This form is used to inform the plaintiff's medical provider that an attorney has been retained by plaintiff and that plaintiff authorizes the release to attorney of all of his or her medical records.
Alaska Authorization for Medical Information
State:
Multi-State
Control #:
US-PI-0244
Format:
Word;
Rich Text
Instant download
Description
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FAQ
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 HIPAA authorization is consent obtained from an individual that permits a covered entity or business associate to use or disclose that individual's protected health information to someone else for a purpose that would otherwise not be permitted by the HIPAA Privacy Rule.
Prior Authorization is required and issued for Alaska Medical Assistance recipients by the following authorizing entities based on service category: Recipients: Many health care services require prior authorization.
As the primary purpose of a medical record authorization is to protect the patient's privacy and you against any litigation, any medical record that you accept or have your patient sign must contain the necessary parts that can hold up in court.
A description of the information that will be used/disclosed. The purpose for which the information will be disclosed. The name of the person or entity to whom the information will be disclosed.
Mandatory disclosure of information Under the CMIA, medical information must be released when compelled: by court order. by a board, commission or administrative agency for purposes of adjudication. by a party to a legal action before a court, arbitration, or administrative agency, by subpoena or discovery request.
The proper release of medical records always requires authorization to protect the patient's privacy and to help keep you from being liable.
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.