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DocuSign Envelope ID: BE23A079025D4F32853E079FA8D525F9Great Rivers Behavioral Health Administrative Services Organization Policy Title:Breach Notification Protected Health Information Process and
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How to fill out designated record set and

01
Request a copy of the designated record set from the healthcare provider or health plan.
02
Review the designated record set to ensure it contains all the required medical records and information.
03
Fill out any necessary forms or paperwork provided by the healthcare provider or health plan.
04
Make sure to provide any additional information requested to complete the designated record set.
05
Submit the completed designated record set back to the healthcare provider or health plan.

Who needs designated record set and?

01
Patients who want to access and review their own medical records.
02
Healthcare providers who need to share medical records with other healthcare professionals.
03
Health plans or insurance companies who require access to medical records for claims processing.
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A designated record set is a group of records maintained by a healthcare provider that includes medical records and billing records about a patient, as well as other records used to make decisions about the patient’s care.
Healthcare providers, health plans, and healthcare clearinghouses that maintain a designated record set are required to file it.
To fill out a designated record set, the healthcare provider must gather all relevant patient-related documents including medical records, billing statements, and other relevant information, and ensure they are complete and accurate before submission.
The purpose of a designated record set is to provide patients with access to their health information and to ensure that records are available for review and correction if necessary.
Information that must be reported includes demographic details, medical histories, records of past visits, treatment plans, and any other information related to the patient’s healthcare.
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