Every health facility shall provide to the primary attending health care practitioner a copy of the complete itemized charges for services rendered to the specified patient, upon request.
The primary attending health care practitioner shall obtain prior written consent from each patient for whom a billing is requested, authorizing the release of the patient's billing.
Providers of health services that receive payment under the Maddy Emergency Medical Services (EMS) Fund program must keep records of the services they rendered, the patient, the date, and any additional information required by the administering agency for a period of three years from the date the of service. The administering agency must not require any additional information from a physician providing emergency medical services that is not found in the patient record.
Physicians and surgeons are eligible to receive payment for patient care services provided by a properly credentialed nurse practitioner or physician's assistant for care rendered under the direct supervision of a physician and surgeon who is present and available for immediate consultation. Payment is limited to claims that are substantiated by a medical record and that have been reviewed and countersigned by the supervising physician and surgeon.
The administrative director must adopt rules and regulations to ensure health care providers and facilities submit medical bills on standardized forms, require employers to accept electronic claims for payment of medical services, and ensure the confidentiality of medical information submitted on electronic claims for medical services payment. To the extent possible such regulations should be consistent with HIPAA.
The department may examine any of the books and records of applicants, providers, or person or entity providing goods or services and seeking reimbursement, to the extent necessary to carry out the listed provisions and regulations. Applicants, providers or others receiving or seeking reimbursement through the Medi-Cal program or other health care program must provide copies of records upon request by the department. The information provided shall only be used to investigate Medi-Cal fraud or abuse.
Physician reimbursement claims must be accompanied by a list of patient names. The agency administering the claim must give the list of names full confidentiality protections.
Authorizes the disclosure of medical information to specified persons involved with patient's care or health care payments; Such disclosure generally requires the person's agreement, or if agreement is not practical, limited disclosure may occur as specified.
Health care providers and local health departments may disclose to each other certain types of health information (listed 1 to 9) for the purpose of immunization and payment for such services.
State DHS and local health departments may disclose to each other certain types of health information (listed 1 to 9) for the purpose of immunization and payment for such services.
