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  • Phi Amendment Request - Intermountain Healthcare

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PHI Amendment Request I would like to request an amendment to the following patient information: NameDOBCurrent AddressMRNMMICityStateName of Personal Representative requesting amendment (if applicable):Zip.

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Amended Related content

Document 2 - file: exh10-7amendedandrestateds.htm...
This Amended and Restated Services Agreement is entered into effective as of January 23...
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Medical Records & Information Release - University...
Patients can request their records through MyChart. Login to MyChart. Select "Health"...
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Association of American Medical Colleges...
gram and policy decisions that the above broad objectives require." The Institutional...
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Amendments Questions & Answers

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A key part of the HIPAA Privacy Rule is your patients' right to amend their own medical records. This allows them to correct errors and improve the accuracy of their health data. Let's look at an overview of your main responsibilities when a patient asks to amend their protected health information (PHI).

In addition to reporting to the Compliance Hotline at 1.800. 442.4845, medical staff concerns can be reported to Intermountain Physician Relations at 1.801. 442.2840. CAREGIVERS WHO REPORT CONCERNS WILL BE PROTECTED FROM RETALIATION AND INTIMIDATION.

If you have a complaint or grievance about the quality of your care, you, your family member, or surrogate should contact the immediate supervisor of the unit or department, send an email to PatientFeedback@imail.org, or call the Intermountain Patient Advocacy Line at 1 (855) 442-7855 from 9:00 a.m. – 5:00 p.m.

(1) Right to amend. An individual has the right to have a covered entity amend protected health information or a record about the individual in a designated record set for as long as the protected health information is maintained in the designated record set.

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Keywords relevant to PHI Amendment Request - Intermountain Healthcare

  • insurers
  • dob
  • disputed
  • applicable
  • wording
  • Providers
  • amendments
  • amended
  • healthcare
  • designate
  • ut
  • amend
  • REBUTTAL
  • PHI
  • Disadvantage
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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232