There is a phrase that we repeatedly tell our insureds—“Contact Copic after any major unexpected outcome or incident that could adversely affect a patient’s care.”
We also stress the importance of doing this in a timely manner. Why? Because early reporting is probably one of the most important aspects of protecting our insureds. The sooner we know, the sooner we can activate our resources and expertise in ways that benefit you.
- There is no penalty for early reporting of an incident.
- Promptly notifying Copic of an incident allows us to consider all possible approaches for the best response and resolution.
- Early reporting enables us to capture details while an incident is fresh in everyone’s minds.
- It also allows us to evaluate whether a situation is appropriate for Copic’s 3Rs Program or the Candor process in Colorado, Iowa, Utah, and Minnesota; these programs provide an alternative to traditional litigation that seek to maintain the physician-patient relationship and resolve matters after an adverse outcome.
- Reporting an incident also serves as a trigger to help determine if and how your insurance coverage may apply.
In addition to unexpected outcomes that adversely affect patients, you should report situations where litigation might occur (e.g., threats or a notice of a lawsuit, attorney requests for medical records), disciplinary or professional review actions against an insured, and data breaches and other cyber liability issues.
Here are our general guidelines for reporting an incident to Copic:
1. Ideally, the provider involved should report the incident—we recognize that some systems may have specially trained risk managers to assist in reporting and we can accept a report from these managers on behalf of an insured.
2. Make every effort to report within a reasonable time (usually 24 to 72 hours) after the provider or practice becomes aware of the incident.
3. Report incidents by calling Copic or initiating the process on our website. The best way to report an incident is by using one of these two ways that alerts us of the incident and reduces discoverability of information:
- Call Copic to report an incident at (720) 858-6395. Copic’s business hours are Mon-Fri, 8am–5pm (MT).
- Initiate the reporting process on our website, which will result in a follow-up call by an occurrence nurse specialist. To submit an online incident report, login to the Service Center and select “Incident Reporting.”
4. Have the following information ready: Patient identification including patient's name and date of birth, patient’s insurance information, date of service, where the incident occurred and summary of the incident.
- Please note that you do not need to obtain a patient’s consent—written or otherwise—to share HIPAA Protected Health Information (PHI) with Copic in an incident report.
Information in this article is for general educational purposes and is not intended to establish practice guidelines or provide legal advice.
Article originally published in 3Q24 Advantage Program Insight.
