The HIPAA (Health Insurance Portability and Accountability Act) Authorization form is a document that allows an appointed person or persons access to your protected health information. You can allow as much or as little access to the information as you choose, you can permit access for a specified period of time, or, you can permit access for as long as you are covered by SummaCare. (Please note that the form does not give the appointed person the right to file complaints or appeals on your behalf.)
Click here to access the form.