( 4 ) An awareness of the issues surrounding reimbursement and insurance fraud .
2 . The Member should consult with the ethics committee as soon as reasonably practicable . The Chief of Staff and CMO / VPMA will oversee this process .
3 . The Chief of Staff and CMO / VPMA may review the case at the conclusion of the treatment episode to assure that appropriate technical and professional standards have been met .
RULE 4-1
Occurrence Reports
An occurrence report regarding a Member , APP , or other practitioner , including a resident , will be forwarded from the quality department to the peer review coordinator to initiate the Peer Review Process . Resident concerns will be forwarded to the appropriate Program Director or their designee . The resident care concerns may also be reviewed by peer review in regards to the sufficiency of oversight provided by the responsible Member .
RULE 4-2 A .
B .
C .
Confidentiality of Medical Staff Records
Applicability . As provided in the Medical Staff Bylaws , all records maintained by or on behalf of the Medical Staff , including the records and minutes of all meetings of Medical Staff committees , Departments , Sections and the credentials and peer review files for Members , APPs , and other practitioners , shall remain confidential and privileged to the extent allowed by law .
Location of Records . All Medical Staff records shall be maintained by Medical Staff Services . Additional quality improvement records are secured in Quality Services , Utilization Management , Trauma Services and Emergency Services . These records will be kept in locked file cabinets or in a secure electronic format under the direction of the Department head of these areas .
Access to Records . All requests under this section for Medical Staff records shall be made to the Medical Staff Services Director , who shall allow access to the records as provided in this Rule . Unless otherwise stated , a person permitted access under this Rule shall be given a reasonable opportunity to inspect the records and make notes , but may not remove or make copies of records . Those individuals may only review information they provided , filled out on our behalf or they were a part of the committee / department at the time of the information they wish to review .
1 . Access for Official Hospital or Medical Staff Functions . Medical Staff officers , Department and Section Chiefs , Members of the Board of Governors , the Medical Staff Services staff , the CEO , and the CMO / VPMA shall have access to Medical Staff records to the extent necessary to perform official functions as follows :
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