West Virginia Hospital Authorization to Visit Form

State:
Multi-State
Control #:
US-5698
Format:
Word; 
Rich Text
Instant download

Description

Hospital Authorization to Visit Form: This Authorization form is signed by a patient seeking to limit his/her visitors to a certain few listed on the Authorization form. This form is to be signed by the requesting patient. This form is available in both Word and Rich Text formats.
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FAQ

Online Access to Your Health InformationCheck with your health care providers or doctors to see if they offer online access to your medical records. Terms sometimes used to describe electronic access to these data include personal health record, or PHR, or patient portal.

The average minimum requirement is five years; however, some Medicare/Medicaid audits and/or actions can occur up to ten years after treatment and/or billing has occurred. Statutory or Regulatory Requirements: Several state and federal regulations and rules may affect medical record retention periods.

To obtain records, a patient, his or her personal representative as defined by HIPAA, or his or her authorized agent or authorized representative must submit a written request with the health care provider. The provider must furnish a copy of the records within 30 days of receiving the request.

You can even download the MyWVUChart app on Apple and Android devices. With MyWVUChart, you can: Manage and schedule appointments: Request appointments and look up information on previous visits. Online scheduling is available for our primary care providers.

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.

What is MyWVUChart? MyWVUChart offers patients personalized and secure on-line access to portions of their medical records. It enables you to securely use the Internet to help manage and receive information about your health.

MyWVUChart Mobile App Our MyWVUChart app for mobile devices lets you access your WVU Medicine information when you are away from your computer. This free app is available for Apple and Android mobile devices.

As a not-for-profit health system, we are dedicated to providing care to every member of our community regardless of their ability to pay. WVU Hospitals operates on patient payments and charitable donations alone, and is responsible for bearing the costs of improving quality of care and access to care.

State law requires many health care providers to keep your medical record for a specific period of time. For example, West Virginia hospitals must keep your medical records for at least five years after your last treatment. In practice, many health care providers keep their medical records longer.

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West Virginia Hospital Authorization to Visit Form