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Quality Survey!
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HIPAA
Consent |
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I understand
that Ramsey
Rehab complies
with HIPAA and
will protect my
Personal Health
Information
(PHI) and will
use it as
allowable by law
in the
treatment,
billing and
collections
pertaining to my
care. HIPAA
Policy is
available to me
in the waiting
room binder and
upon request.
I also authorize
the release of
any information
pertinent to my
case to any
insurance
company and
adjuster, or
attorney for the
purpose of
securing payment
under this
policy of
insurance or to
any medical
provider
associated with
my case to
effectively
treat me.
This
authorization is
in effect until
90 days from the
date the last
bill is
collected.
A photocopy of
this agreement
shall be
considered
effective and
valid as the
orginal. |
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Form Object |
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