HIPPA

A HIPAA (Health Insurance Portability and Accountability Act) authorization is a legal document that allows a covered entity, such as a healthcare provider or insurance company, to use or disclose a patient’s protected health information (PHI) for specific purposes beyond treatment, payment, or healthcare operations.

Key Elements of a HIPAA Authorization:

1. Description of Information: Clearly specify what information is being disclosed (e.g., medical records, lab results).

2. Who May Disclose: Name the person or entity authorized to release the information.

3. Recipient: Identify who will receive the information.

4. Purpose: State why the information is being disclosed.

5. Expiration Date: Indicate when the authorization will expire (e.g., a specific date or event).

6.Right to Revoke: Include a statement informing the patient they can revoke the authorization at any time in writing.

7.Signature and Date: The patient or their legal representative must sign and date the authorization.

When Is HIPAA Authorization Required?

  • Sharing PHI for marketing purposes.
  • Disclosing information to third parties not involved in treatment or healthcare operations.
  • Using PHI for research that isn’t exempt under HIPAA.

Exceptions:

  • HIPAA authorization isn’t required for disclosures:
  • Related to treatment, payment, or healthcare operations.
  • Required by law, such as public health reporting.
  • To protect the patient or public in emergencies.

HIPAA Journal Sample HIPAA Release Form V 1 Pdf
PDF – 226.4 KB 15 downloads
HIPAA Release Form Texas Pdf
PDF – 205.3 KB 12 downloads
HIPAA Release Form California Pdf
PDF – 137.7 KB 13 downloads