Form and Manner of Request for Internals Appeals

(1) The RBPO or ACO shall adopt a process to accept appeals by telephone, in person, by mail, or by electronic means, provided that an oral appeal made by the Patient or the Patient’s Authorized Representative shall be reduced to writing by the RBPO or ACO and a copy forwarded to the Patient or the Patient’s Authorized Representative. (2) Where an appeal requires review of a Patient’s medical records such appeal shall include, if necessary, a form signed by the Patient or the Patient’s Authorized Representative authorizing the release of medical and treatment information relevant to the appeal.