Hawaii Medical Information Affidavit

State:
Hawaii
Control #:
HI-SKU-0390
Format:
PDF
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Description

Medical Information Affidavit

The Hawaii Medical Information Affidavit (MIA) is a legal document used in the state of Hawaii to authorize the release of medical information between a patient and healthcare provider. The MIA is required when a medical provider needs to obtain sensitive medical information from a patient or a patient's family. The MIA allows the patient to provide consent for the release of their medical records and can be used to authorize the release of any type of medical information, including personal health information, medical history, diagnosis, test results, and treatment plans. There are two types of MIA: an Authorization for Release of Medical Information and an Authorization for Disclosure of Medical Records. The Authorization for Release of Medical Information form is used to authorize the release of medical information from a patient to a healthcare provider. The Authorization for Disclosure of Medical Records is used to authorize the release of medical information from a healthcare provider to a patient or a patient's family. Both forms require the patient to provide their name, address, date of birth, and other personal information. The forms also require the patient to sign and date the document, which serves as their consent for the release of the medical information.

How to fill out Hawaii Medical Information Affidavit?

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FAQ

Hawaiian health care providers (such as medical doctors, surgeons, podiatrists and hospitals) generally must keep your whole medical record for at least seven years after the last time they entered information in your record. Health care providers must keep minors' medical records at least until the minor turns 25.

Hawaii law requires that medical records be retained for a minimum of seven (7) years after the last entry was made. Importantly, while medical records can be destroyed after seven years, basic patient information must be retained for twenty-five (25) years after the last chart entry.

To keep your practice compliant with their regulations, you must retain all medical records for at least five years. Critical access hospitals must do so for six years.

For example: In the USA? the Health Insurance Portability and Accountability Act (HIPAA) requires healthcare providers and other Covered Entities to retain medical records for six years, measured from the time the record was created, or when it was last in effect, whichever is later.

Hawaiian health care providers (such as medical doctors, surgeons, podiatrists and hospitals) generally must keep your whole medical record for at least seven years after the last time they entered information in your record. Health care providers must keep minors' medical records at least until the minor turns 25.

Call (808) 469-4924. You may fax requests or information to (808) 447-3943 You may also e-mail us at medrecs@ucera.org.

The Health Insurance Portability and Accountability Act (HIPAA) requires Covered Entities and Business Associates to maintain required documentation for a minimum of six (6) years from the date of its creation, or the date when it last was in effect, whichever is later.

Patient disclosures and records are treated confidentially, and except when required by law, patients are given the opportunity to approve or refuse release of their record. Patients may request restrictions on the uses or disclosures of their information, and request an accounting of disclosures of their information.

More info

Please complete this form to the best of your knowledge and ability. Evidence of medical reports, statements, or records; testimony of health care provider or custodian of records.Edit, sign, and share medical records affidavit form online. No need to install software, just go to DocHub, and sign up instantly and for free. The Right to Access medical records doesn't provide attorneys the right to receive an executed Custodian of Records Affidavit for litigation. This is a separate form from the FCVS affidavit and release. If you are using FCVS, you must complete both FCVS and UA affidavits. The Opt Out Affidavits dataset provides information on providers who have decided not to participate in Medicare. How to correct a certificate with the Affidavit for Correction. The SIME binders contain copies of all the medical records in my possession. d.

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Hawaii Medical Information Affidavit