Hipaa Forms | Download Dental Hipaa Forms

HIPAA Compliance Form & Privacy Rules

HIPAA (Health Insurance Portability and Accountability Act) of 1996 mandates data privacy and security for safeguarding patient’s medical information.

Download Updated HIPAA Form 2022

Learn More About HIPAA Compliance Regulations

The Security Rule requires Healthcare facilities to safeguard and maintain confidentiality of all Electronic protected health information.

HIPAA states the following:

1

Ensure complete confidentiality, integrity, and availability of all Electronic protected health information that is created, received or transmitted.

2

Identify and protect against reasonably anticipated threats to the patients information & security.

3

Identify & protect against reasonably anticipated, impermissible uses or disclosures.

4

Ensure complete compliance by your workforce.

General HIPAA Privacy Breaches in Dental Offices

Not properly maintaining confidentiality of patient data via encryption.

Failing to attain patient authorization prior to release of personal information.

Improper discarding of patient data via paper forms.

mConsent provides 100% HIPAA Compliant Online Dental Intake Forms.

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All you wanted to know about Dental HIPAA Release Forms?

HIPAA (Health Insurance Portability and Accountability Act) of 1996 mandates data privacy and security for safeguarding patient’s medical information.

What is a Dental HIPAA Form?

A Dental HIPAA Release form is a legal document that Authorizes release of Information to Indicated parties.

What are the requirements to make a HIPAA Authorization/Release Form valid?

Ensure Accurate & Complete Patient Info Provided

Patient’s Full Name
Patient’s DOB
Other Source of Identification as Needed

Disclosure to Which Entity, Office or Party

Another Dental Office
Self
Other (Indicate)

Method of Delivery

Fax
Postal Mail
Email
Pickup

What Information is Being Disclosed
Indicate the type of information

Treatment Plans
Radiology X-Rays & Images
Billing Records
Other Info

Option for Specific Instructions

Allow option for Patient to Indicate What should not be Disclosed

Expiration Date of Disclosure

Clear Indication of dates that Disclosure of information is permitted
Ensure that the applicable dates are followed by your office
If patient information is shared with a third party outside of the expiration date, you could face legal consequences

Signed Acknowledgement

Patient or legal Guardian must sign the form
Bypassing a patient’s signature can have legal ramifications
Never Disclose patient’s information without their signed consent
If patient is under the age of 18 be sure to have a legal guardian sign on their behalf

Download Updated HIPAA Form 2022

Learn More About HIPAA Compliance Regulations

The Security Rule requires Healthcare facilities to safeguard and maintain confidentiality of all Electronic protected health information.

HIPAA states the following:

1

Ensure complete confidentiality, integrity, and availability of all Electronic protected health information that is created, received or transmitted.

2

Identify and protect against reasonably anticipated threats to the patients information & security.

3

Identify & protect against reasonably anticipated, impermissible uses or disclosures.

4

Ensure complete compliance by your workforce.

What are the benefits of a HIPAA Release Form?

HIPAA release forms ensure that a patient or their guardian has control over their personal health information. Who has access to their health records, to what extent, and for how long, are all decided by the patient or their guardian. HIPAA release forms safeguard the privacy of health information for patients in accordance with federal regulations. Without the implementation of HIPAA release forms, a patient’s health information may not be securely guarded according to the patient’s (or their guardian’s) wishes. The security and confidentiality of health information is prioritized via HIPAA release forms.

What are Patient Rights under HIPAA privacy rules?

n accordance with HIPAA, there are patient rights that must be acknowledged by healthcare providers. The first is that patients have the right to request access to their health information. If a patient requests their personal health records, the provider’s office is obligated to provide an avenue for the patient to receive their records consistent with HIPAA regulations. Patients also have the right to privacy of their health records. A patient or their guardian must provide authorization via a HIPAA form before their health information can be shared with another individual or entity. Patient rights implemented via HIPAA regulations are vital for safeguarding patient information and access to healthcare records.

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FAQs on HIPAA Forms

What is a HIPAA Form?

A HIPAA authorization form is a privacy policy form used to attain patient authorization prior to release of personal information.

Who is covered by HIPAA Privacy Policy?

HIPAA Privacy rules came about due to a void in the healthcare system regarding privacy of patient health care information, and in giving patients the right to access their own medical records. The policy aims to protect patients, providers, and entities requesting patient information.

What would be in violation of HIPAA?

Violations of HIPAA privacy rules would include:
*Releasing or sharing patient information without proper authorization
*Exposing, storing, or discarding patient information in a way that is not in accordance with HIPAA
Healthcare practitioners found violating HIPAA regulations may face substantial consequences, such as a fine or criminal penalties.

How do I download the HIPAA form?

Scroll back up to the top of the page and click on the button - "Download Updated HIPAA Form."

Why is a dental HIPAA form necessary?

A Dental HIPAA form is necessary to attain patient authorization prior to release of personal information, in accordance with HIPAA policies.

Client Success Stories

Before using mConsent we had to find and pull patients' charts and input data, it takes a lot of time.

Stefanie Daley

Before using mConsent I had to print out the router sheet everyday and get the patient's signature, very time consuming.

ADIRA "DEE" BAILEY

Efficiency at it's finest. Easy, convenient, user friendly, patient approved... I mean the list goes on. It has drastically changed how our office functions. They have a great support team as well.
Zero complaints.

Ryan Blatchley