Why do I have to attach/fax medical records when I submit a treatment plan to eviti|Connect?
Medical records are required anytime a treatment plan requires additional review by the eviti, Inc. Medical Office. Medical records help with our clinical review and to avoid unnecessary calls to your office or delays in approval by the insurance company. eviti, Inc. only requests the portion of the medical record that is relevant to the treatment plan under review for preauthorization. Without medical records to support the treatment plan, your authorization request will not be reviewed and may be denied by the insurance company for a lack of information.
Do I need a signed release from the patient before sending medical records to eviti, Inc.?
No. Your patient's insurance company has contracted with eviti, Inc. to complete treatment plan reviews for oncology treatment. eviti and the insurance company have a signed Business Associate Agreement [BAA] to comply with 45 C.F.R. Parts 160-164 (the “HIPAA and Privacy and Security Rules”) Regulations. As a “covered entity” under the HIPAA Privacy Rule, the insurance company is required to have a written contract with each of its ‘business associates” in order to disclose “protected health information” (which includes most individually identifiable health information) to the business associate. Under business associate clauses in its contracts, the insurance company obtained assurance that the business associate will appropriately safeguard protected health information and use such information only for authorized purposes for prospective utilization review services. You may request a copy of the signed BAA or contact your patient’s insurance company directly to verify that eviti, Inc. is their vendor for oncology health utilization review.
Are medical records kept confidential?
Yes. All medical records are kept confidential and adhere to eviti, Inc.’s strict Health Insurance
Portability and Accountability Act (HIPAA) and confidentiality policies.