Who needs a HIPAA form 960?
Any person who needs to disclose part of his medical records in court or for any reason can submit this form at any New York State court.
What is HIPAA form 960 for?
Attorneys and hospital officials worked out a standard application for medical records. This form is meant for litigation, and it doesn’t contradict with the Health Insurance Portability and Accountability Act (HIPAA). It allows use of a certain part of medical records concerning drug and alcohol abuse, HIV-related confidential information and mental treatment from a selected period of time. With this form the applicant authorizes the discussion of his medical information between attorneys and court officials.
Is it accompanied by other forms?
It doesn’t require any addenda.
When is Form 960 due and for what period of time is it valid?
The applicant can choose the due dates for, and duration, of the disclosure of records. For example the applicant can authorize disclosure for one year or only disclose records since September 2012 to October 2013.
How do I fill out a HIPAA form 960?
The patient has to write down his name, address, date of birth and social security number in the top box of the application. He has to read the terms of use of his records carefully. When the patient has finished reading, he can write the name and address of his record keeper, whether it’s a hospital, family doctor, or rehabilitation clinic. After that he has to add the dates of the requested documents or limit the period of time to access them.
Where do I send it?
The applicant should send the completed HIPAA form to the New York State court where the hearing takes place. It doesn’t matter if it’s been printed out or submitted as a PDF document.
