Related links
Medical Records Guidelines
The Authorization to Use or Disclose Protected Health Information form should be completed to provide medical record release authorization.
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HIPAA Privacy Policy
The Health Plan may use or disclose health information for its own operations to facilitate the administration of the Health Plan and as necessary to provide
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Authorization to Release Protected Medicaid Member
By signing this form, I understand that I am allowing the New York State Department of Health to use or disclose all of the payment information for the Medicaid
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