Medical Records Request Form Authorization For Disclosure Of Protected Health Inform: Fill & Download for Free

The unintended consequence is that HIPAA became the rule - instead of the exception that is was designed to cover.The Title of the Legislation is literally:Health Insurance Portability and Accountability Act (1996)See that word portability? It's right there in the title.But we need to break it apart because there were 2 parts to the legislation - Title 1 and Title 2.Title 1:Title I of HIPAA regulates the availability and breadth of group health plans and certain individual health insurance policies. It amended the Employee Retirement Income Security Act, the Public Health Service Act, and the Internal Revenue Code.Title I also limits restrictions that a group health plan can place on benefits for preexisting conditions. (NB: there were some exceptions to this part)Title II:Title II of HIPAA defines policies, procedures and guidelines for maintaining the privacy and security of individually identifiable health information (AKA PHI - or Personal Health Information) as well as outlining numerous offenses relating to health care and sets civil and criminal penalties for violations. It also creates several programs to control fraud and abuse within the health care system.However, the most significant provisions of Title II are its Administrative Simplification rules. Title II requires the Department of Health and Human Services (HHS) to draft rules aimed at increasing the efficiency of the health care system by creating standards for the use and dissemination of health care information.These rules apply to "covered entities" as defined by HIPAA and the HHS. Covered entities include health plans, health care clearinghouses, such as billing services and community health information systems, and health care providers that transmit health care data in a way that is regulated by HIPAA.Per the requirements of Title II, the HHS has promulgated five rules regarding Administrative Simplification: the Privacy Rule, the Transactions and Code Sets Rule, the Security Rule, the Unique Identifiers Rule, and the Enforcement Rule.First up - let's take a gander at that Privacy Rule:The effective compliance date of the Privacy Rule was April 14, 2003 with a one-year extension for certain "small plans". The HIPAA Privacy Rule regulates the use and disclosure of Protected Health Information (PHI) held by "covered entities" (generally, health care clearinghouses, employer sponsored health plans, health insurers, and medical service providers that engage in certain transactions.) PHI is any information held by a covered entity which concerns health status, provision of health care, or payment for health care that can be linked to an individual. This is interpreted rather broadly and includes any part of an individual's medical record or payment history. Covered entities must disclose PHI to the individual within 30 days upon request. They also must disclose PHI when required to do so by law such as reporting suspected child abuse to state child welfare agencies.A covered entity may disclose PHI (Protected Health Information) to facilitate treatment, payment, or health care operations without a patient's express written authorization.Any other disclosures of PHI (Protected Health Information) requires the covered entity to obtain written authorization from the individual for the disclosure. However, when a covered entity discloses any PHI, it must make a reasonable effort to disclose only the minimum necessary information required to achieve its purpose.Now - stop right there. As a small (or solo) healthcare practice - or say a small clinic. Or even a medium-sized clinic. How much of this do you want to risk to "interpretation?" That's right - very little. Especially when a signed release on the part of every patient - affords you - the provider - maximum protection.What started out as a form to handle "exceptions" (those minority cases where you would need to share PHI outside of the allowed regulation) is now the standard - the default - the required release that - as patients - we're required to sign almost every time (and certainly for every new healthcare provider we see). It protects the provider - but offers very little in the way of any actual protection to patients.

I don't know what this Medical record file is that you are talking about. If you mean the original hospital case file where they write the daily notes. I don't think there is any useful information that can be gleaned out if them since daily notes are not written in detail.The hospital is entitled to keep their original medical records to themselves as they need to document and medically audit case records. In case of some malpractice suits, the original medical records are the hospital/ doctor's only defense against frivolous claims.Medical record keeping has evolved into a science of itself. This will be the only way for the doctor to prove that the treatment was carried out properly. Moreover, it will also be of immense help in the scientific evaluation and review of patient management issues. Medical records form an important part of the management of a patient. It is important for the doctors and medical establishments to properly maintain the records of patients for two important reasons. The first one is that it will help them in the scientific evaluation of their patient profile, helping in analyzing the treatment results, and to plan treatment protocols. It also helps in planning governmental strategies for future medical care. But of equal importance in the present setting is in the issue of alleged medical negligence. The legal system relies mainly on documentary evidence in a situation where medical negligence is alleged by the patient or the relatives. In an accusation of negligence, this is very often the most important evidence deciding on the sentencing or acquittal of the doctor.The government of India has made it mandatory for all hospitals to keep their original medical records so it is understandable why it is so. With the advent of electronic medical records, many hospitals do not have any paper records. It has become easier for hospitals to maintain records safely. Hospitals also have the responsibility to share medical records with patients while keeping patient confidentiality.The Medical Council of India guidelines also insist on preserving the inpatient records in a standard proforma for 3 years from the commencement of treatment. The records that are the subject of medico-legal cases should be maintained until the final disposal of the case even though only a complaint or notice is received. It is necessary that the Government frames guidelines for the duration for which medical records are preserved by the hospitals so that hospitals are protected from unnecessary litigation in issues of medical records.However you can request the hospital management for a copy/Photocopy of the whole patient file at your own cost. Some records can run into hundreds and thousands of pages. That is your right but you have to pay for it. Just don't expect it for free.What will be useful to you would be a case report or a detailed discharge summary. You can request it from the hospital which may take a couple of days. Some hospitals may charge a fee but most give it for free. In my opinion you should ask this. Make a written request for a case report and take an acknowledgement stamped by their office staff.This is what the law says about patient confidentiality:Disclosure of personal health information is permitted and does not amount to a violation of privacy in the following situationsduring referral,when demanded by the court or by the police on a written requisitionwhen demanded by insurance companies as provided by the Insurance Act when the patient has relinquished his rights on taking the insurancewhen required for specific provisions of workmen's compensation cases, consumer protection cases, or for income tax authoritiesdisease registrationcommunicable disease investigationsvaccination studiesdrug adverse event reporting.If the hospital refuses to give you either the copy of the case file or the case report then you can complain to the state medical council which will take action against the concerned hospital. You can warn the hospital that you will complain which may make them change their mind. The hospitals would be very foolish to refuse sharing patient records after your warning.References:Medical records and issues in negligencePrivacy in Healthcare: Policy GuideA2A

