§ 7–1202.07. Limited disclosure to 3rd-party payors.
(a) A mental health professional or mental health facility may disclose to a 3rd-party payor mental health information necessary to determine the client’s entitlement to, or the amount of, payment benefits for professional services rendered; provided, that the disclosure is pursuant to a valid authorization, or for participating providers, a joint consent, and that the information to be disclosed is limited to:
(1) Administrative information;
(2) Diagnostic information;
(3) The status of the client (voluntary or involuntary);
(4) The reason for admission or continuing treatment; and
(5) A prognosis limited to the estimated time during which treatment might continue.
(b) In the event the 3rd-party payor questions the client’s entitlement to or the amount of payment benefits following disclosure under subsection (a) of this section, the 3rd-party payor may, pursuant to a valid authorization, or for participating providers, a joint consent, request an independent review of the client’s record of mental health information by a mental health professional or professionals. Mental health information disclosed for the purpose of review shall not be disclosed to the 3rd-party payor.