Hennepin Minnesota Authorization to Use or Disclose Protected Health Information

State:
Multi-State
County:
Hennepin
Control #:
US-3580
Format:
Word; 
Rich Text
Instant download

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.
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FAQ

You must obtain authorization from an individual before disclosing their protected health information in most non-emergency situations. This is particularly important when sharing records for purposes that are not related to treatment, payment, or healthcare operations. Ensuring compliance with the requirements of Hennepin Minnesota Authorization to Use or Disclose Protected Health Information will help you avoid legal issues.

Located in Paris, Tenn., the medical center provides affordable, high-quality, patient-centered care that respects the privacy, needs and dignity of each individual, regardless of their ability to pay. HCMC is a county-owned and operated, nonprofit institution affiliated with the Tennessee Hospital Association.

Effective February 8, 2012, Hennepin County Medical Center will become a member of the VHA/Novation Group Purchasing Organization as an affiliate of Allina Hospitals and Clinics. Allina's VHA/Novation Membership ID is 559.

Hennepin County Medical Center (HCMC) is a Level I adult and pediatric trauma center and safety net hospital in Minneapolis, Minnesota, the county seat of Hennepin County.... Hennepin County Medical CenterTypeTeachingAffiliated universityUniversity of MinnesotaServicesEmergency departmentLevel I trauma center16 more rows

The MHRA generally grants patients with the right to access their health records upon request. Additionally, providers must provide written notice of their health records practices and written notice of patients' rights to access their records.

Hennepin Healthcare has a large psychiatric program, home care, and hospice, and operates a research institute, and philanthropic foundation. Hennepin Healthcare includes Emergency Medical Services, which operates a large fleet of ambulances serving 14 cities in Hennepin County.

Hennepin Healthcare is an integrated system of care that includes a nationally recognized Level I Adult and Pediatric Trauma Center, an acute care hospital, as well as a clinic system with primary care clinics located in Minneapolis and across Hennepin County.

With limited exceptions, the HIPAA Privacy Rule (the Privacy Rule) provides individuals with a legal, enforceable right to see and receive copies upon request of the information in their medical and other health records maintained by their health care providers and health plans.

The safety net system was created by the Minnesota legislature as a public benefit corporation and is operated as a subsidiary of Hennepin County. Hennepin Healthcare is: A nationally recognized public safety net health care system that is the largest in the Upper Midwest.

In March 2018, the provider that operates HCMC was rebranded as Hennepin Healthcare. However, the hospital retained the name HCMC.

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Hennepin Minnesota Authorization to Use or Disclose Protected Health Information