Confidentiality, Privacy and Security

Telephone consent

  • 1.  Telephone consent

    Posted 03-25-2020 15:16
    Hi,

    We are working on a social distancing plan to provide services.  Does anyone have any resources or recommendations for capturing consent over the phone?

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    Ta-Tanisha Ingram, MSM, RHIA, CHPS
    Medical Records Administrator/District Privacy Officer
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  • 2.  RE: Telephone consent

    Posted 03-26-2020 07:19
    Hi all.

    At our facility, we have already put into place the process of telephone consents.  This is the process we have.  Like everything else, things change on a moments notice so this could also change.  However, this is what we have in place at this time.  I would love to see what others have as well.

    Contacting the Client or Guardian to Conduct and Intake Via Phone:

    1. Contact the client or guardian for whom the service is for and who will be responsible for authorizing the service.
      1. If it is a guardian, we will need a copy of the guardianship paperwork sent back to us along with the signed consent forms.
    2. When beginning the phone conversation, make sure you are getting some kind of verification you are talking to the client (ask them for the last four of their SSN or ask for their DOB). 
      1. If it is the guardian, ask them for the client's last four of the SSN or DOB not their own.
    3. In discussion with the client or guardian, confirm the plan for service delivery via telephone or telehealth due to COVID-19.
      1. Make sure that the service you are providing can be provided via telephone or telehealth before proceeding this way.
    4. Secure verbal consent for treatment.  Once obtained, you can write on the signature line of your Notification of Rights Consent to Treat that you have that you verified it was the client or guardian on the phone and that you obtained a verbal consent to treat on XX/XX/XXXX at X time.  Write your name.  This document will go in the record.  The signed Notification of Rights Consent to Treat that comes in the mail from the client or guardian will be filed as well but this verbal consent will cover us until that time. 
      1. This is only for consents.  We cannot do this for ROIs.
    5. Other intake documents you will need to do this for would minimally include:
      1. Assignment of Benefits
      2. Client Agreement
    6. Inform the client or guardian that they will receive an opening paperwork packet in the mail that we would ask them to please sign and return to us.
    7. Document this conversation and the fact that you obtained verbal consent to treat in the session note.

     

    Sending the Intake Packet Information to the Client:

    1. Administrative staff will send out the opening paperwork packet to the client and will place sign here tabs in all of the places that the client needs to sign.
      1. Clinical staff assigned to the client for this service should work with the administrative staff to determine what releases should be included in the initial packet. Releases must be signed by the client.
    2. A return stamped envelope will be placed in the packet so that the client or guardian will be able to just place the documents in the envelope and send them back to us.
    3. Once we receive the packet back, those documents will need to go into the record.

    Obviously, this would vary between facilities but this is what we are working with currently.  I hope this is somewhat helpful and could service as a starting point.

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    Elizabeth Sheridan
    Manager of Health Information Management
    Privacy Officer
    Community Health and Counseling Services
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  • 3.  RE: Telephone consent

    Posted 03-26-2020 08:56
    Tried sharing what I created.  But I am not able to upload the file. I can send it to you via email if you would like.

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    Stacey Goodenough
    Manager of Medical Records / Privacy Officer
    Wayne Memorial Hospital
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  • 4.  RE: Telephone consent

    Posted 03-27-2020 11:02
    Edited by Kathryn Wood 03-27-2020 11:31
      |   view attached

    Good morning,
    Stacey shared her script with me and I modified her script to fit our outpatient clinic reception process. I worked with the reception leaders and then I tried to make it look nice and not as boring. Stacey used italic script to indicate the words to the patient and I really liked that idea.

    I should also note that we have canned text for each provider to use in their templates. We feel that this clearly identifies the type of visit, both to the coder and for future reference. They are listed below:

    The patient was made aware that there are limitations due to this visit is being performed using the telephone. The benefits include efficient medical evaluation and management by allowing the patient to stay in their home or remote site.  The risks/limitations of a telephone visit include but are not limited to the lack of physical exam and possible technology failure. The patient verbalized understanding and provided consent to continue with the visit.

    The patient was made aware that this visit is being performed using virtual visit technology, and that this communication method may not be HIPAA Compliant. The benefits include efficient medical evaluation and management by allowing the patient to stay in their home or remote site.  The risks/limitations of a virtual visit include but are not limited to the lack of physical exam and possible technology failure. The patient verbalized understanding and provided consent to continue with the visit.


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    Kathryn Wood, RHIA
    Assist Dir of Information Systems/Privacy Officer
    War Memorial Hospital
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