Written statement with signature (digital signature not valid) if forms are not available to the patient(s).
Carabelli Dental must do their do diligence to ensure that the person requesting the records is in fact the patient
Ask for ID when signing in office
Send copy of ID if emailing personally
Verifying signature match
Only the person (over 18 years old) whose file is being released may sign the request form unless we have legal documentation/POA on file.
Parents no longer own medical/dental records when their child turns 18 years old.
Spouses cannot sign for each other.
One Form per person
Records request coming from a Law Firm/Insurance Agency/Law Enforcement should go through the Office Manager/Legal Department prior to being sent.
Records must be sent via [email protected] email address and ALWAYS use encryption (Virtue)
Ensure a response is made to the requesting provider office letting them know we have received the request and that we will release records between 1 week but not to exceed 30 days via encrypted email.
Comm Logs must be made when receiving records request, when sending records, and any conversation in regards to records has taken place.
Example 1: “ Received records request via email from (dental office). Office has been notified that we have received the request and that we will review and release records between 1 week to 30 days”
Example 2 “ Dental x-rays taken in the last 5 years have been emailed with encryption to (other dental office) via info email account on (date) by (name of carabelli employee).“
Records Request form is completed by staff and scanned into the patient chart.
