Do the HIPAA laws prohibit Health Insurance companies from allowing members to fill out and submit medical claim forms on line?

No, nothing in HIPAA precludes collecting the claim information online.However, the information needs to be protected at rest as well as in-flight. This is typically done by encrypting the connection (HTTPS) as well the storage media

How do I get a pre-authorization for out-of-state primary care from the Tufts Health Together plan?

I doubt that you can. If the Tufts plan is an HMO, then you will need to ask your PCP for a referral. HMOs are paid a capitation fee per month for each patient. The HMO becomes the insurance carrier. Therefore, if you ask for an out of state referral for routine care, they must reimburse the other provider which they won’t want to do.If you need emergency care due to risk of life or limb, then that’s a different ballgame and should not be a problem as the ER of any hospital will coordinate with the HMO.Hope this helps.

Are health clubs, gyms and other public businesses that require customers and clients to fill out health and/or medical forms or releases required to protect that information under HIPAA?

This does not fall under HIPAA. Under the HIPAA regulations, the entities that must comply with the rules are defined as covered entities which are: health care plans, health care providers, and health care clearinghouses. So health clubs or gyms do not meet this definition and are therefore not subject to HIPAA. However, depending on your state, there may be laws which protect the sharing of this type of information.

What are some reasons that a health insurance company would ask for a pre-authorization form to be filled out by a Dr. before filling a prescription?

One common reason would be that there is a cheaper, therapeutically equivalent drug that they would like you to try first before they approve a claim for the prescribed drug. Another reason is that they want to make sure the prescribed drug is medically necessary.Remember that nothing is stopping you from filling the prescribed drug. It just won't be covered by insurance until the pre-authorization process is complete.

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Claim Form Chamber Primary Health Plan Westfield Health 2010-2025

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Claim Form Chamber Primary Health Plan Westfield Health 2010-2025

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Westfield Claim 2010-2025 Form

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How to safeguard your westfield form when executing electronically?

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