Privacy Issues in Mental Health and Substance Abuse Treatment: Information Sharing Between Providers and Managed Care Organizations: Final Report. Appendix E: Personal Health Information Requested by MCOs and MBHOs

01/17/2003

 

Patient Health Information Commonly Requested in Outpatient Treatment Request Forms, 
By Type of Response. MCOs Only - 
Total Examined – 4
Requested Information(1) Categorical Narrative Both
Demographic/Administrative Information
Patient’s Name   4  
Patient’s Date of Birth   4  
Patient’s Social Security/Insurance ID number   4  
Practitioner’s Name, Address, Phone   4  
Practitioner’s License and/or ID number   4  
Initial Authorization or Continuing 4    
Length of Treatment/Start and End Dates   2  
Diagnosis
DSM-IV Diagnosis Code 4    
Current Global Assessment of Functioning (GAF) 4    
Highest GAF in past year 3    
Patient History
Previous MH/SA Treatment 2 2 1
History of Substance Abuse   2  
Level of Functioning
Symptoms 1 1 2
Duration and Severity of Symptoms 2 1  
Risk Assessment Suicide/Homicide     2
Current Substance Abuse 1   2
Family/Social Relationships 1 1 1
Job/School Performance 1 1 1
Obsessions/Compulsions 1   1
Treatment Information      
Requested Procedures/Types of Services 3   1
Frequency/Duration of Treatment 2 2  
Expected Treatment Outcomes 1 3  
Member Notified/Concurs with Goals? 2 1  
Medications
Current Medications 1 3  
Dosage/Frequency   3  
Compliance 1 1  
Care Coordination
Communication with PCP 3    
Patient Receiving Other Community Services   3  

 

Patient Health Information Commonly Requested in Outpatient Treatment Request Forms, 
By Type of Response MBHOs Only -
Total Examined – 7
Requested Information(2) Categorical Narrative Both
Demographic/Administrative Information
Patient’s Name   7  
Patient’s Date of Birth   6  
Patient’s Social Security/Insurance ID number   6  
Practitioner’s Name, Address, Phone   7  
Practitioner’s License and/or ID number   6  
Initial Authorization or Continuing 2 1  
Length of Treatment/Start and End Dates   6  
Diagnosis
DSM-IV Diagnosis Code 7    
Current Global Assessment of Functioning (GAF) 6    
Highest GAF in past year 5    
Patient History
Previous MH/SA Treatment   2 1
History of Substance Abuse 2 3 1
Presenting Problems
Symptoms 5 1 1
Duration and Severity of Symptoms 4    
Risk Assessment Suicide/Homicide 5   1
Current Substance Abuse 4 1 1
Family/Social Relationships 3 1 1
Job/School Performance 3 1 1
Obsessions/Compulsions 3   1
Treatment Information
Requested Procedures/Types of Services 5 1 1
Frequency/Duration of Treatment 2 5  
Expected Treatment Outcomes 3 2  
Member Notified/Concurs with Goals? 3    
Medications
Current Medications 1 5  
Dosage/Frequency 1 4  
Compliance 2 2  
Care Coordination
Communication with PCP 3 1  
Patient Receiving Other Community Services 3 2  

(1) Elements were included in table if they were listed in six of the eleven examples studied.
(2) Elements were included in table if they were listed in six of the eleven examples studied.

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