Medical Record Guidelines
In this chapter, you will find policies on how to maintain member medical records, including medical record standards and contractual requirements regarding retention and disclosure of information.
Glossary terms found on this page:
A legal agreement between an individual member or an employer group and a health plan that describes the benefits and limitations of the coverage.
Acronym for Medicare Advantage. An alternative to the traditional Medicare program in which private plans run by health insurance companies provide health care benefits that eligible beneficiaries would otherwise receive directly from the Medicare program.
An individual and each of his or her eligible dependents, including Medicare beneficiaries who are enrolled or participate in a benefit program and who are entitled to receive covered services from the practitioner pursuant to such benefit program and the terms of the practitioner's agreement.