Guam Request for an Individuals Health Information

State:
Multi-State
Control #:
US-3577
Format:
Word; 
Rich Text
Instant download

Description

This form is used by an individual to request access to his or her protected health information. The individual's rights regarding this access are also acknowledged by the individual.

Title: Guam Request for an Individual's Health Information: Detailed Description and Types Introduction: A Guam Request for an Individual's Health Information is a formal request made by an individual or authorized representative to obtain personal medical records or health-related information. This ensures compliance with the Health Insurance Portability and Accountability Act (HIPAA) regulations, which prioritize the privacy and security of an individual's health information. Description: 1. Purpose: The purpose of a Guam Request for an Individual's Health Information is to facilitate access to medical records, allowing individuals to gather important health-related information, address medical concerns, seek second opinions, apply for insurance claims, participate in research studies, or manage their overall healthcare needs effectively. 2. Content of the Request: The request typically includes the requester's identifying information, such as name, contact details, date of birth, and any other relevant personal information. Additionally, the following information is provided to ensure accurate identification and retrieval of the health records: — Dates or time frame for which the health information is requested — Healthcare provider's name, facility, or organization where the records were created or maintained — Types of medical records being requested, such as diagnostic reports, treatment plans, laboratory results, progress notes, and more. 3. Authorization: To release an individual's health information, a signed and properly completed Authorization for Use or Disclosure of Health Information form should accompany the request. This form must comply with HIPAA regulations and includes specific information regarding who can access the records, the purpose of the release, the recipient of the information, and the expiry date of consent. Types of Guam Request for an Individual's Health Information: 1. General Medical Records Request: This category encompasses the retrieval of a comprehensive set of an individual's medical records from various healthcare providers or facilities, providing a comprehensive history of the patient's health information. 2. Specialist or Specialty Records Request: When an individual requires certain specialized medical records or diagnoses, such as records specific to cardiology, dermatology, orthopedics, or other specialties, they can opt for a specialist or specialty records request. This ensures they are only requesting pertinent health information for their specific medical needs. 3. Emergency or Urgent Records Request: In emergency situations where immediate access to health records is necessary, such as for trauma cases or sudden illnesses, an emergency or urgent records request may be made to expedite the process and ensure prompt and efficient care delivery. Conclusion: A Guam Request for an Individual's Health Information serves as a critical tool in facilitating secure access to personal medical records. By following the proper procedures and ensuring compliance with HIPAA regulations, individuals can obtain the necessary health information to make informed decisions regarding their well-being, improving overall healthcare management and enhancing patient-doctor communication.

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FAQ

Medicaid Overview Guam became a territory in 1950 and its Medicaid program was established in 1975. It is a 100% fee-for-service delivery system with two hospitals currently servicing the territory.

Medicaid and Medicare programs are available on Guam. There is also a locally-funded Medically Indigent Program (MIP) designed to pay for medical expenses of low-income families without other health insurance. Those who don't qualify for assistance may opt for private insurance.

The following are the new Guam Medicaid poverty level income guidelines: Household size: 1 - Monthly gross income: $1,595. Household size: 2 - Monthly gross income: $2,156. Household size: 3 - Monthly gross income: $2,715.

It applies to everybody in the United States, and with regard to the security and privacy of health information in our country, there is no more important resource than HIPAA.

But HIPAA affects a great number of people other than healthcare providers. Employers that offer group health plans and any business or individual that provides services to physicians, healthcare providers, hospitals and insurance companies may also be affected by HIPAA.

In Guam, the HIPAA Privacy Rule sets most of the standards that Guam health care providers must follow when they handle medical records. The Privacy Rule applies to most physicians, the civil hospital and other health care providers. In Guam, you have the right to: See and get a copy of your medical record.

Now Accepting these Dental Plans We welcome new patients and accept most insurance plans, including Hawaii Dental Service, Calvo's SelectCare, Staywell, Netcare, Takecare, United Concordia, AETNA, MetLife, Cigna, Medicaid, and MIP. Most health plans with dental benefits cover 100% of preventive care.

Guam is the only territory that covers all mandatory benefits, including nursing facility services. Enrollees can receive care outside of the territory with prior authorization, when medically necessary, and Page 2 2 when services are not provided in Guam (CMS 2014a).

Refer to the licensure verification resource at to determine fees and preferred verification method(s) for each state medical and osteopathic verifying board. You may use this form for each board that requires a written request for verification.

The following are the new Guam Medicaid poverty level income guidelines: Household size: 1 - Monthly gross income: $1,595. Household size: 2 - Monthly gross income: $2,156. Household size: 3 - Monthly gross income: $2,715.

More info

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Guam Request for an Individuals Health Information