New Hampshire Authorization to Use or Disclose Protected Health Information

State:
Multi-State
Control #:
US-3580
Format:
Word; 
Rich Text
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Description

This form is used by an individual to consent to the use or disclosure of protected health information as described within. The individual also indicates the acknowledgment of his or her rights regarding consent to the use and disclosure of the information.

New Hampshire Authorization to Use or Disclose Protected Health Information (NH AD PHI) is a legal document that grants permission for the exchange or release of an individual's health information. This authorization is an important aspect of maintaining patient privacy and complying with state and federal regulations, such as the Health Insurance Portability and Accountability Act (HIPAA). NH AD PHI serves as a consent form, allowing healthcare providers, insurers, or other designated entities to access, use, or share an individual's health information for specific purposes. The document outlines the details of the requested disclosure or use and provides explicit instructions on how the information should be handled and protected. Within the realm of NH AD PHI, there are different types of authorizations tailored to specific situations: 1. General Authorization: This is the most common type of NH AD PHI, allowing authorized individuals to use or disclose health information for various purposes, such as treatment, payment, or healthcare operations. It grants broad permission but can be limited by specifying the types of information and entities involved. 2. Research Authorization: This authorization enables the use or disclosure of protected health information for research purposes. It ensures compliance with research protocols and ethical standards while safeguarding the privacy of participants. The authorization grants access only to the minimum necessary information required for the specific research study. 3. Psychotherapy Notes Authorization: Psychotherapy notes are distinct from regular medical records and contain details of a mental health professional's conversations with a patient. This specific authorization is required to disclose or use the psychotherapy notes, as they receive an extra layer of protection under the law. 4. Marketing Authorization: This type of authorization allows healthcare providers or institutions to use or disclose protected health information for marketing purposes, such as sending promotional materials or treatment options. It typically requires a separate authorization, as it involves using patient information for commercial or promotional activities. In conclusion, the New Hampshire Authorization to Use or Disclose Protected Health Information (NH AD PHI) is a vital document that grants permission for the exchange or disclosure of an individual's health information. It serves as a means to balance patient privacy with the necessary sharing of information for treatment, payment, research, or marketing purposes. The different types of authorizations within NH AD PHI ensure that the disclosure or use of protected health information adheres to specific guidelines, protecting the privacy rights of individuals.

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FAQ

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.

Q. May the hospital use or disclose a patient's entire medical record based on the patient' signed consent? A. Yes, as long as the Authorization describes, among other things, the information to be used or disclosed by the hospital in a "specific and meaningful fashion," and is otherwise valid under the Privacy Rule.

A HIPAA authorization is a detailed document in which specific uses and disclosures of protected health are explained in full. By signing the authorization, an individual is giving consent to have their health information used or disclosed for the reasons stated on the authorization.

Covered entities may disclose protected health information that they believe is necessary to prevent or lessen a serious and imminent threat to a person or the public, when such disclosure is made to someone they believe can prevent or lessen the threat (including the target of the threat).

With limited exceptions, the HIPAA Privacy Rule gives individuals the right to access, upon request, the medical and health information (protected health information or PHI) about them in one or more designated record sets maintained by or for the individuals' health care providers and health plans (HIPAA covered

Marketing Activities: A covered entity must obtain an individual's authorization prior to using or disclosing PHI for marketing activities. Marketing is considered any message or statement to the public in an effort to get them to use or seek more information about a product or service.

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.

Valid HIPAA Authorizations: A ChecklistNo Compound Authorizations. The authorization may not be combined with any other document such as a consent for treatment.Core Elements.Required Statements.Marketing or Sale of PHI.Completed in Full.Written in Plain Language.Give the Patient a Copy.Retain the Authorization.

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.

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.

More info

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New Hampshire Authorization to Use or Disclose Protected Health Information