North Carolina Authorization for Medical Information

State:
Multi-State
Control #:
US-PI-0244
Format:
Word; 
Rich Text
Instant download

Description

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.

North Carolina Authorization for Medical Information is a legal document that allows individuals to grant permission to healthcare providers or facilities to disclose their medical information to designated individuals or organizations. This authorization is essential for ensuring the privacy of medical records and facilitating effective communication between healthcare professionals. One type of North Carolina Authorization for Medical Information is the General Authorization for Release of Medical Information. This type of authorization is widely used and permits the disclosure of all medical information, including patient history, diagnoses, treatments, and laboratory results. Another type is the Limited Authorization for Release of Medical Information, which is more specific in granting access only to certain medical records or for a limited period. This type of authorization protects sensitive or confidential information that a patient may choose to withhold from disclosure. The North Carolina Authorization for Medical Information also encompasses the HIPAA Authorization, which complies with the federal Health Insurance Portability and Accountability Act. This authorization ensures that healthcare providers adhere to strict guidelines when sharing patient information, protecting the individual's privacy rights and preventing unauthorized access. When completing the North Carolina Authorization for Medical Information, individuals need to provide certain essential details. These include their full name, date of birth, Social Security number, contact information, and specific identification or case numbers related to their medical records. Additionally, the document requires the names and contact information of the designated recipients who will have access to the medical information. It is crucial to understand that the North Carolina Authorization for Medical Information is a legally binding document. By signing it, individuals voluntarily agree to allow healthcare providers to disclose their medical information as specified within the document. It's recommended to carefully review and understand the terms and scope of the authorization before signing, as it directly impacts the privacy and confidentiality of personal health records. In conclusion, the North Carolina Authorization for Medical Information is a crucial document that grants permission for the release of medical records. It ensures both effective communication between healthcare providers and the protection of patients' privacy rights. Understanding the different types of authorizations available and their specific purposes can help individuals make informed decisions when granting access to their medical information.

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The HIPAA Privacy rule, a different regulation, separately requires that patients give written Authorization before a covered entity may use or disclose patients' protected health information for research.

More specifically, a North Carolina HIPAA release authorizes your health care provider, including any physician, dentist, health plan, hospital, clinic, laboratory, or pharmacy, to give, disclose, and release, without restriction, all of your identifiable health information and medical records regarding any past, ...

You have the right to see or get a copy of these records whether they are kept on paper or are kept on a computer. Who has the right to keep my original medical record? Under North Carolina law, your health care provider is required to keep your original medical record. You have the right to see and get a copy of it.

compliant HIPAA release form must, at the very least, contain the following information: A description of the information that will be used/disclosed. The purpose for which the information will be disclosed. The name of the person or entity to whom the information will be disclosed.

Under the HIPAA Privacy Rule, when a release of information is intended for purposes other than medical treatment, healthcare operations, or payment, you'll need to sign an authorization for ROI. The healthcare organization releasing your information will check that the authorization is valid during the ROI process.

Under the HIPAA Privacy Rule, healthcare providers, health plans, business associates, and others involved in administration of healthcare, may not share a patient's protected health information (PHI) without that patient's written authorization.

The HIPAA Privacy Rule requires that an individual provide signed authorization to a covered entity, before the entity may use or disclose certain protected health information (PHI).

A Privacy Rule Authorization is an individual's signed permission to allow a covered entity to use or disclose the individual's protected health information (PHI) that is described in the Authorization for the purpose(s) and to the recipient(s) stated in the Authorization.

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If treatment is research-related, treatment may be denied if authorization is not given. I further understand that I may request a copy of this signed ... For access to medical records you may submit your completed form one of many ways: Via email: MedicalRecordsROI@atriumhealth.org, Fax: 704-446-6037, or. Mail: ...You should then complete, sign, and submit your request form(s) to us in any of the following ways: 1. Fill in your Authorization form. The authorization ... Fill out an authorization form for medical records and mail it to one of our locations. 1 / 3. Electronic Access to Your Medical Record. Nov 1, 2005 — The Division of Public Health shall disclose IIHI only upon explicit written authorization by a client or personal representative, unless state ... Federal law permits sources with information about you, to release that information if you sign a single authorization to release all your information from all ... For the limited purpose of this Authorization, I hereby waive the North Carolina physician-patient privilege, nurse-patient privilege, and any other ... I have read and understand the information in this Authorization form. Signature of Patient: Printed Name: Date: OR. Signature of. Authorized Representative:. 2. Take this form to a physician licensed to practice medicine in the. State of North Carolina or any state of the United States for completion. Requesting your medical records. 1. Fill in your Authorization form. (HIM #1409-s). The authorization form can be obtained from any UNC Hospitals, UNC ...

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North Carolina Authorization for Medical Information