Internal Transfer of Records: Guidelines between PCP Offices Paper Chart Office to Paper Chart Office Transfer of Patients from Primary Care Office to Primary Care Office. Internal Transfer: Patient has requested to transfer care to an Advantage Health or Saint Mary’s PCP Office. Paper Chart Office to Paper Chart Office (Part One) Sending AH/SM office Receiving AH/SM Office Paper Chart Paper Chart Patient to complete Authorization to Release Medical Information form when requesting transfer from their current Primary Care Provider’s office to another Primary Care Provider’s office. NOTE: If patient is making a verbal request staff can complete the Authorization to Release Medical Information form and note "per patient request via phone call 11-4-2011". Staff should initial this statement and begin the transfer process so as not to hold up care/treatment. Staff receives request (Authorization to Release Medical Information form) indicating transfer to another PCP office. Staff verifies the patient is actively seeking treatment elsewhere by contacting the receiving office. Staff communicates timeframe when Staff receives call from sending AH/SM office verifying the patient has the receiving office should expect the medical information. requested transfer. Staff writes name of receiving provider and date of patient’s appointment at Staff informs sending office of receiving provider and date of patient's the receiving office at the top of the release form. appointment. The release form and the patient’s chart are given to the Primary Care Provider. Provider writes an order indicating he/she approves the transfer of the patient’s medical records. Provider to contact receiving PCP as needed. If any portion of the patient’s record is in storage, sending staff write Kent If any portion of the patient’s record is in storage, receiving office will Records box number on the release form. request record from storage if needed. Paper Chart Office to Paper Chart Office (Part Two) Sending AH/SM office Receiving AH/SM Office Paper Chart Paper Chart NOTE: If the entire patient record is in storage because the patient has not been in years, sending office needs to alert receiving office. Both If the entire patient record is in storage sending office will notify. Both offices will decide who will request record from storage to be offices will decide who will request record from storage to be delivered directly to receiving office. delivered directly to receiving office. Staff document on physician’s order the date original record is being sent to receiving AH/SM office. Sending office should fax release form to Quality/Sue Viviano to process change of PCP. The original medical record is placed in a plain envelope marked ‘confidential’ and the name of the receiving AH/SM office. (Do not write “medical records” on the envelope.) Send the chart in the prepared envelope to the receiving AH/SM office with the release form paper-clipped to the outside – front flap of chart folder. Create an Alert in NexGen (EPM) in the patient's chart under the clinical history/notes. "Patient transferred from Caledonia to NW office - chart sent." Be sure to set the expiration date for 60 days. Receiving AH/SM office documents on physician’s order date chart was received. Staff files Authorization to Release Medical Information form within the paper chart.
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