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What is a HIPAA authorization form?

What is a HIPAA authorization form?

A HIPAA authorization form is a legal document that grants healthcare providers permission to use or disclose a patient's protected health information (PHI) for specific purposes. These forms outline the types of information to be disclosed, the parties involved, the purpose of the disclosure, and the duration of the authorization. 


Purpose and importance of HIPAA authorization forms

HIPAA authorization forms serve multiple purposes and hold significant importance in healthcare.

  • Patient privacy protection: A HIPAA authorization form allows patients to decide who can access their health information, promoting privacy and control over their medical records.
  • Facilitating treatment and coordination of care: Authorization forms enable healthcare providers to share patient information with other authorized parties involved in their treatment or care coordination. 
  • Research and study participation: With proper patient consent through HIPAA authorization forms, healthcare organizations can use PHI for medical research, clinical trials, and other studies.
  • Legal compliance: Healthcare providers and organizations must comply with HIPAA regulations by obtaining written authorization.


Components of a HIPAA authorization form

To ensure compliance with HIPAA regulations, healthcare professionals must understand the six components of a HIPAA authorization form:

  1. Patient information: The form begins by collecting the patient's name, date of birth, contact details, and other relevant identifiers. 
  2. Outline of the information to be disclosed: This section specifies the protected health information (PHI) the patient authorizes to disclose. It may include medical records, test results, and treatment plans.
  3. Recipient of the information: The HIPAA authorization form identifies who will receive the medical records. This could be another healthcare provider, insurance company, family member, or other legal representative involved in the patient's care.
  4. Purpose of the disclosure: Clearly stating the purpose helps patients make informed decisions about their health information. The disclosure must align with their intentions and preferences, whether it's for treatment purposes, healthcare operations, or research.
  5. Duration of authorization: This section determines the duration for which the HIPAA authorization remains valid.
  6. Revocation rights: HIPAA authorization forms highlight the patient's right to revoke the authorization at any moment.


Essential elements of a HIPAA authorization form

Healthcare organizations and patients should incorporate these three essential elements in a HIPAA authorization form to ensure compliance with regulations:

Clear and specific language: A well-crafted HIPAA authorization form uses clear and straightforward language to ensure patients fully understand its content. It avoids ambiguous terms and provides clear explanations to minimize confusion and prevent misinterpretation.

HIPAA privacy notice: Including a Privacy Notice in the form allows healthcare organizations to specify how patient health information is used, disclosed, and protected. Patients gain access to their privacy rights and gain a better understanding of the importance of giving consent to appropriate parties.

Patient signature and date: A patient's signature on the authorization form signifies that they have read and understood its content, agree to the terms, and give informed consent to disclose their PHI. The date on the signature line proves the validity of the signature.


When is a HIPAA authorization form required?

A HIPAA authorization form is required before any disclosure of a patient's protected health information for reasons not specified in 45 CFR §164.506, These reasons, outlined in 45 CFR §164.508, include:

  • Sharing PHI with a third party for non-standard healthcare purposes (e.g., with an insurance underwriter)
  • Using PHI for HIPAA compliant email marketing or fundraising
  • Providing PHI to a research organization
  • Disclosing psychotherapy notes
  • Selling or sharing PHI involving compensation

Read more: How does HIPAA differentiate between consent and authorization? 


How Paubox can help

Paubox Forms is designed to securely collect patient data in compliance with HIPAA regulations. It's included with the Paubox Email Suite service and features a user-friendly drag-and-drop form builder. 

The forms can be customized with various question options, such as text fields, dropdowns, multiple-choice questions, file uploads, and even signatures. 

You can adjust question settings, design elements, and manage form settings. Once a form is built, it can be published and linked to websites or emails. Form submissions are viewable in the Paubox Admin Panel, and users can customize submission messages and manage form recipients.  


In the news

In 2015, the University of California, Los Angeles (UCLA) Health System found itself embroiled in a high-profile scandal that showed the necessity of patient privacy and compliance with HIPAA regulations. It was revealed that several UCLA Health employees, including medical professionals and support staff, had illicitly accessed the medical records of well-known individuals such as Kim Kardashian and Farrah Fawcett. Rather than for legitimate medical purposes, these records were accessed out of sheer curiosity, blatantly disregarding the necessity for patient authorization as mandated by HIPAA. 

This breach not only violated the trust and privacy of the affected patients but also reiterated the pressing need for stringent safeguards to prevent unauthorized access to sensitive medical information. As a result of the ensuing investigation by the Office for Civil Rights (OCR) within the U.S. Department of Health and Human Services, UCLA Health System faced substantial penalties and a settlement agreement, serving as a reminder to healthcare providers nationwide of the severe consequences of non-compliance with HIPAA regulations.



Can a patient revoke a HIPAA authorization once it is given?

Yes, a patient can revoke a HIPAA authorization at any time, in writing. The revocation will not affect any disclosures that were made with the authorization prior to the revocation. Covered entities must honor the revocation request and cease any further use or disclosure of the PHI as specified in the original authorization.


What happens if a HIPAA authorization form is incomplete or invalid?

If a HIPAA authorization form is incomplete or invalid, the covered entity cannot use or disclose the PHI based on that authorization. An authorization is considered invalid if it lacks any of the required elements, has been revoked by the patient, has expired, or contains materially false information. In such cases, the entity must inform the patient and obtain a valid authorization before proceeding with any use or disclosure of the PHI.


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). 


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?



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