Medical Records Release Form (HIPAA)

A medical records release form is a document that permits a medical office to disclose a patient’s protected health information. Medical release forms include details about the information authorized for disclosure, its purpose, and the patient’s rights under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Medical Records Release Form (HIPAA)

A medical records release form is a document that permits a medical office to disclose a patient’s protected health information. Medical release forms include details about the information authorized for disclosure, its purpose, and the patient’s rights under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

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Last updated April 24th, 2024

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A medical records release form is a document that permits a medical office to disclose a patient’s protected health information. Medical release forms include details about the information authorized for disclosure, its purpose, and the patient’s rights under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

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By Type (4)

Dental

Hospital

Medicare

Veterans Affairs (3)

Covered Entities

Healthcare providers that transmit medical records electronically are considered covered entities and must comply with HIPAA’s rules when sharing or using protected health information (PHI).

Fees ($)

When an individual requests access to their medical files or asks for their records to be forwarded to a third party, the covered entity can charge a “reasonable, cost-based fee” to pay for the following [1] :

HIPAA Requirements for Authorization

Generally, covered entities must obtain the patient’s approval before sharing PHI for marketing purposes or other reasons that require patient authorization under HIPAA’s privacy rule. [2] To authorize a disclosure, patients will need to sign a release form that contains the following [3] :

The release must also include certain disclosures, including that [4] :

Covered entities must disclose medical records within 30 days of receiving a request from the patient. [5] This time frame can be extended an additional 30 days by providing a written statement outlining the reasons for the delay (only one extension is permitted). [6]

Sources

  1. 45 CFR 164.524(c)(4)
  2. 45 CFR 164.508(a)(1), 45 CFR 164.502(a)(1)
  3. 45 CFR 164.508(c)(1)
  4. 45 CFR 164.508(c)(2)
  5. 45 CFR 164.524(b)(2)(i)
  6. 45 CFR 164.524(b)(2)(ii)