Hawaii Authorization for Release of Information
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How to fill out Authorization For Release Of Information?
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FAQ
An Authorization remains valid until its expiration date or event, unless effectively revoked in writing by the individual before that date or event.
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.
Generally, an authorization provides the authority for a doctor's release of PHI for specified purposes, which are generally other than treatment, payment, or healthcare operations, or, to disclose protected health information to a third party specified by the individual.
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.
You must ensure that release of PHI is only granted with permission from the appropriate individual. Staff should be trained to ask for verification of the identity and the authority of the individual making the request.
Q: How long does an authorization remain valid? A: It remains valid until the expiration date/event, unless the patient revokes it beforehand in writing.
What information must be on the authorization form for the release of patient information? The authorization form must identify the purpose or need for the information, the extent of the information that may be released, any limits of authorization, date, and signature of patient consent.
A HIPAA authorization form gives covered entities permission to use protected health information for purposes other than treatment, payment, or health care operations.
No. A HIPAA authorization remains valid until it expires or is revoked by the individual.
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.
