Arkansas Authorization for Use and / or Disclosure of Protected Health Information

State:
Multi-State
Control #:
US-178EM
Format:
Word; 
Rich Text
Instant download

Description

This form allows an employee to authorize the types of medical information to be disclosed by human resources.
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FAQ

"Minimum Necessary" means, when protected health information is used, disclosed, or requested, reasonable efforts must be taken to determine how much information will be sufficient to serve the intended purpose.

An authorization must specify a number of elements, including a description of the protected health information to be used and disclosed, the person authorized to make the use or disclosure, the person to whom the covered entity may make the disclosure, an expiration date, and, in some cases, the purpose for which the

A covered entity must obtain the individual's written authorization for any use or disclosure of protected health information that is not for treatment, payment or health care operations or otherwise permitted or required by the Privacy Rule.

Marketing Activities: A covered entity must obtain an individual's authorization prior to using or disclosing PHI for marketing activities. Marketing is considered any message or statement to the public in an effort to get them to use or seek more information about a product or service.

Under the HIPAA Privacy Rule, a covered entity must disclose protected health information in only two situations: (a) to individuals (or their personal representatives) specifically when they request access to, or an accounting of disclosures of, their protected health information; and (b) to the Department of Health

A HIPAA authorization is a detailed document in which specific uses and disclosures of protected health are explained in full. By signing the authorization, an individual is giving consent to have their health information used or disclosed for the reasons stated on the authorization.

A patient authorization is not required for disclosure of PHI between Covered Entities if the disclosure is needed for purposes of treatment or payment or for healthcare operations. You may disclose the PHI as long as you receive a request in writing.

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Arkansas Authorization for Use and / or Disclosure of Protected Health Information