MEDICAL RECORDS PROTOCOL

This Medical Records Protocol has been adopted to satisfy the requirements of Arizona law, including A.R.S. § 12-2291, et seq. and A.R.S. § 32-3211, the regulations of the Arizona State Board of Chiropractic Examiners (the “Board”) and the Health Insurance Portability and Accountability Act (“HIPAA”). For purposes of this Protocol, the patient’s medical record includes diagnostic quality x-rays and any other imaging studies performed by this Practice.

Confidentiality.

 1.1             This Practice considers all medical records and payment records, and the information contained in medical records and payment records, as privileged and confidential. This Practice will only disclose that part or all of a patient’s medical  records and payments records as are authorized by state or federal law or by a written authorization signed by the patient or the patient’s health care decision maker.

Release of Medical Records.

2.1             This Practice shall disclose medical records or payment records, or the information contained in medical records or payment records, without the patient’s written authorization if required by law or when ordered by a court or tribunal of competent jurisdiction.

2.2             This Practice shall disclose medical records or payment records, or the information contained in medical records or payment records, pursuant to written authorization signed by the patient or the patient’s health care decision maker.

2.3             This Practice may disclose medical records or payment records, or the information contained in medical records or payment records, without the written authorization of the patient or the patient’s health care decision maker under the following circumstances:

To health care providers who are currently providing health care to the patient for the purpose of diagnosis or treatment of the patient;

To health care providers who have previously provided treatment to the patient, to the extent that the records pertain to the provided treatment; 
To ambulance attendants for the purpose of providing care to or transferring the patient whose records are requested; 
To a private agency that accredits health care providers and with whom this Practice has an agreement requiring the agency to protect the confidentiality of patient information; 
To the Board;
To health care providers for the purpose of conducting utilization review, peer review and quality assurance pursuant to state law; 
To a person or entity that provides billing, claims management, medical data processing, utilization review or other administrative services to the patient’s health care providers and with whom this Practice has an agreement requiring the person or entity to protect the confidentiality of patient information; 
To this Practice’s legal representatives for the purpose of obtaining legal advise; To the patient’s third party payor or such payor’s contractor; and 
To the Industrial Commission of Arizona or parties to an Industrial Commission claim pursuant to state law.

2.4  This Practice may disclose a deceased patient’s medical records or payment records, or the information contained in medical records or payment records, to the patient’s health care decision maker at the time of the patient’s death or to the personal representative or administrator of the estate of the deceased patient. Additionally, in the event the deceased patient did not have a health care decision maker, personal representative or administrator appointed, this Practice shall disclose a deceased patient’s medical records or payment records to the following persons in the following order of priority, unless the deceased patient during the deceased patient’s lifetime advised this Practice in writing that the deceased patient opposed the release of the medical records or payments records: 

The deceased patient’s spouse, unless the patient and the patient’s spouse were legally separated at the time of the patient’s death; 

The acting trustee of a trust created by the deceased patient if the trust was a revocable inter vivos trust during the deceased patient’s lifetime and the deceased patient was a beneficiary of the trust during the deceased patient’s lifetime; 
An adult child of the deceased patient; 
A parent of the deceased patient; 
An adult brother or sister of the deceased patient; or 
A guardian or conservator of the deceased patient at the time of the deceased patient’s death. 

2.5 This Practice shall disclose medical records or payment records, or the information contained in medical records or payment records, pursuant to a properly issued and served Subpoena in accordance with applicable state or federal law, including A.R.S. § 12-2294.01.

2.6 This Practice shall provide copies of the medical and payment records in the possession of this Practice to the persons described in Sections 2.1 thru 2.4 above within ten (10) business days of this Practice’s receipt of a written request for such records that is signed by the person authorized by such Section to receive copies of the records.

2.7  In the event this Practice receives original x-rays or other imaging studies from another health care provider, this Practice shall return the original x-rays or imaging studies to the health care provider from which they were obtained within ten (10) business days of a written request to do so. 

Charges for Medical Records. 

3.1             Except as otherwise provided below or by applicable law, this Practice may charge a person who requests copies of medical records or ayment records a reasonable fee for the production of such records. 

3.2             This Practice does not charge for the pertinent information contained in medical records provided to the following: To another health care provider for the purpose of providing continuing care to the patient to whom th medical records pertain; 

To the patient to whom the medical record pertains for the demonstrative purpose of obtaining health care;

To the health care decision maker of the patient to whom the medical record pertains for the demonstrative purpose of obtaining health care for the patient; or

To the Board.

Storage and Retention of Medical Records.

4.1 This Practice shall maintain all of our patients’ medical records and payment records in a safe and secure location designed to preserve the confidentiality of such medical and payment records. If and to the extent this Practice stores any medical or payment records of inactive patients at a location other than the office of this Practice, this Practice shall insure that the person or organization storing such records shall commit to maintain the confidentiality of such records.

4.2 This Practice shall retain the original or copies of all of our patients’ medical records and payment records as follows:

  1. If the patient was an adult when last treated, for at least six (6) years after the last date the adult patient received medical or health care services from this Practice. 
  2. If the patient is a child, either for at least six (6) years after the child’s 18th birthday or for at least six (6) years after the last date the child received medical or health care services from this Practice, whichever date occurs later. 

4.3  If the chiropractor who owns this Practice terminates or sells this Practice under circumstances where the patient’s medical records and payment records will not remain in the same physical location, this Practice shall take the following steps in order to insure our patients have access to their records: 

  1. At least thirty (30) days prior to terminating or selling this Practice’s practice, this Practice shall notify the Board and all of this Practice’s “Active Patients” that this Practice is being terminated or sold, which notice shall advise the Board and such patients of the name, address and telephone number of the person or organization to contact in order to access the patients’ records. For purposes of this Section 4.3.a, an “Active Patient” is a patient previously seen in the Practice whose medical records have not previously been disposed of in the manner described in Section 5 below. 
  2. This Practice shall make arrangements to insure that this Practice’s patients’ medical records and payment records are retained, and that patients have access to such records, following the termination or sale of this Practice for at least the periods described in paragraph 4.2 above.
In the event this Practice is sold to a third party, this Practice will make arrangements with the buyer of this Practice that the buyer will maintain, retain and provide access to such records in a manner consistent with this Protocol or, if the buyer does not agree to maintain, retain and provide access to such records, then this Practice shall do so in the manner described above.

Disposal of Medical Records.

5.1  Prior to disposing of any medical records or payment records, this Practice shall send a written notice to the patient, advising the patient of this Practice’s intent to dispose of such records. The notice shall be addressed to the patient’s last known address, and sent out at least thirty (30) days prior to disposing of such records. If such records have not been claimed within such time period, such records shall be disposed of in a manner that will insure the confidentiality of such records, such as shredding or burning such records.

5.2  In the event this Practice or the chiropractor who owns this Practice receives a request for records from a patient or the patient’s appropriate representative following the patient being notified of this Practice’s intent to dispose of the records, the original of such records shall be sent to the patient or the patient’s medicalrepresentative  within  ten  (10) business  days  of  the request for the records.                                                                                          

In such event, this Practice shall not maintain a copy of such records.

602-932-8113.