Patient Authorization for Release of PHI review
HIPAA authorization for use / disclosure of PHI under 45 C.F.R. § 164.508.
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What it checks
Specific description of information to be used / disclosed
Authorization must contain a specific and meaningful description of the information to be used or disclosed.
Critical · HC-010
Name of person / class authorized to make the use / disclosure
Authorization must identify the person(s) or class authorized to make the use or disclosure.
Critical · HC-011
Name of person / class to whom the disclosure is made
Authorization must identify the person(s) or class to whom the use or disclosure may be made.
Critical · HC-012
Description of purpose
Authorization must describe the purpose of the use or disclosure.
Critical · HC-013
Expiration date or event
Authorization must include an expiration date or expiration event.
Critical · HC-014
Right to revoke authorization
Authorization must include a statement of the individual's right to revoke in writing and the exceptions.
Critical · HC-015
No conditioning on treatment / payment / enrollment / benefits
Authorization must state whether treatment / payment / enrollment / benefits are conditioned on the authorization.
Critical · HC-016
Risk of re-disclosure by recipient
Authorization must state that information disclosed may be re-disclosed by the recipient and no longer protected by HIPAA.
Critical · HC-017
Signature + date + authority (if not the individual)
Authorization must be signed and dated by the individual or by a personal representative with authority recital.
Critical · HC-018
Every run also applies 104 general checks that belong to any agreement: structure, parties and signatures, defined terms, cross-references, dates, amounts, and one-sided terms.
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