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Elm croft Of Dills burg 153 Logan Road Dills burg, PA 17019 ×P) (717× 5021000 ×F) (717× 5021005 REQUEST FOR AN ACCOUNTING OF DISCLOSURES OF PROTECTED HEALTH INFORMATION You have the right to request
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Begin by gathering all necessary personal information, including your full name, date of birth, and contact details.
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Provide accurate and up-to-date medical history, including any pre-existing conditions, allergies, surgeries, and current medications.
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Be prepared to disclose your social security number, insurance information, and any other relevant identification numbers.
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Answer all questions thoroughly and honestly, ensuring that the information provided is complete and accurate.
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Follow any specific instructions or requirements provided by the healthcare provider or organization requesting the protected health information.

Who needs protected health information made?

01
Healthcare providers: Doctors, nurses, and other medical professionals require protected health information in order to provide appropriate care, make accurate diagnoses, and determine appropriate treatment plans.
02
Insurance companies: Insurers may request protected health information to verify coverage, process claims, and assess medical necessity for certain treatments or procedures.
03
Researchers and public health agencies: Protected health information can be used for medical research, public health studies, and statistical analysis to improve healthcare practices and outcomes.
04
Legal entities: In some cases, protected health information may be required in legal proceedings, such as personal injury claims or court cases related to medical malpractice.
It is essential to handle and share protected health information with utmost care and in accordance with applicable privacy laws and regulations, such as the Health Insurance Portability and Accountability Act (HIPAA) in the United States.
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Protected health information (PHI) is any information in a medical record or electronic health record (EHR) that can be used to identify an individual and that was created, used, or disclosed in the course of providing a healthcare service, such as a diagnosis or treatment.
Covered entities, including healthcare providers, health plans, and healthcare clearinghouses, are required to file protected health information.
Protected health information is typically filled out using standardized forms and formats provided by the Health Insurance Portability and Accountability Act (HIPAA).
The purpose of protected health information is to ensure the privacy and security of individuals' medical information while allowing for the efficient exchange of healthcare data.
Protected health information must include demographic information, medical history, insurance information, and any other information that can be used to identify an individual.
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