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Answer: Be careful not to assume, even it it's a family member, that the patient authorizes this. Under the Privacy Rule the patient must be given an \u201copportunity to agree or object\u201d to the disclosure of PHI to someone else, even family members, but it does NOT have to be in writing.
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.
Refusing to sign the acknowledgement does not prevent a provider or plan from using or disclosing health information as HIPAA permits. If you refuse to sign the acknowledgement, the provider must keep a record of this fact.
The program, called \u201cBelieve Me,\u201d allowed patients who believed they were Kaiser Permanente members but were not yet officially entered in the system to get care without paying at the time of service. Kaiser holds the medical bills for 90 days to give the system time to catch up.
Kaiser Permanente will accept a request for retroactive authorization if the request meets either of the following guidelines: The request precedes a bill for services (no claim received by Kaiser Permanente) and is within fourteen days of the service OR.

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Valid HIPAA Authorizations: A Checklist No 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.
HIPAA Authorization for the Use or Disclosure of Health Information from Kaiser Permanente. Completion of this document authorizes the use and disclosure of health information about you. Failure to provide all information requested may invalidate this Authorization.
This form is used to release your protected health information as required by federal and state privacy laws. Your authorization allows the Health Plan (your health insurance carrier or HMO) to release your protected health information to a person or organization that you choose.
The core elements of a valid authorization include: A meaningful description of the information to be disclosed. The name of the individual or the name of the person authorized to make the requested disclosure. The name or other identification of the recipient of the information.
The core elements of a valid authorization include: A meaningful description of the information to be disclosed. The name of the individual or the name of the person authorized to make the requested disclosure. The name or other identification of the recipient of the information.

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