SAMPLE POLICY WORK

confidentiality and data integrity in line with HIPAA and state data protection guidelines.

d. Roles and Responsibilities in Target Population Verification The successful implementation of the target population policy relies on clearly defined roles across multiple departments.

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Intake Staff and Frontline Personnel:

– Primary Responsibilities: Collect preliminary documentation and verify the authenticity of historical records during initial screening. – Documentation: Ensure that all collected records are complete and adhere to the standardized forms and checklists. – Communication: Liaise with applicants and external organizations to obtain missing or additional documentation as required. • Eligibility Specialists: – Primary Responsibilities: Conduct in-depth reviews of submitted records and verify eligibility criteria according to target group definitions. – Documentation: Confirm and record eligibility decisions in the electronic health record system, indicating clear references to the criteria met. – Escalation: Flag any ambiguities or inconsistencies to supervisors for further review and possible corrective action. • Compliance and Regulatory Affairs Team: – Oversight Function: Monitor the entire eligibility process and conduct periodic audits to ensure each case complies with the regulatory guidelines. – Training: Provide ongoing training sessions on eligibility criteria, use of documentation checklists, and updates in regulatory requirements. – Coordination: Collaborate with department heads to resolve discrepancies and update policies as needed based on audit outcomes and feedback.

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Record Management and IT Personnel:

– Primary Responsibilities: Maintain secure, efficient, and accessible digital repositories for all target population documentation. – Data Security: Ensure compliance with HIPAA, state licensing regulations, and internal confidentiality policies during secure data handling and storage. – Update Support: Work with eligibility teams to update profiles and record all approved eligibility determinations reliably.