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Request to Amend Protected Health Information (PHI)Use this form to request an amendment to your PHI in the Designated Record Set(s) that Blue Cross and Blue Shield of Texas or its Business Associates

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What is designated record set access amendment?

Designated record set access amendment refers to the process by which individuals can request changes or corrections to their health information contained in a designated record set, which includes medical records and billing records.

Who is required to file designated record set access amendment?

Individuals, such as patients or authorized representatives, are required to file a designated record set access amendment when they believe that their medical records contain inaccurate or incomplete information.

How to fill out designated record set access amendment?

To fill out a designated record set access amendment, individuals typically need to complete a request form that specifies the information to be amended, provide a detailed explanation of why the amendment is necessary, and submit it to the healthcare provider or organization maintaining the record.

What is the purpose of designated record set access amendment?

The purpose of designated record set access amendment is to ensure the accuracy and completeness of individuals' health information, allowing them to correct any errors that may affect their treatment or care.

What information must be reported on designated record set access amendment?

The information that must be reported includes the specific details of the record that needs to be amended, the proposed changes, the reason for the amendment, and identification information of the individual requesting the change.

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