Delaware 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.

Delaware Authorization for Use and / or Disclosure of Protected Health Information is a legal document that grants permission for the sharing or utilization of an individual's protected health information (PHI) in the state of Delaware. PHI includes any individually identifiable information related to an individual's past, present, or future physical or mental health, healthcare services, or payment for healthcare. The Delaware Authorization for Use and / or Disclosure of Protected Health Information is an essential component of the Health Insurance Portability and Accountability Act (HIPAA), which ensures the privacy and security of PHI. This authorization serves as a written consent from the patient, allowing healthcare providers, insurers, or other relevant entities to access, use, or disclose their PHI for specific purposes. The primary purpose of the Delaware Authorization for Use and / or Disclosure of Protected Health Information is to enable healthcare professionals to provide optimal care and treatment for patients while maintaining their privacy rights. This authorization allows the sharing of medical records, test results, treatment plans, and other relevant information between healthcare providers and entities involved in the patient's care, such as healthcare facilities, insurance companies, and specialized laboratories. Delaware recognizes different types of authorizations for the use and/or disclosure of protected health information. These may include: 1. General Authorization: This type of authorization grants overall permission for the use and/or disclosure of PHI for a particular purpose or specific activities related to the individual's healthcare, payment, or related administrative purposes. 2. Research Authorization: If an individual's PHI is being requested for research purposes, a separate research authorization may be needed. This authorization specifies that the individual's PHI will be used solely for the specified research study and includes details about the research protocol, risks, and benefits. 3. Psychotherapy Notes Authorization: Delaware allows individuals to specifically authorize the use and/or disclosure of psychotherapy notes. These notes typically contain detailed information recorded by a mental health professional during a counseling session and require a separate authorization from the patient. 4. Non-Disclosure Authorization: In certain situations, individuals may choose to limit or restrict the use and/or disclosure of their PHI. This authorization establishes specific conditions under which PHI can be released or used. For example, a patient may restrict access to their PHI by certain family members or healthcare providers. It is important to note that Delaware Authorization for Use and / or Disclosure of Protected Health Information must comply with both federal HIPAA regulations and state laws. Healthcare providers and entities in Delaware should adhere to these regulations and ensure proper handling and protection of patient's PHI to safeguard their privacy and maintain legal compliance.

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FAQ

An authorization is a detailed document that gives covered entities permission to use protected health information for specified purposes, which are generally other than treatment, payment, or health care operations, or to disclose protected health information to a third party specified by the individual.

This form is used to release your protected health information as required by federal and state privacy laws. Your authorization allows the Health Plan (your health insurance carrier or HMO) to release your protected health information to a person or organization that you choose.

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.

The HIPAA Privacy Rule establishes national standards to protect individuals' medical records and other individually identifiable health information (collectively defined as protected health information) and applies to health plans, health care clearinghouses, and those health care providers that conduct certain

The Privacy Rule excludes from protected health information employment records that a covered entity maintains in its capacity as an employer and education and certain other records subject to, or defined in, the Family Educational Rights and Privacy Act, 20 U.S.C. §1232g.

HIPAA does not protect all health information. Nor does it apply to every person who may see or use health information. HIPAA only applies to covered entities and their business associates.

Typically, patient charts include vitals, medications, treatment plans, allergies, immunizations, test results, patient demographics, diagnoses, progress notes and reports. All information in patient charts comes from nurses, lab technicians, physicians and other practitioners involved in the patient's care.

Disclose and Disclosure means the release of, transfer of, provision of, access to, or divulging in any manner, of Protected Health Information outside of Mayo or to persons other than its workforce members.

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.

Submitting Requests for RecordsIf you are a patient or legal representative, your request can be faxed to Release of Information at 302-320-4692.If you are a healthcare provider, your requests can be faxed to 302-320-4859.If you are an attorney your requests can be faxed to 302-623-1431.

More info

The Rule requires appropriate safeguards to protect the privacy of protected health information and sets limits and conditions on the uses and disclosures ... 01-Aug-2020 ? In addition, we may disclose your protected health information toin reliance on the use or disclosure indicated in the authorization.Hipaa privacy authorization form authorization for use or disclosure of protected health information (required by the health insurance portability and ... You may give us written authorization to use your protected health information or to disclose it to anyone for any purpose. If you give us an authorization, you ... I hereby authorize. (?Provider?) to use and/or disclose the protected health information about me described below (?PHI?) to the University of Delaware. I hereby authorize. (?Provider?) to use and/or disclose the protected health information about me described below (?PHI?) to the University of Delaware. Treatment We may use and disclose your protected health information toinformation to a health oversight agency for activities authorized by law. INFORMATION SHARING FOR TREATMENT PURPOSES UNDER STATE LAW AND HIPAA ? The Delaware mental health statute allows disclosure of treatment information to ... 23-Sept-2013 ? How We May Use and Disclose Protected Health Information About Youapproval or to determine whether your plan will cover the treatment. To submit your request, simply fill out, sign and send (via mail, email or fax) an Authorization to Release form. Requests are normally processed within 8-10 ... Treatment: We will use and disclose your health information to provide you within your treatment, to pharmacists who are filling your prescriptions, ...

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