with HNS may be requested at any time by a patient, by HNS or a HNS contracted payor and/or by regulatory bodies.


    Requests for copies of records will be clearly documented in the health care record and will include the date of the request and the name of the person or entity requesting the records, as well as the date the copies were released.


    Providers should never release original records; only copies of the records should be released. If the patient's authorization is required to release records, the clinical record will include a copy of the patient's signed and dated authorization to release, and the name of the person/entity to which the records were released.


    When clinical records are requested, providers will promptly respond to such requests. Abbreviation key (or legend) should be produced when providing copies of health care records.


    Providers may not charge for providing health care records for patients whose health care plan contracts with HNS.


  6. Requests from Contracted Payors or Regulatory Agencies
    Network providers must promptly comply with requests for health care records from HNS contracted payors and/or regulatory bodies (such as state licensing boards and/or Departments of Insurance).


    If a due date is provided in the requests, records must be received by the stated due date. If a due date is not provided, records should be submitted within 10 days of receipt of request.


  7. Requests from HNS
    As a business associate of all contracted health care professionals, HNS is authorized to have access to, and review, health care records relevant to services and programs HNS provides.


    Network providers are required to submit copies of health care records if requested by HNS and providers will promptly comply with such requests. All requests from HNS for patient health care records will include a due date and records must be submitted to HNS by the due date stated.


  8. Requests from Patients
    Network providers are required to provide copies of health care records if requested by the patient and providers will promptly comply with such requests. Network providers will provide patient with copies of the health care record within 10 days of receipt of request from patient.