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Updates to the Authorization for Release of PHI form

The Authorization for Release of Protected Health Information (PHI) form has been updated. 


What is this form used for?
This form must be completed if a member wishes to make their PHI available to a third party. The form must be filled out in its entirety by the member or the member’s legal representative. 


What has been changed on the form? 
The content of the form has not changed, but the language has been simplified to make the form more  understandable to the member. 


Where can I find the form?
You can access the form on by clicking here. Please be sure to access the form from this location for the most up-to-date version. 


When should you begin to use the new form?  
We ask that clients begin using the updated form at their earliest convenience. We will process authorization requests submitted on the old version of the form until May 1, 2016. We have selected this as the last date to accept the old form to allow you to use your current stock and update any postings where this may appear. Once your current stock has run out, you can access the new form here.


Please contact your client relationship manager if you have any questions.


Compliance Quarterly is being provided as an informational tool. It is recommended that plans consult with their own experts or counsel to review all applicable federal and state legal requirements that may apply to their group health plan. By providing this publication and any attachments, Meritain Health is not exercising discretionary authority over the plan and is not assuming a plan fiduciary role, nor is Meritain Health providing legal advice.