Alabama Health Information Privacy Complaint Form for filing with HIPAA Privacy Office
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How to fill out Health Information Privacy Complaint Form For Filing With HIPAA Privacy Office?
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FAQ
Your complaint must: Be filed in writing: sent by mail, fax or e-mail. Name the person that is the subject of the complaint and describe the act or acts believed to be in violation of the Patient Safety Act requirement to keep PSWP confidential.
To submit an electronic complaint, go to OCR's Web site at: .hhs.gov/ocr/privacy/hipaa/complaints/index.html. To submit a complaint using alternative methods, see reverse page (page 2 of the complaint form). When do you believe that the violation of health information privacy rights occurred?
Your complaint must: Be filed in writing by mail, fax, e-mail, or via the OCR Complaint Portal. Name the covered entity or business associate involved, and describe the acts or omissions, you believed violated the requirements of the Privacy, Security, or Breach Notification Rules.
If the review identifies a potential HIPAA violation, it will be investigated further. An investigation can result in several outcomes. If no violation is identified, you should receive a communication explaining why. If a minor violation is identified, the organization will likely take steps to rectify it.
If you suspect a violation of your HIPAA privacy rights, you can report it anonymously. You may do so by calling 1-866-633-6472, or filling out this complaint form.
You may file a Security Rule complaint electronically via the OCR Complaint Portal, or using our Health Information Privacy Complaint Package. If you mail or fax the complaint, be sure to send it to the appropriate OCR regional office based on where the alleged violation took place.
If you suspect a violation of your HIPAA privacy rights, you can report it anonymously. You may do so by calling 1-866-633-6472, or filling out this complaint form.
In all cases, serious violations of HIPAA rules including potential criminal violations, willful/widespread neglect of HIPAA Rules, and multiple suspected HIPAA violations should be reported to the Office for Civil Rights directly.
