Transcription
Information Blocking/”Open Notes”1.2.3.4.5.6.I use Therapy Appointment (EMR) but TA submits claims using Office Ally (EHR?) What does this mean for my notes?How does the apply to releasing records to agencies such as disability insurance provider , insurance companies like BCBS?Does the open notes rule apply to companies such as BetterHelp or Talkspace. Especially if they don't provide you adiagnosis?What's appropriate when a client's insurance company requests either verbal or written information from a client'srecord?I work at an instiution that uses point and click which is an EHR. In order to "upgrade" to the open notes functionality, weneed to get a bid, request funds, and pay for this. Are we obligated to do this?Are evaluations to determine child custody considered civil process/ and notes allowed to be withheld. I'm not doing theevaluation, but was asked to write a summary of treatment (Parent with a young child in dyadic therapy) . So my questionis can this summary, for these purposes be withheld. (The non-custodial parent is asking for it.)
Psychotherapy notes /Paper Records1.2.3.4.if you just write down what client said, is it count as psychotherapy notes?Is there a recommendation regarding what to do about keeping more detailed notes about the session to prompt theproviders memory but would be too detailed or not appropriate to put into medical record since psychotherapy notes do notseem like a good way to do that?Does this suggest that clinicians will no longer be able to release a summary instead of actual notes?For mental health training programs (counseling, psychology), how do supervision notes compare to psychotherapy notes?Would supervision notes be considered the same as psychotherapy notes, with regard to the exception?
Release of Records:1.2.3.4.Under informed consent for client's rights, would it be OK to have a form to check RELEASE to (Dr x Dr Y, etc.)followed by Yes No checkboxes? Clients change doctors and might not want either old or new providers tohave access to their records.In the context of a neuropsych eval, would the outside records reviewed and then stored be considered as partof my corporation's records and need to be accessible to patient and released upon request?Can't clients themselves deny some providers to be able to access their records? I have learned that BCBS inmy state incentivizes medical practices to send their EHR Medical records to a central databank (3rd partvendor) who makes all medical records available to any treating physician. I found this out on a providerbulletin. I never was asked for consent as a patient. That doesnt seem OK. Similarly, there shoud be arequirement that patients must OPT IN for any sharing between providers, not merely Opt OUT -- IF theyhappen to discover it is being shared without their knowledge and permission. Honestly I think this wholeeffort is for benefit of technology vendors more than patients/clients. Comments?Are you saying records will be automatically shared/accessible to other providers without patient/clientrequest/consent? Or are records only shared/accessible when the patient/client initiates the request?
Exceptions to Release1.2.3.Could “physical harm” include potential exacerbation of somatic symptoms and/or chronic health conditions inresponse to psychological distress?Eric referred to an exception to access when services are provided within some kind of civil or criminalactivity/action/practice, can you give some example document types?In the event of working with children where parents have access to therapy records, are there any caveats you couldshare when a child discloses information about the parent that would clearly cause harm/distress to the child if it isdisclosed to the parent?
Records Use after Release/Redisclosure:1.2.how does the part 2 prohibition on redisclosure affect patients accessing records you get from anotherprovider?Once we share our notes, how are they protected? It occurs to me that a client or therapy notes recipient couldmodify or excerpt our notes that could result in problems or abuse of records?
Special Cases:1.When a client commits suicide what rights of access. would spouse have to the progress notes? What would theyneed to give therapist legally? Is it okay for therapist to talk with family members without a legal documentrequesting it?
Electronic vs. PaperRecords:1.2.3.4.Does stored electronically also refer to typed paper notes or only refer to EHR or Practice Management?Are records in the form of word processor documents (taken from practice management software) consideredelectronic records?Can Eric and/or Roy say more about their choice to maintain paper records? Thanks in advance.If you are just jotting stuff down during telehealth session, things that do not include tx plan, dx etc, is it ok toshred after session rather than keep as psychotherapy notes?
Couples/Family Members1.2.Do I have to give access to one member of a couple or family member when the notes include data on theother family members?If parents/caregivers are seeing some notes and not others, this will immediately lead to suspicion aroundwhat and why something is being withheld and potentially lead to undue pressure by caregiver on patient todisclose or authorize disclosure to parent. How do you think these competing demands can be managed?
State Specific1.Hope this Q w/i scope of this topic: Any changes or new considerations when CPS (WA State) requestsinformation pursuant to an open investigation? i.e. RCW 26.44.030
Charging for Recordsprocessing:1.If I sign off FMLA document that client requested, can I charge them for me to finish that? Thank you
Rob’s Section:1.2.3.4.5.6.7.Also I missed what Rob was referring to regarding merit based reimbursement. What is that under?Does this apply to those of us who don't accept insurance at all, let alone Medicare?where would you go to check the status of my state for HIE?Patients should be able to OPT IN for HIE engagement of their practitioners. I live in a small town and purposelydo all medical care in a large city far away so my medical infor is never seen by my patients who are medicalproviders. As a patient I am not happy that my informed consent was not required for this. We still should be ableto release provider by provider as we want unless unconscious in life-threatening situation. Certainly thepersonally sensitive info of Beh Health should not be included in this mandate. Small towns and companies arepeople who do not need any sort of medical GPS on others. Doesnt anyone see this danger? I have client stories ofsensitive info in hands of people they'd never want to have it. What to do?If you have paper records now and switch to a practice management are you saying that we would need tosomehow digitize the old records?I work with child welfare clients who's case manager is insistent on all aspects of their treatment. I so not want torelease all of my clients information to them as it seems that they are looking for reasons to terminate thirparental rights. What can you suggest that they receive? All of it?Does the client need to provide specific consent for disclosure for another "professional" that is part of the HIE orEHR system for that other "professional" to see their behavioral health records?
Save 100 off Risk Analysisand Risk Mitigation ServiceUse Coupon Code:HAPPYPCTGet RA/RM 3 months Group PracticeOffice Hours (or Office Hours)Valid for the first 10 folks who redeem
1. I use Therapy Appointment (EMR) but TA submits claims using Office Ally (EHR?) What does this mean for my notes? 2. How does the apply to releasing records to agencies such as disability insurance provider , insurance companies like BCBS? 3. Does the open notes
