Hennepin Minnesota Autorización de Uso y/o Divulgación de Información de Salud Protegida - Authorization for Use and / or Disclosure of Protected Health Information

• Category: Empleo: políticas y procedimientos
• State: Multi-State
• County: Hennepin
• Control #: US-178EM
• Format: Word

Description

Este formulario permite que un empleado autorice los tipos de información médica que debe divulgar el departamento de recursos humanos. Hennepin Minnesota Authorization for Use and/or Disclosure of Protected Health Information (PHI) is a legal document that allows an individual's health information to be shared or used for specific purposes. This authorization is governed by the federal Health Insurance Portability and Accountability Act (HIPAA) and the Minnesota Health Records Act, ensuring the privacy and security of individuals' medical information. The Hennepin Minnesota Authorization for Use and Disclosure of Protected Health Information grants permission for healthcare providers or other relevant entities to release or disclose specific PHI to designated individuals or organizations. This authorization is typically required when an individual seeks to share their medical records with another healthcare provider, insurance company, legal representative, or any other party involved in their healthcare. The Hennepin Minnesota Authorization for Use and/or Disclosure of Protected Health Information must contain certain specific elements to be valid. These elements often include the individual's name, date of birth, description of the information to be disclosed, the purpose of the disclosure, the names of authorized parties, the expiration date of the authorization, and the individual's signature. Different types of Hennepin Minnesota Authorization for Use and/or Disclosure of Protected Health Information may include: 1. General Authorization: This type of authorization grants permission for the release or disclosure of PHI for a specific purpose, such as sharing medical records between primary care physicians and specialists. 2. Research Authorization: Research organizations or institutions may require a separate authorization when collecting or accessing PHI for research purposes. This authorization specifies how the data will be used and ensures compliance with ethical standards. 3. Mental Health Authorization: Mental health services providers may require a specific authorization for the release or disclosure of PHI related to mental health diagnoses or treatments. This authorization provides individuals with control over who can access their sensitive mental health information. 4. Substance Abuse Treatment Authorization: Substance abuse treatment facilities or programs may have their own specialized authorization form for the release or disclosure of PHI related to addiction treatment. This authorization ensures confidentiality regarding an individual's substance abuse history and treatment. 5. Marketing Authorization: In some cases, healthcare providers or organizations may seek authorization to use an individual's PHI for marketing purposes, such as sending promotional materials or information about new treatments or services. This authorization allows individuals to choose whether they want their health information used for marketing purposes. It is important for individuals to understand the purpose and scope of any authorization they sign, as they retain the right to revoke or limit the authorization at any time. The Hennepin Minnesota Authorization for Use and/or Disclosure of Protected Health Information ensures that individuals have control over the sharing of their medical information, promoting transparency and safeguarding their privacy.

Hennepin Minnesota Authorization for Use and/or Disclosure of Protected Health Information (PHI) is a legal document that allows an individual's health information to be shared or used for specific purposes. This authorization is governed by the federal Health Insurance Portability and Accountability Act (HIPAA) and the Minnesota Health Records Act, ensuring the privacy and security of individuals' medical information. The Hennepin Minnesota Authorization for Use and Disclosure of Protected Health Information grants permission for healthcare providers or other relevant entities to release or disclose specific PHI to designated individuals or organizations. This authorization is typically required when an individual seeks to share their medical records with another healthcare provider, insurance company, legal representative, or any other party involved in their healthcare. The Hennepin Minnesota Authorization for Use and/or Disclosure of Protected Health Information must contain certain specific elements to be valid. These elements often include the individual's name, date of birth, description of the information to be disclosed, the purpose of the disclosure, the names of authorized parties, the expiration date of the authorization, and the individual's signature. Different types of Hennepin Minnesota Authorization for Use and/or Disclosure of Protected Health Information may include: 1. General Authorization: This type of authorization grants permission for the release or disclosure of PHI for a specific purpose, such as sharing medical records between primary care physicians and specialists. 2. Research Authorization: Research organizations or institutions may require a separate authorization when collecting or accessing PHI for research purposes. This authorization specifies how the data will be used and ensures compliance with ethical standards. 3. Mental Health Authorization: Mental health services providers may require a specific authorization for the release or disclosure of PHI related to mental health diagnoses or treatments. This authorization provides individuals with control over who can access their sensitive mental health information. 4. Substance Abuse Treatment Authorization: Substance abuse treatment facilities or programs may have their own specialized authorization form for the release or disclosure of PHI related to addiction treatment. This authorization ensures confidentiality regarding an individual's substance abuse history and treatment. 5. Marketing Authorization: In some cases, healthcare providers or organizations may seek authorization to use an individual's PHI for marketing purposes, such as sending promotional materials or information about new treatments or services. This authorization allows individuals to choose whether they want their health information used for marketing purposes. It is important for individuals to understand the purpose and scope of any authorization they sign, as they retain the right to revoke or limit the authorization at any time. The Hennepin Minnesota Authorization for Use and/or Disclosure of Protected Health Information ensures that individuals have control over the sharing of their medical information, promoting transparency and safeguarding their privacy.

Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.