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HIPAA Privacy Manual & Forms

$375
  

This Policy Manual addresses compliance with federal and state law concerning privacy of medical records for your clinical care Center.

The HIPAA Privacy Rule sets standards that apply to records held by health care providers across the nation. State law sets standards for records held by doctors, hospitals and other health care providers within the state. Most health care providers must follow both the HIPAA Privacy Rule and state law. We have used Massachusetts law as an example of applicable state law. Therefore, if you hire legal counsel to tailor this form document to your situation, then your attorney may search for the Massachusetts law examples as illustrations of places where specific state law should be inserted.

For your convenience, we have highlighted sections of the Manual to which you should pay particular attention (i.e., names and dates relevant to you), and have highlighted updates relating to 2009 federal legislation (the American Recovery and Reinvestment Act of 2009).

The file is provided as a Word document for easy editing.

Chapter 1 — Introduction and Basic Policies
  Where HIPAA Applies
  Administrative Requirements
  Designated Privacy Officer & Complaints Contact Person


Chapter 2 — Procedures for Patient Privacy
  Background - Patient Confidentiality
  Before Provision of Care - Authorizations Obtained on First Visit
  Ongoing Forms for Communicating with Patient about PHI Authorizations/Disclosures
  Policy/Procedure Re: Authorization for Release of Medical Records
  Policy/Procedure Re: Authorization to Obtain Medical Records
  Policy/Procedure Re: Amendment of Records
  Policy/Procedure Re: Disclosure of Records
  Policy/Procedure Re: Legal Considerations
  Policy/Procedure Re: Access Without Consent
  Policy/Procedure Re: Accounting for Access


Chapter 3 — Business Entities/Business Associate Procedures


Chapter 4 — Security & Electronic Transaction Standards


Chapter 5 — HIPAA Compliance Administrative Policies
  Policy/Procedure Re: Patient Complaints Procedure
  Policy/Procedure Re: Managing a Breach in Patient Confidentiality
  Policy/Procedure Re: Maintaining & Updating Privacy Policies & Procedures


HIPAA Forms
 

Patient Forms (completed by patients as needed)

  PF 1

Notice To Patients
  PF 2

General Authorization For Release Of Medical Records
  PF 3

Disclosure To Family/Friends
  PF 4

Restriction On Use And Release Of Medical Records
  PF 5

Specific Authorization For Release Of Medical Records
  PF 6

Request For Amendment Of Medical Record
  PF 7

Authorization To Obtain Medical Records
 

Staff/Provider Forms (to communicate with patients as needed)

  SF 1

Granting Of Request By Patient For Disclosure
  SF 2

Denial Of Request By Patient For Disclosure
  SF 3

Response To Request To Amend Records
  SF 4

Notice Of Amendment To Medical Record
  SF 5

Accounting For Access Provided To Medical Records
 

Business/Management Forms (for internal management of confidentiality)

  BF 1

Privacy Officer
  BF 2

Contact Person Identification Form
  BF 3

Administrative Complaints Form
  BF 4

Business Associate Agreement
  BF 5

HIPAA Training Attendance Log Sheet
  BF 6

HIPAA Annual Training Schedule
  BF 7

Electronic Standards Compliance Letter To Billing Company