Form preview

Get the free business associate agreement

Get Form
HIPAA SECONDER BUSINESS ASSOCIATE AGREEMENT THIS LETTER OF AGREEMENT (“Agreement “) is dated, 201 by and between (Broker) and (BrokerNetUSA). BACKGROUND STATEMENTS A. BrokerNetUSA is a Business
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign business associate agreement

Edit
Edit your business associate agreement form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your business associate agreement form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing business associate agreement online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Follow the guidelines below to take advantage of the professional PDF editor:
1
Create an account. Begin by choosing Start Free Trial and, if you are a new user, establish a profile.
2
Simply add a document. Select Add New from your Dashboard and import a file into the system by uploading it from your device or importing it via the cloud, online, or internal mail. Then click Begin editing.
3
Edit business associate agreement. Add and replace text, insert new objects, rearrange pages, add watermarks and page numbers, and more. Click Done when you are finished editing and go to the Documents tab to merge, split, lock or unlock the file.
4
Get your file. Select the name of your file in the docs list and choose your preferred exporting method. You can download it as a PDF, save it in another format, send it by email, or transfer it to the cloud.
It's easier to work with documents with pdfFiller than you can have believed. Sign up for a free account to view.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out business associate agreement

Illustration

How to fill out a business associate agreement:

01
Obtain a copy of the business associate agreement (BAA) template: It is recommended to start by getting a standard BAA template from a reputable source, such as the U.S. Department of Health and Human Services' website. This template will serve as a starting point for your agreement.
02
Review the BAA thoroughly: Carefully read through the entire BAA to understand its terms and requirements. Familiarize yourself with the definitions, obligations, and responsibilities outlined in the agreement.
03
Customize the agreement: Tailor the BAA to your specific business needs. Insert your company's name and the name of the covered entity (if applicable) in the appropriate sections. Customize any other sections that pertain to your particular circumstances.
04
Identify parties and responsibilities: Clearly identify all parties involved in the agreement, including your organization as the business associate and the covered entity. Make sure to outline the roles and responsibilities of each party to ensure understanding and accountability.
05
Define permitted uses and disclosures: Specify what information can be used and disclosed by the business associate, as well as any limitations or restrictions. This section should align with the requirements outlined in the Health Insurance Portability and Accountability Act (HIPAA) and other applicable laws and regulations.
06
Address safeguards and security measures: Include provisions that outline the necessary safeguards and security measures to protect the privacy and security of protected health information (PHI). This may involve technical, administrative, and physical safeguards, as required by HIPAA.
07
Describe incident reporting and breach notification procedures: Clearly define the procedures for reporting any security incidents or breaches involving PHI. Detail the timeframe and method for reporting these incidents, as well as the responsibilities of both parties in the event of a breach.
08
Specify termination provisions: Include provisions that outline the conditions under which the agreement can be terminated by either party. This may involve providing a notice period and specifying the responsibilities for returning or destroying PHI upon termination.

Who needs a business associate agreement:

01
Healthcare providers: Hospitals, clinics, physicians, dentists, and other healthcare providers who engage third-party vendors or contractors to perform services that involve the use or disclosure of PHI.
02
Health insurance companies: Insurance companies and health plans that subcontract certain functions or services to external entities that require access to PHI.
03
Business associates: Any individual or organization that performs certain functions or activities on behalf of a covered entity and involves the use or disclosure of PHI. This includes services like claims processing, data analysis, legal services, or IT support.
04
Covered entities: Covered entities, such as healthcare providers or health insurance plans, are also responsible for ensuring that a business associate agreement is in place with any third-party vendor or contractor that handles PHI on their behalf.
In summary, filling out a business associate agreement involves obtaining a template, customizing it to fit your specific needs, clearly defining roles and responsibilities, addressing safeguards and security measures, and outlining incident reporting and termination provisions. Business associate agreements are required for various healthcare providers, health insurance companies, business associates, and covered entities to protect the privacy and security of PHI.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.0
Satisfied
32 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

You can quickly make and fill out legal forms with the help of the pdfFiller app on your phone. Complete and sign business associate agreement and other documents on your mobile device using the application. If you want to learn more about how the PDF editor works, go to pdfFiller.com.
Use the pdfFiller app for iOS to make, edit, and share business associate agreement from your phone. Apple's store will have it up and running in no time. It's possible to get a free trial and choose a subscription plan that fits your needs.
On an Android device, use the pdfFiller mobile app to finish your business associate agreement. The program allows you to execute all necessary document management operations, such as adding, editing, and removing text, signing, annotating, and more. You only need a smartphone and an internet connection.
A business associate agreement is a contract between a covered entity and a business associate that outlines the terms of how protected health information will be handled.
Covered entities and their business associates are required to have a business associate agreement in place.
Business associate agreements can be filled out by detailing the responsibilities of the business associate in protecting and using protected health information.
The purpose of a business associate agreement is to ensure that protected health information is safeguarded and used appropriately by business associates.
Business associate agreements should include details on how protected health information will be used, disclosed, and safeguarded.
Fill out your business associate agreement online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.