HIPAA authorization forms

Among its many provisions, HIPAA mandates the protection of individuals' protected health information (PHI). However, there are situations where disclosure of PHI is necessary, but not covered under routine healthcare operations. This is where HIPAA authorization forms come into play.

Understanding HIPAA authorization forms

HIPAA authorization forms are legal documents used to obtain permission from patients or individuals to disclose their PHI for specific purposes not covered under routine healthcare operations. 

See also: The different types of HIPAA forms

Contents of a HIPAA authorization form

A HIPAA authorization form contains several components to ensure compliance with HIPAA regulations and facilitate the lawful disclosure of PHI. While the exact layout and wording may vary depending on the organization or specific circumstances, the following are common contents found in a HIPAA authorization form:

Title and introduction

• Title: Indicates that the document is a HIPAA authorization form.
• Introduction: Briefly explains the purpose of the form, emphasizing the voluntary nature of authorization and the individual's right to revoke the authorization.
  
  

Identification of parties involved

• Patient's information: Full name, date of birth, address, contact information, and any other relevant identifiers.
• Authorized representative (if applicable): Information of the individual authorized to act on behalf of the patient.
• Covered entity: Name and contact information of the covered entity seeking authorization to disclose PHI.
  
  

Description of PHI to be disclosed

• Specific information: Clearly specify the PHI to be disclosed.
• Limitations: State sny limitations on the scope of disclosure.

Read more: HIPAA PHI: Definition of PHI and List of 18 Identifiers 

Purpose of disclosure

• Explanation: A detailed description of why the disclosure of PHI is necessary.
  
  

Recipient of PHI

• Individual or entity: Name, address, and contact information of the recipient authorized to receive the disclosed PHI.
• Third-party authorization (if applicable): If PHI will be disclosed to a third party, their identity and relationship to the recipient should be clearly specified.
  
  

Expiration date

• Validity period: The timeframe within which the authorization is valid, after which it expires.
• Revocation information: Instructions on how the individual can revoke the authorization before or after the expiration date.
  
  

Signatures

• Patient's signature: Signature of the individual authorizing the disclosure of PHI.
• Date of signature: The date when the authorization was signed by the patient.
• Authorized representative's signature (if applicable): Signature of the individual acting on behalf of the patien.
• Witness signature (optional): In some cases, a witness may be required to attest to the authenticity of the signatures.
  
  

Additional provisions

• Any additional provisions or conditions agreed upon by the parties involved.
  
  

Notice of rights

• Information regarding the individual's rights under HIPAA, including the right to revoke authorization, access their medical records, and file complaints.
  
  

Contact information

• Contact details for the covered entity's Privacy Officer in case the individual has questions or concerns about the authorization process.
  
  

HIPAA compliance statement

• A statement affirming that the authorization form complies with the requirements of HIPAA and other relevant privacy laws.

See also: How to send HIPAA compliant patient forms

Types of authentications forms

There are several types of HIPAA authorization forms tailored to specific purposes or situations. Here are some common types of HIPAA authorization forms:

• General: This is a standard authorization form used for general purposes, such as authorizing the release of medical records to a third party for treatment coordination, insurance claims, legal proceedings, or other healthcare-related activities. 
• Research: Research authorization forms are used when individuals voluntarily participate in research studies or clinical trials that involve the use or disclosure of their PHI for research purposes. 
• Psychotherapy notes: Authorization for the disclosure of psychotherapy notes requires a separate form specifically designated for this purpose. 
• Marketing: Marketing authorization forms allow individuals to grant permission for their PHI to be used for marketing communications, promotions, or other marketing activities related to healthcare products or services.
• Release of information: This type of authorization form is used 
• Parental or guardian: When the patient is a minor or otherwise lacks the capacity to provide authorization, a parental or guardian authorization form may be used to obtain consent for the disclosure of PHI on behalf of the patient. 
•  Employer: Employer authorization forms allow individuals to authorize the disclosure of their PHI to their employer for specific purposes related to employment.
•  Drug or alcohol treatment: Authorization forms specific to drug or alcohol treatment may be used when individuals seek treatment for substance abuse or addiction. 

  See also: HIPAA compliant email marketing: What you need to know 

   

  How Paubox can help

  Paubox Forms allows you to collect patient data securely via a HIPAA compliant form. You can create custom questions using an intuitive form builder, and it's entirely free with Paubox Email Suite. 

   

  FAQ’s

  Can a healthcare provider refuse to accept a HIPAA authorization form from a patient?

  Healthcare providers are generally required to accept valid HIPAA authorization forms from patients. However, they may refuse to accept an authorization form that does not meet the requirements of the HIPAA Privacy Rule or if they have reason to believe it is fraudulent or invalid.

   

  What should I do if I have concerns about how my PHI is being used or disclosed?

  Individuals concerned about the use or disclosure of their PHI should contact the covered entity's Privacy Officer to discuss their concerns and, if necessary, file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights (OCR).

  Related: Filing a HIPAA complaint

   

  What is the difference between consent and authorization?

  While both consent and authorization involve granting permission for certain actions to occur, consent primarily relates to medical treatment and healthcare interventions, while authorization specifically pertains to the disclosure of protected health information for purposes beyond routine healthcare operations.

  Go deeper: How does HIPAA differentiate between consent and authorization?