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This form is used for you to request Confidential Communications of your Protected Health Information. (PHI). Confidential Communication means communicating with you by alternate means or locations. because of a Privacy Related concern. Questions regarding this form should be directed to the.
The records must be picked up at the OHCA office building located at 4345 N. Lincoln Blvd, Oklahoma City, OK 73105. Upon arrival at the OHCA, you will be provided a detailed billing of the search and retrieval fee. Payment by check or money order will be required before the records can be provided to you.
The ROI form gives the healthcare organization like a hospital the authority to release a specific portion of your medical record. When the healthcare organization receives the ROI request, the ROI department immediately records it. They also check whether or not the authorization is valid.
To respect HIPAA compliance rules, a signed HIPAA release form must be obtained from a patient before their protected health information can be shared with other individuals or organizations, except in the case of routine disclosures for treatment, payment or healthcare operations permitted by the HIPAA Privacy Rule.
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