760 IAC 1-49-8 Confidentiality

Sec. 8. (a) A medical claims review agent shall preserve the confidentiality of individual medical records to the extent required by state and federal laws. (b) To assure confidentiality, a medical claims review agent must, when contacting a health care provider's office or hospital, provide its certification number and the caller's name to the provider's named claim review agent representative in the health care provider's office. (c) Medical records and patient-specific information shall be maintained by the medical claims review agent in a secure area with access limited to medical claims review personnel only. (d) Information generated and obtained by the medical claims review agent or employer of the medical claims review agent in the course of medical claims review shall be retained for at least two (2) years if the information relates to a case for which an adverse decision was made at any point or if the information relates to a case that may be reopened.