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Authorization to Disclose/Obtain Information - dhs state il

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The document is an 'Authorization to Disclose/Obtain Information' form from the Illinois Department of Human Services. It allows individuals to authorize the disclosure or obtaining of sensitive health information, including mental health and substance abuse records, for specified purposes such as personal use or continuity of care. The form requires details about the individual, the information to be shared, the parties involved, and includes legal disclaimers regarding privacy rights under HIPAA and federal confidentiality rules.

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What is the purpose of a HIPAA authorization form?

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.

What information must be on the authorization form?

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.

What does disclosure authorization mean?

Authorized Disclosure means the disclosure of Protected Information strictly in accordance with the Confidentiality Control Procedures applicable thereto: (i) as to all Protected Information, only to a Related Party that has a need to know such Protected Information strictly for Project Purposes and that has agreed in ...

What authorization is required for Hipaa?

The HIPAA Privacy Rule expressly requires an authorization for uses or disclosures of protected health information for ALL marketing communications, except in two circumstances: When the communication occurs in a face-to-face encounter between the covered entity and the individual; or.

What is the authorization for disclosure of information form used for?

A HIPAA authorization form gives covered entities permission to use protected health information for purposes other than treatment, payment, or health care operations. Continue reading to find out what authorization to disclose health information is needed.

What does it mean to use protected health information?

PHI stands for Protected Health Information and is any information in a medical record that can be used to identify an individual, and that was created, used, or disclosed in the course of providing a health care service, such as a diagnosis or treatment.

Which use disclosure of PHI is allowed?

Question 2: Which use/disclosure of PHI is allowed under the HIPAA Privacy Rule? PHI should be disclosed only to those with a need to know, such as providers involved in the patient's care.

Which uses and disclosures of PHI are allowed without a person's consent?

There are a few scenarios where you can disclose PHI without patient consent: coroner's investigations, court litigation, reporting communicable diseases to a public health department, and reporting gunshot and knife wounds.

What is the difference between use and disclosure of PHI?

In general, the use of PHI means communicating that information within the covered entity. A disclosure of PHI means communicating that information to a person or entity outside the covered entity, or the communication of PHI from a health care component to a non-health care component of a hybrid entity.

When authorization is needed for use and disclosure of PHI?

Answer: A patient authorization is not required for disclosure of PHI between Covered Entities if the disclosure is needed for purposes of treatment or payment or for healthcare operations. You may disclose the PHI as long as you receive a request in writing.

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