They are required to have told you how you can get and what records are yours when you start treatment. The records you have a right to may not include therapy notes in many cases. Your health care provider usually must let you see your medical record or give you a copy of it as promptly as required by the circumstances, but no later than 15 working days after they receive your request. This right is called the right to access your medical record. Your health care provider cannot deny you access to your record because they think the information in the record might upset you or that it might cause you mental harm. However, they can deny your request if they believe you will become upset enough to physically harm yourself or another person.Here are some of the Washington State laws.(1) A health care provider who provides health care at a health care facility that the provider operates and who maintains a record of a patient's health care information shall create a "notice of information practices" that contains substantially the following:NOTICE"We keep a record of the health care services we provide you. You may ask us to see and copy that record. You may also ask us to correct that record. We will not disclose your record to others unless you direct us to do so or unless the law authorizes or compels us to do so. You may see your record or get more information about it at . . . . . ."(2) The health care provider shall place a copy of the notice of information practices in a conspicuous place in the health care facility, on a consent form or with a billing or other notice provided to the patient.Here is the Washington State law:RCW 70.02.310Mental health services—Information and records.(1) Resource management services shall establish procedures to provide reasonable and timely access to information and records related to mental health services for an individual. However, access may not be denied at any time to records of all medications and somatic treatments received by the person.(2) Following discharge, a person who has received mental health services has a right to a complete record of all medications and somatic treatments prescribed during evaluation, admission, or commitment and to a copy of the discharge summary prepared at the time of his or her discharge. A reasonable and uniform charge for reproduction may be assessed.(3) Information and records related to mental health services may be modified prior to inspection to protect the confidentiality of other patients or the names of any other persons referred to in the record who gave information on the condition that his or her identity remain confidential. Entire documents may not be withheld to protect such confidentiality.(4) At the time of discharge resource management services shall inform all persons who have received mental health services of their rights as provided in this chapter .The exceptions when they can deny you your records are this:Patient's request—Denial of examination and copying.(1) Subject to any conflicting requirement in the public records act, chapter 42.56 RCW, a health care provider may deny access to health care information by a patient if the health care provider reasonably concludes that:(a) Knowledge of the health care information would be injurious to the health of the patient;(b) Knowledge of the health care information could reasonably be expected to lead to the patient's identification of an individual who provided the information in confidence and under circumstances in which confidentiality was appropriate;(c) Knowledge of the health care information could reasonably be expected to cause danger to the life or safety of any individual;(d) The health care information was compiled and is used solely for litigation, quality assurance, peer review, or administrative purposes; or(e) Access to the health care information is otherwise prohibited by law.(2) If a health care provider denies a request for examination and copying under this section, the provider, to the extent possible, shall segregate health care information for which access has been denied under subsection (1) of this section from information for which access cannot be denied and permit the patient to examine or copy the disclosable information.(3) If a health care provider denies a patient's request for examination and copying, in whole or in part, under subsection (1)(a) or (c) of this section, the provider shall permit examination and copying of the record by another health care provider, selected by the patient, who is licensed, certified, registered, or otherwise authorized under the laws of this state to treat the patient for the same condition as the health care provider denying the request. The health care provider denying the request shall inform the patient of the patient's right to select another health care provider under this subsection. The patient shall be responsible for arranging for compensation of the other health care provider so selected.The guidelines state: "In the absence of a superseding requirement, psychologists may consider retaining full records until seven years after the last date of service delivery for adults or until three years after a minor reaches the age of majority, whichever is later." So, if it is longer than that they may have disposed of them.Civil remedies.(1) A person who has complied with this chapter may maintain an action for the relief provided in this section against a health care provider or facility who has not complied with this chapter.(2) The court may order the health care provider or other person to comply with this chapter. Such relief may include actual damages, but shall not include consequential or incidental damages. The court shall award reasonable attorneys' fees and all other expenses reasonably incurred to the prevailing party.(3) Any action under this chapter is barred unless the action is commenced within two years after the cause of action is discovered.(4) A violation of this chapter shall not be deemed a violation of the consumer protection act,Here is a typical notice from a psychological services facility:Client RightsThe health and financial records we create and store are the property of the Washington State University Psychology Clinic. The protected health information in it, however, generally belongs to you. You have a right to:Receive a copy, read, and ask questions about your protected health information as well as request restrictions to its use and/or disclosure. You must deliver this request to us in writing. Although we are not required to grant the request, we consider it and typically comply unless the request could pose a potential harm.Request and receive a paper copy of the most current “Notice of Privacy Practices” for protected health information.Request that you be allowed to see and obtain a copy of your protected health information. You may make this request in writing. Charges for copies of your medical record will apply in accordance with Washington state law.Ask that your health information be given to you by another means or at another location. Please sign, date, and give us your request in writing.Cancel prior authorizations to use or disclose health information by giving us a written revocation. Your revocation does not affect information that has already been released. Also, it does not affect any action taken before we have received it.Please note that we do not normally include raw psychological testing materials in disclosures of information, in order to protect the security of these tests.