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Authorization for Protected Health Information (PHI)

Authorization for Protected Health Information (PHI) 2025

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The document is an authorization form for the release of protected health information (PHI) related to a patient's transplant evaluation. It includes patient and provider details, specifies the purpose of disclosure, and outlines the types of medical information that may be shared. The patient is informed of their rights regarding the authorization, including the ability to refuse or revoke it.

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2017	4.8 Satisfied (146 Votes)

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Who has the right to access PHI?

An individual has a right to access PHI about themselves in a medical record or other designated record set maintained by a covered entity, regardless of the date the information was created or whether the information is maintained onsite, remotely, or is archived.

How do I give someone a HIPAA authorization?

A HIPAA-compliant HIPAA release form must, at the very least, contain the following information: A description of the information that will be used/disclosed. The purpose for which the information will be disclosed. The name of the person or entity to whom the information will be disclosed.

Which types of PHI require a signed authorization?

Short Answer: Individuals generally must authorize any use or disclosure of their PHI that is not for treatment, payment, or health care operations. HIPAA authorizations must contain specific core elements and required statements to be valid.

What is required for an authorization to disclose PHI?

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.

Who has permission to access a patients personal health information?

Any qualified person who may access records on behalf of a patient under State law is a personal representative with a right of access under federal law. Parents have a right of access to their childrens medical records under federal law to the same extent that they have that right under state law.

Who is authorized to access PHI?

An individuals personal representative (generally, a person with authority under State law to make health care decisions for the individual) also has the right to access PHI about the individual in a designated record set (as well as to direct the covered entity to transmit a copy of the PHI to a designated person or

Who can access PHI without patient consent?

A covered entity is permitted, but not required, to use and disclose protected health information, without an individuals authorization, for the following purposes or situations: (1) To the Individual (unless required for access or accounting of disclosures); (2) Treatment, Payment, and Health Care Operations; (3)

What is an authorized personal representative?

A patients Personal Representative is the person who has the authority, under California law, to make health care decisions on behalf of the patient. Although there are exceptions, in general a person who has the capacity to make his or her own health care decisions does not have a Personal Representative.

Authorization for Protected Health Information (PHI) 2025

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