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Exhibit I BUSINESS ASSOCIATE AGREEMENT This Addendum (Addendum) is effective as of, 2002 (Effective Date) by and between (Lawyer) and (Covered Entity) (individually a Party and collectively the Parties).

How to fill out exhibit i business associate

1. Begin by reviewing the instructions provided for filling out Exhibit I Business Associate. Make sure you understand the purpose and requirements of this document.
2. Gather all the necessary information and documents you will need to complete Exhibit I. This may include information about your business, contact details, services provided, and any relevant agreements or contracts.
3. Start by filling in the header section of Exhibit I. Enter the name and contact information of your business, including your legal entity name, address, and phone number.
4. Proceed to the next section, which typically asks for detailed information about the business associate. Fill in the necessary details about the individual or entity you are designating as your business associate. This may include their legal name, address, contact information, and any other relevant details specified in the form.
5. Depending on the specific exhibit, you may need to provide additional information about the nature of your relationship with the business associate. For example, you might need to specify the services they are providing to your organization, the date the agreement was executed, and the duration of the association.
6. Review the completed Exhibit I for accuracy and completeness. Ensure that all required fields are filled in and that the information provided is consistent with any supporting documents or agreements.
7. If required, sign and date the exhibit as per the instructions provided. Keep a copy for your records and submit it as per the specified submission process or requirements.
8. The Exhibit I Business Associate is typically needed by businesses or organizations that have a relationship with another individual or entity acting as a business associate. This may include but is not limited to healthcare providers, vendors, consultants, or contractors who handle protected health information (PHI) or have access to other sensitive business information.
9. The purpose of Exhibit I is often to establish a written agreement between the parties involved to ensure compliance with applicable laws and regulations, specifically in relation to privacy and security of information. It helps delineate the responsibilities and obligations of both the covered entity (your organization) and the business associate.
10. By completing Exhibit I accurately and thoroughly, you can ensure that your organization is meeting its legal obligations and safeguarding sensitive information. It is important to consult legal or compliance professionals if you have any questions or uncertainties about how to fill out Exhibit I properly.

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What is exhibit i business associate?

Exhibit I is a form that lists the business associates of a covered entity under the Health Insurance Portability and Accountability Act (HIPAA). A business associate is an organization or individual that performs certain functions or activities that involve the use or disclosure of protected health information on behalf of a covered entity.

Who is required to file exhibit i business associate?

Covered entities, such as healthcare providers, health plans, and healthcare clearinghouses, are required to file exhibit I to identify their business associates as per the HIPAA regulations.

How to fill out exhibit i business associate?

To fill out exhibit I, a covered entity needs to list the name, address, and contact information of each business associate in a structured format. The details of the specific functions or activities performed by each business associate should also be included.

What is the purpose of exhibit i business associate?

The purpose of exhibit I is to create a record of the business associates working with a covered entity, ensuring compliance with HIPAA regulations. It helps in managing and maintaining the privacy and security of protected health information shared with business associates.

What information must be reported on exhibit i business associate?

Exhibit I should include the name, address, and contact information of each business associate, along with a description of the functions or activities performed by them that involve the use or disclosure of protected health information.