HIPAA Compliance Forms
Form solutions that make you confident that you are in compliance with HIPAA regulations.

At patient sign-in, make one HIPAA privacy worry

 Keep Practices Compliant with forms specially designed to meet HIPAA Requirements!

  As of April 14, 2003 HIPAA requires that healthcare practices take certain steps, and provides for steep penalties for those that do not comply.  Under HIPAA, Patients are now given new fundamental rights, including:

  • the right to inspect and/or obtain copies of their medical record
  • the right to request amendments to their record
  • the right to request restrictions on the disclosure of their protected health information
  • the right to ask practices to communicate with them in a certain manner
  • the right to ask practices for a log of who has accessed their protected health information

Our forms were created with the understanding that running a healthcare practice is a difficult job, and that added burdens practices can have serious negative effects.  Best of all, the forms are easy to use, and will help meet the new federal requirements.

Use these forms to:
-
Comply with Federal HIPAA Privacy Regulations
- Document information necessary to show that you are HIPAA compliant
- Integrate easily with your existing medical record system
- Help simplify administrative processes
- Ensure that patients privacy rights are not violated

A Very Brief Overview of HIPAA

The Health Insurance Portability & Accountability Act (HIPAA) was signed into law in 1996.  The federal regulation includes mandates that set standards for protecting the privacy of medical & health information; now referred to as Protected Health Information (PHI).  PHI is information that is maintained by healthcare entities, for example: hospitals, pharmacies, healthplans, dental practices, and private physician practices.

HIPAA requires covered entities to take steps to limit the use and disclosure of PHI, which means that healthcare entities will be required to develop new policies and procedures that address protecting the privacy and security of patients' rights.  The Office of Civil Rights is the oversight agency responsible for HIPAA compliance.

The deadline for compliance with the privacy standards is April 14, 2003 (small health plans have until April 14, 2004).  To ensure compliance, healthcare entities will be required to document (forms) information captured as patients exercise their privacy rights.

    
Related HIPAA Links
Health Insurance Portability and Accountability Act
www.cms.hhs.gov/hipaa
    
US Department of Health and Human Services
aspe.hhs.gov/admnsimp
   
Unsure how to handle HIPAA?
www.hipaa.org

Get the Final HIPAA Regulations
www.hhs.gov/ocr/hipaa/finalreg.html

Office for Civil Rights - HIPAA Medical Privacy
National Standards to Protect the Privacy of PHI
www.hhs.gov/ocr/hipaa/privacy.html

HIPAA Readiness Checklist

Department of Health and Human Services
Security Guidelines, Effective February, 2005
 

HIPAA Employee Training Record Form 101
HIPAA Employee Training Record Form 102
Protected Health Information PHI Access Log Form 103
Protected Health Information (PHI) Disclosure Log Form 104
Patient Request for Amendment of Health Information Form 105
Patient Request for Accounting of Disclosures Form 106
Patient Request to Inspect PHI Form 107
Patient Request for Confidential Communications Form 108
Patient Request for Restrictions on Use and Disclosure of PHI Form 109
Protected Health Information (PHI) Tracking Log Form 110
Authorization to Release Information Form 111
Notice of Privacy Practices Form 120

ALL OUR FORMS ARE OF THE HIGHEST QUALITY,  ARE PRINTED IN STRICT COMPLIANCE  WITH GOVERNMENT SPECIFICATIONS AND ARE APPROVED BY CENTERS FOR MEDICARE AND MEDICAID SERVICES AND THE INSURANCE INDUSTRY.
OUR FORMS HAVE BEEN APPROVED BY THE GOVERNMENT.
The American HCFA Forms division of DFL Enterprises, Inc. is an independent supplier of US Government
approved claim forms and NOT an affiliate of CMS (
www.cms.gov)

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