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A HIPAA authorization form gives covered entities permission to use protected health information for purposes other than treatment, payment, or health care operations.
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.
HIPAA Authorization is a document that authorizes the release of medical records which are protected under HIPAA. The authorization names designated representatives who may receive protected medical records, despite the privacy protections of HIPAA.
HIPAA Authorization Defined 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.
Therefore, a verbal authorization is allowed under the HIPAA Privacy Rule for those individuals involved in the care of an individual.
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According to HIPAA's Privacy Rule, you are not required to sign these documents. Although the receptionists handing you these forms may not be fully aware of this fact, you are under no legal obligation to give your signature (HHS).
All authorizations must be in plain language, and contain specific information regarding the information to be disclosed or used, the person(s) disclosing and receiving the information, expiration, right to revoke in writing, and other data.
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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