Washington 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.

The Washington Authorization for Medical Information is a legal document that allows individuals to grant permission for the release and disclosure of their medical information to designated individuals or organizations. This authorization is an essential tool to ensure the privacy and confidentiality of one's medical records while accommodating their needs for sharing pertinent information with healthcare providers, insurance companies, legal representatives, or any other authorized entity. With regard to the different types of Washington Authorization for Medical Information, there are primarily two significant categories: 1. General Authorization for Medical Information: This type of authorization applies to a broad range of medical information and allows for the release and disclosure of all relevant healthcare records, including but not limited to medical history, diagnosis, treatment plans, lab results, medications, and sensitive mental health information. This versatile authorization is often used when individuals want to grant access to their medical records to a specific healthcare practitioner, insurance company, or for personal record-keeping purposes. 2. Limited Authorization for Medical Information: As the name suggests, this type of authorization restricts the release and disclosure of medical information to specific aspects or timeframes. For instance, if an individual seeks legal representation for a personal injury case, they may provide a limited authorization specifying the medical records related to that specific incident only. This form of authorization allows individuals to control the extent and purpose of the medical information shared while protecting their overall privacy. Both types of authorizations are valid under Washington state law, as long as they are properly executed and comply with the necessary requirements. These may include identifying the authorized individuals or organizations, specifying the scope and purpose of the disclosure, setting limitations on the duration of the authorization, and clearly stating the rights of the individual providing the authorization. In summary, the Washington Authorization for Medical Information is a vital legal document that grants individuals the power to control the release and disclosure of their medical information. By utilizing either a general or limited form, individuals can safeguard their privacy while ensuring necessary access to healthcare providers or authorized entities.

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FAQ

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.

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.

A(fill in type of health care provider)has a duty to inform a [patient] [patient's representative] of all material facts, including risks and alternatives, that a reasonably prudent patient would need in order to make an informed decision on whether to consent to or reject a proposed course of treatment.

The Rule requires appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization.

More generally, HIPAA allows the release of information without the patient's authorization when, in the medical care providers' best judgment, it is in the patient's interest. Despite this language, medical care providers are very reluctant to release information unless it is clearly allowed by HIPAA.

The proper release of medical records always requires authorization to protect the patient's privacy and to help keep you from being liable.

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.

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Complete the General Information for Authorization form (13-835) with all supporting documentation and fax it to: 1-866-668-1214. Note: The General Information ... 4. Client ID: (Required). Enter the client ID - 9 numbers followed by WA. For Prior Authorization (PA) requests when the client ID is unknown (e.g. client ...NOTE: Recent medical records are available via MyChart for immediate download without filling out this form. Please go to https://www.uwmedicine.org/mychart for ... Oct 11, 2023 — We prefer that you submit prior authorizations through our Care Management Portal (JIVA). By using the portal, you can check eligibility and ... If you should feel that you did not receive a complete set of the information requested please feel free to reach out to the Health Information Department. Print and complete the Authorization for Use or Disclosure of Health Information form · The release form must be completed, dated and signed · Please be sure to ... RECIPIENT INFORMATION: Print name, address, phone number, fax number and email address. Delivery method: Please PRINT the email address clearly. KP.ORG/WA – ... "I authorize this patient's information to be released"*: Write in the patient's name, date of birth, and any other name(s) the patient is known as. Complete and sign a Authorization for Release of Medical Records form. One form can be filled out for medical records and imaging. Ensure that your email ... Information to be Disclosed. My initials and signature authorize Western Washington University's Student Health Center or the above named person/entity to ...

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Washington Authorization for Medical Information