Beneficiary and ACO Program Records. The Parties shall prepare, maintain, and protect the confidentiality, security, accuracy, completeness and integrity of all appropriate medical and other records related to the provision of care to ACO Program Beneficiaries (including, but not limited to, medical, encounter, quality, financial, accounting, administrative and billing records) in accordance with: (i) applicable state and federal laws and regulations including, but not limited to, applicable confidentiality requirements of HIPAA; and (ii) ACO Program billing, reimbursement, and administrative requirements. For Participants and Preferred Providers, such records shall include such documentation as may be necessary to monitor and evaluate the quality of care and to conduct medical or other health care evaluations and audits to determine, on a concurrent or retrospective basis, the medical necessity and appropriateness of care provided.
Appears in 4 contracts
Samples: Risk Bearing Participant & Preferred Provider Agreement, Onecare Provider Agreement, Risk Bearing Participant & Preferred Provider Agreement
