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A general authorization for the release of medical or other information is NOT sufficient for this purpose. This form authorizes Blue Cross and Blue Shield of Nebraska (BCBSNE) to release your Protected Health Information (PHI).You only need to complete. Completing this form will allow Nebraska Total Care to share your health information with the person or group that you identify below. Use these tools to see if a pre-authorization is needed. They're quick and easy. Complete Authorization Form or Patient Access Request Form. â–¡ Discharge Summary. The Authorization of Release of Information and the Certification of Experience Outside of Nebraska needs to be completed for the developer and owner. Nebraska Department of Health and Human Services.