Dental Business Associate Agreement Tracking

Tracks business associate agreements with dental labs, imaging centers, and software vendors that handle PHI.

Agreement Overview

• Vendor / Business Associate Name
  Legal or commonly used name of the vendor, lab, imaging center, or software provider.
• Vendor Type
• PHI Access Scope
  Select all that apply based on how the vendor creates, receives, maintains, or transmits PHI.
• Agreement Status
• Internal Owner
  Department or role responsible for managing the agreement record.

Contract Dates and Renewal

• Effective Date
• Expiration Date
• Renewal Type
• Renewal Notice Period (Days)
  Number of days before expiration when notice should be sent.
• Next Compliance Review Date

Documentation and Safeguards

• Executed BAA Document
  Upload the signed agreement or a secure link to the stored document.
• Document Storage Location
  Link to the approved repository where the agreement is stored.
• Required Safeguards Confirmed
  Select the safeguards verified for this vendor relationship.
• Does the vendor use subcontractors that may access PHI?

Compliance Review and Audit Trail

• Compliance Risk Rating
• Exceptions or Gaps
  Describe any missing terms, expired coverage, or unresolved compliance issues.
• Follow-Up Action
• Review Notes
  Add concise notes for the audit trail. Do not include unnecessary PII.