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  • Authorization To Disclose Health Information - Superior Healthplan

Get Authorization To Disclose Health Information - Superior Healthplan

Authorization to Disclose Health Information Notice to Member: Completing this form will allow Superior HealthPlan to share your health information with the person or group that you identify below.

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Under the HIPAA Privacy Rule, healthcare providers, health plans, business associates, and others involved in administration of healthcare, may not share a patient's protected health information (PHI) without that patient's written authorization.

Please contact Member Services by phone at 1-877-687-1196 (Relay Texas/TTY 1-800-735-2989) to speak directly to a customer services representative or use the Secure Member Portal.

Authorization is a more formal and mandatory process. Authorization is required when healthcare providers need to use or disclose PHI for purposes not covered by consent. Unlike consent, authorization is a detailed document specifying various elements, including: Type of PHI to be used or disclosed.

A Privacy Rule Authorization is an individual's signed permission to allow a covered entity to use or disclose the individual's protected health information (PHI) that is described in the Authorization for the purpose(s) and to the recipient(s) stated in the Authorization.

It's why Superior is one of the leading Medicaid plans in Texas.

Authorization. A covered entity must obtain the individual's written authorization for any use or disclosure of protected health information that is not for treatment, payment or health care operations or otherwise permitted or required by the Privacy Rule.

When Must Patient Authorization be Obtained for Uses and Disclosures of PHI? Authorizations are generally required for psychotherapy notes, substance abuse disorder and treatment records, and for marketing purposes.

Superior HealthPlan provides quality Medicaid and CHIP health insurance to members across Texas. If you have STAR or CHIP coverage, call 1-800-783-5386 to speak with a Superior HealthPlan representative.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232