This form is used to inform the plaintiff's medical provider that an attorney has been retained by plaintiff and that plaintiff authorizes the release to attorney of all of his or her medical records.
New Jersey Authorization for Medical Information
State:
Multi-State
Control #:
US-PI-0244
Format:
Word;
Rich Text
Instant download
Description
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How to fill out Authorization For Medical Information?
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FAQ
HOW LONG MUST A DOCTOR KEEP MY MEDICAL RECORDS? A doctor has to keep a patient's medical records for seven years. After that, the physician may destroy them. There is no requirement in the law that requires the physician to notify a patient prior to destroying the records.
CAN A DOCTOR CHARGE ME FOR MY MEDICAL RECORDS? The doctor may charge you to copy your records. The cost may not be greater than $1.00 per page or $100.00 for the entire record, whichever is less. If your records are no more than 10 pages, the doctor may charge $10.00.
Your health care provider usually must let you see your medical record or give you a copy of it within 30 days of receiving your request. Your health care provider is allowed to charge you for copies of your medical record. They can also charge you for postage.
For a request by an authorized third party, the fee for reproducing medical and billing records that are not stored on microfilm or microfiche is to be no more than $1 per page, and the fee for reproducing records stored on microfilm or microfiche is to be $1.50 per image.
How long must a physician keep medical records? ing to the New Jersey State Board of Medical Examiners' rules, medical records must be kept for seven (7) years from the last date of service.
The New Jersey Health Care Quality Act (HCQA), N.J.S.A. S-1 et seq. and rules establish certain rights AND responsibilities for health care providers that contract with carriers for business that is subject to the HCQA.
A doctor must obtain the patient's informed consent before the doctor may treat or operate on the patient. A doctor has a duty to evaluate the relevant information and disclose all courses of treatment that are medically reasonable under the circumstances.
You can request medical records in several ways: Complete the online patient authorization form for release of information. Mail, fax, scan or email your completed authorization form to the hospital's address. You can also stop by the hospital in person with your completed authorization form.