Get INFORMATION RELEASE AUTHORIZATION - Nd

There are several common reasons for the release of information, including medical treatment purposes, medical billing, insurance billing, health studies, legal proceedings, and marketing purposes. Sometimes a third party — like an insurance company or an attorney — needs to request your medical information.

A Privacy Rule Authorization is an individual's signed permission to allow a covered entity to use or disclose the individual's protected health information (PHI) that is described in the Authorization for the purpose(s) and to the recipient(s) stated in the Authorization.

A statement from the individual who is the subject of the records saying: “I declare, certify, verify or state that, under penalty of perjury under the laws of the United States of America, the foregoing is true and correct.” This statement should be signed by the individual who the records are about, and be dated ...

A: “Consent” is a general term under the Privacy Rule, but “authorization” has much more specific requirements. The Privacy Rule permits, but does not require, a CE to obtain patient “consent” for uses and disclosures of PHI for treatment, payment, and healthcare operations.

By setting up a Release Authorization (ARI), you are giving customer service your permission to disclose information about your accounts to another person. Typically, this is used to give account access to a spouse or other family member.