The importance of PRD forms for complex patients and staying updated on changes

Personal representative designation (PRD) forms are critical to the care process for patients and providers alike. Not only do PRDs support accurate, efficient, and compliant patient care—they also streamline administrative processes.

These forms can be critical for complex patients, such as those who have multiple chronic conditions, developmental or intellectual disabilities, high medical or behavioral health needs, or frequent hospitalizations or care transitions, including minors.  Staying updated on changes to them is important for giving patients and their parents/guardians the best possible experience.

• Beginning at age 13, parents/guardians may not be able to discuss certain aspects of their child’s health information or answer provider questions unless there is a PRD form on file.
• If a child is 18 years old or older, a PRD form is necessary for parents/guardians to discuss any information.
• If a PRD form was completed prior to age 18, a new form must be completed after the child’s 18th birthday.

What can happen without a PRD on file
Parents or guardians may not always consider PRD forms as their children get older. Not having a completed PRD on file can create challenges for pediatric caregivers. For instance, without a completed PRD form on file, a parent or guardian cannot file a grievance for a service that has been delayed or denied.

What providers can do
Health care providers can assist parents/guardians in completing the necessary PRD form to facilitate health-related information, general health care, and the member’s coverage. As a provider, you can find the PRD form under the Medical Prior Authorization and Physician Forms section at upmchealthplan.com/providers/medical.

What parents can do
Parents/guardians are encouraged to create an account for their child on the UPMC Health Plan member site to access health-related information and find care, resources, and commonly used forms.