Delaware Authorization for Use and / or Disclosure of Protected Health Information
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How to fill out Authorization For Use And / Or Disclosure Of Protected Health Information?
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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.