This form is used to inform the plaintiff's medical provider that an attorney has been retained by plaintiff and that plaintiff authorizes the release to attorney of all of his or her medical records.
Maryland Authorization for Medical Information
State:
Multi-State
Control #:
US-PI-0244
Format:
Word;
Rich Text
Instant download
Description
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How to fill out Authorization For Medical Information?
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FAQ
The proper release of medical records always requires authorization to protect the patient's privacy and to help keep you from being liable.
Gaining Access to Your Records To do so, you must make a written request. This signed and dated request must state your name, the name of your health care provider and the party who should receive your records. Your authorization to release your records is good for one year.
Code, Health-Gen. § 4-302. Section 4-302 - Confidentiality and disclosure generally (a) A health care provider shall: (1) Keep the medical record of a patient or recipient confidential; and (2) Disclose the medical record only: (i) As provided by this subtitle; or (ii) As otherwise provided by law.
Mandatory disclosure of information Under the CMIA, medical information must be released when compelled: by court order. by a board, commission or administrative agency for purposes of adjudication. by a party to a legal action before a court, arbitration, or administrative agency, by subpoena or discovery request.
There are several common reasons for the release of information, including medical treatment purposes, medical billing, insurance billing, health studies, legal proceedings, and marketing purposes. Sometimes a third party ? like an insurance company or an attorney ? needs to request your medical information.
As the primary purpose of a medical record authorization is to protect the patient's privacy and you against any litigation, any medical record that you accept or have your patient sign must contain the necessary parts that can hold up in court.
A HIPAA authorization is consent obtained from an individual that permits a covered entity or business associate to use or disclose that individual's protected health information to someone else for a purpose that would otherwise not be permitted by the HIPAA Privacy Rule.
Provisions § 4-306. A custodian shall deny inspection of a hospital record that: (1) relates to: (i) medical administration; (ii) staff; (iii) medical care; or (iv) other medical information; and (2) contains general or specific information about one or more individuals.