UCMC 218 AUTHORIZATION for RELEASE of PATIENT PROTECTED HEALTH INFORMATION Indd

What is the UCMC 218 AUTHORIZATION FOR RELEASE OF PATIENT PROTECTED HEALTH INFORMATION indd

The UCMC 218 AUTHORIZATION FOR RELEASE OF PATIENT PROTECTED HEALTH INFORMATION is a legal document that allows healthcare providers to share a patient's protected health information (PHI) with designated individuals or entities. This form is essential for ensuring that patient privacy is maintained while allowing for the necessary exchange of medical information. It is commonly used in healthcare settings to facilitate communication between providers and other parties involved in a patient's care.

How to use the UCMC 218 AUTHORIZATION FOR RELEASE OF PATIENT PROTECTED HEALTH INFORMATION indd

Using the UCMC 218 form involves several straightforward steps. First, the patient must complete the form by providing their personal information, including name, date of birth, and contact details. Next, the patient must specify the information to be released, the purpose of the release, and the recipients of the information. After filling out the form, the patient should sign and date it to authorize the release. It is important to ensure that all sections are completed accurately to avoid delays in processing.

Steps to complete the UCMC 218 AUTHORIZATION FOR RELEASE OF PATIENT PROTECTED HEALTH INFORMATION indd

Completing the UCMC 218 form requires careful attention to detail. Follow these steps:

• Provide your full name and contact information.
• Enter your date of birth and any identification numbers, if applicable.
• Clearly indicate the specific health information you wish to be released.
• State the purpose for the release of your information.
• List the names of individuals or organizations authorized to receive your information.
• Sign and date the form to confirm your authorization.

Key elements of the UCMC 218 AUTHORIZATION FOR RELEASE OF PATIENT PROTECTED HEALTH INFORMATION indd

The UCMC 218 form includes several key elements that are crucial for its validity. These elements encompass:

• Patient Information: Complete and accurate details about the patient.
• Information to be Released: Specific details about the health information that will be shared.
• Purpose of Disclosure: A clear statement outlining why the information is being released.
• Recipient Information: Names and contact details of those who will receive the information.
• Patient Signature: An authorized signature confirming consent.

Legal use of the UCMC 218 AUTHORIZATION FOR RELEASE OF PATIENT PROTECTED HEALTH INFORMATION indd

The legal use of the UCMC 218 form is governed by federal and state laws regarding patient privacy and the sharing of health information. Under the Health Insurance Portability and Accountability Act (HIPAA), patients have the right to control who has access to their medical records. The UCMC 218 form must comply with these regulations to be considered legally binding. It is essential for healthcare providers to ensure that they have valid authorization before releasing any patient information.

State-specific rules for the UCMC 218 AUTHORIZATION FOR RELEASE OF PATIENT PROTECTED HEALTH INFORMATION indd

While the UCMC 218 form is designed to meet federal standards, individual states may have specific regulations that impact its use. These rules can include additional requirements for patient consent, restrictions on the type of information that can be disclosed, and the duration for which the authorization is valid. It is important for patients and healthcare providers to be aware of these state-specific rules to ensure compliance and protect patient rights.