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Reasons to Deny a Request To Release Records

Great River Pediatric Clinic maintains the right to deny the patient or their legally qualified representative access to their protected health information in the following situations:

  1. The information may be detrimental to the physical or mental health of the patient. A notation is made in the medical record explaining what information was withheld and why.
  2. The information is likely to cause the patient to harm himself/herself or another.
  3. There is reasonable doubt to the identity of the person presenting the authorization.
  4. There is evidence that the party requesting the information is not identical to the party named in the authorization.
  5. There is evidence that the patient is not of legal age (18) to sign.
  6. If the parent or legal guardian is requesting information on a minor who meets the following criteria (emancipated minor):
    • The minor is living separate and apart from his/her parents or legal guardian, and managing his/her financial affairs; or
    • Married or
    • Has borne a child; or
    • Receiving services to determine the presence of or to treat pregnancy and conditions associated with pregnancy, family planning, venereal disease, or alcohol and drug abuse.
  7. The requested information is legally not available to the patient or their legally appointed representative, ex. Psychotherapy notes, information from internal peer review.

PROCEDURE:

Releasing Information
  1. The patient can complete a Patient Authorization to release/Receive Medical Information form (Attachment A). The “TO” section should indicate the institution or person they want the records sent to. Great River Pediatric Clinic will honor completed Patient Authorizations from other institutions/persons as long as they are valid.
  2. We must verify that the Patient Authorization is valid, complete, signed and dated within the maximum of one year.
  3. Reasonable charges are assessed based on guidelines established by the state of Arkansas.
  4. When the request has been fulfilled, file the authorization in the patient’s chart with the following information: date processed, name of the person processing request and how the information was transmitted or mailed.
  5. Deliver the requested information to the requesting party via: direct pickup from the front desk, US Mail, priority mail, courier or fax, whichever method is requested or determined to be suitable. If the records are being picked up from the front desk, acceptable identification must be shown.
Receiving Records From Outside Great River Pediatric Clinic
  1. Requests can be received daily via mail, in person or by fax
  2. The Medical Records Clerk will record receipt of the records in the database.
  3. Upon receipt of the chart, the records will be attached and forwarded to the practitioner for review.
  4. The practitioner will review and determine which records are pertinent to the current records and then return to them to the business office to be scanned.
  5. An employee authorized to scan will file the records into the patient’s chart.
Revocation of An Authorization

A patient may revoke their written authorization at any time by:

  1. Notifying Great River Pediatric Clinic Medical Records in writing of their request.
  2. The revocations will be documented and filed in the patient medical record.
  3. A record of revocation and other release of information activity is maintained on an ROI form in the medical record.
  4. Great River Pediatric Clinic will honor this request as long as we have not already taken action on the previous authorization.
Right to Confidential Communications

Patients have the right to request that we provide their PHI to them in a confidential manner. For example, they may request that we send their PHI by an alternate means or to an alternate address or phone number. We will accommodate any reasonable requests, unless they are administratively too burdensome, or prohibited by law.