This form authorizes the release of plaintiff's confidential medical records to plaintiff's attorney.
Idaho Authorization to Release Confidential Records
State:
Multi-State
Control #:
US-PI-0312
Format:
Word;
Rich Text
Instant download
Description
How to fill out Authorization To Release Confidential Records?
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FAQ
A covered entity is permitted, but not required, to use and disclose protected health information, without an individual's authorization, for the following purposes or situations: (1) To the Individual (unless required for access or accounting of disclosures); (2) Treatment, Payment, and Health Care Operations; (3) ...
TEXAS ALLOWABLE CHARGES Paper format: The provider may charge no more than $25 for the first twenty pages and $. 50 per page for every copy thereafter. For example, if a record is 25 pages, the provider may charge $27.50 ($25 + 5 x . 50 = $27.50).
Colorado law establishes the following reasonable fees that a health care facility may charge a third party. The fees may not exceed the following: For the first ten pages: $18.53. For the next thirty pages (pages 11 through 40): 85 cents per page.
Call 208-334-5564 to speak with someone about a public record request. Requests for records such as copies of contracts may be completed by filling out the Online Public Records Request Form. Please visit our Idaho Bureau of Vital Records and Health Statistics page.
However, the reasonable charge for paper copies shall not exceed seventy-five cents per page AND THE REASONABLE CHARGE FOR COPIES PROVIDED IN AN ELECTRONIC FORMAT SHALL BE THE LESSER OF EITHER SEVENTY-FIVE CENTS PER PAGE OR A TOTAL OF ONE HUNDRED DOLLARS.
NEVADA. No more than $0.60 per page for paper copies of medical records. A reasonable cost may be charged for x-ray photographs and other health care records produced by similar processes.
Idaho does not have specific medical record copying fees to set pricing limitations.
Usually, your health care provider must respond to your request for your record no later than 30 days after receiving your request. Generally, your health care provider must give you a copy in the format that you request if they are able to do so. Your provider may charge you a fee to copy your medical record.
