wellcare authorization to release protected health information

Get the free wellcare authorization to release protected health information

Signature of Member or Personal Representative if applicable Date Please return the signed WellCare HIPAA Release of Information Form to the sign it. WELLCARE HIPAA RELEASE OF INFORMATION FORM This form is used to confirm a Member s permission that the Health Plan may discuss or disclose Protected Health Information PHI to a particular person who acts as the Member s Personal Representative. Section E Signature/Authorization I have had full opportunity to read and consider the content of...
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HIPAA stands for Health InsurancePortability and Accountability a HIPPO release and authorization allows an individual to authorize healthcare providers to release protected health information to third parties under the privacy rules in the Federal HealthInsurance Portability and Accountability Act of 1996 health care providers generally are not allowed to disclose protected health information to anyone other than the patient or the patient's agent without authorization HIPAAprotects an individual's past present or future physical or mental health condition the provision of health care to an individual the payment of expenses relating to the individual's past present or future healthcare an authorization must specify several things including in some cases the purpose for which the information may be used or disclosed a description of the protected health information to be used and disclosed the person authorized to make the use or disclosure the person to whom the covered entity may make the disclosure an expiration date or an expiration event that relates to the patient or the reason for the disclosure of the information the authorization remains valid until that time or until it is revoked authorization can be revoked at any time a HIPAA release and authorization form only allows the name agent or agents to access and receive the patient's medical records the agents not authorized to act on the patient's behalf with respect to medical decisions the Privacy Rule does not prohibit doctors nurses laboratory techs or other healthcare providers from the medical records of the patient if the information needs to be shared for the health of the patient there is no requirement that a release and authorization form be notarized more information for HIPAA authorization can be found on the US Department of Health and Human Services' website WWF HHS govt
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