Member-initiated corrections and amendments to their records

Providers are required to respond to members' requests 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 in writing a correction or amendment of their health care information for as long as that health information is maintained in the medical record. You may either grant or deny the correction or amendment, but you must respond to the request within 10 business days of receipt.

If you grant the correction or amendment:

  1. Make the appropriate amendment to the health information or record.
  2. Inform the member that the amendment is accepted, and obtain the member's identification of and agreement to have you notify any relevant persons with whom the amendment needs to be shared.
  3. Make reasonable efforts to inform persons identified by the member as having received subject health information.

If you refuse such a 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.

You must mark the challenged entry to indicate that the member has challenged it as inaccurate or incomplete.

You must indicate at the challenged entry 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 community.

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