Confidentiality
The policy of AllMed Healthcare Management Inc., is the strict maintenance of confidentiality to ensure protection of rights and privacy of all persons whose medical records, health benefits information, and plan documents are provided to AllMed Healthcare Management, Inc. for the purpose of external review.
The business of AllMed Healthcare Management, Inc. is the completion of timely, accurate, standardized reviews of confidential medical records, resulting in the statement of opinions of medical necessity, pre-existing determinations, disability determinations, cosmetic surgery review and other types of claims. In order to process the reviews, information is handled by a number of persons employed by or contracted with AllMed, all of whom acknowledge the inherent right of each patient's privacy. All staff members and contracted professionals are to hold such material in the strictest possible confidence.
All medical and healthcare information provided to AllMed is for the purpose of conducting the review. This information may be contained in AllMed's computer system, paper files, or file storage location. This information shall not be disclosed or discussed outside of AllMed's review program. It shall be kept confidential in accordance with applicable federal and state laws and regulations.
Only the client information needed for completion of the review may be requested.
Only AllMed review personnel and those staff members participating in the review process, such as Specialty Panel members and office personnel, shall have access to the records.
Only the client's designated case manager, nurse manager, or authorized person, the client's legal department, or any other person designated by the client shall receive the review and any supporting material from AllMed.
AllMed's Confidentiality Policy and Confidentiality Agreement may be provided to clients and any other specifically authorized entity. All employees of AllMed are required to sign the Confidentiality Agreement as a condition of employment.
Patient-specific information is defined as any and all demographic information and any medical/diagnostic information accompanying demographic information.
Provider-specific information is defined as any information regarding the performance of providers of care by name and professional practice title.