Member-initiated corrections and amendments to their records

Providers are required to respond to a member request for correction or amendment of medical records in a manner that complies with the state laws, federal laws, or both.

A member has the right to request a correction or amendment of their health care information for as long as that health information is maintained in the medical record. The request must be in writing. The provider may either accept or deny the correction or amendment, but you must respond to the request within 10 business days of receipt.

If you accept the correction or amendment:

  1. Make the appropriate correction or amendment to the record.
  2. Inform the member that the amendment is accepted.
  3. Review prior disclosures from the patient’s chart to determine if the information in question has been previously released. If, yes, the corrected information must be re-disclosed to the previous recipient.

If you deny the request:

The member has the right to file, as part of the medical record, a concise statement and explanation for the requested correction or amendment.

The challenged entry must be marked to indicate that the member has challenged it as inaccurate or incomplete, and the challenged entry must indicate where in the record the statement of disagreement is located.

Erasure or deletion from the record is contrary to the intent of statutes, regulations, and standards governing health care information and to the generally accepted practice within the health care community.

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