Privacy and HIPAA Resources

HIPAA Policies

For more information send us an email or phone 619-515-4243.

HIPAA, Privacy Rules

•  Individual Access to Protected Health Information in the Designated Record Set (HHSA-L-1)
  • Request for Access and/or Copy of Protected Health Information (Form 23-01) Spanish
  • Granting of Request for Access to Protected Health Information (Form 23-02)
  • Denial Letter Template (Reviewable Grounds)
  • Denial Letter Template (Unreviewable Grounds)
•  Request For Amending Protected Health Information (HHSA-L-2)
  • Request for Modification/Amendment of Protected Health Information (Form 23-03) Spanish
  • Denial Letter Template for Requests to Amend PHI
•  Accounting of Disclosures of Protected Health Information (HHSA-L-3)
  • Report of Disclosure of Patient Information For Accounting (Form 23-04)
  • Request for Accounting of Disclosure of Protected Health Information (Form 23-05) Spanish
•  Requests For Restriction of Uses & Disclosures For Treatment, Payment, & Healthcare Operations
  (HHSA-L-4)
  • Request for Restrictions on Uses and Disclosures of Protected Health Information (Form 23-06) Spanish
  • Denial Letter Template of Request for Restrictions
•  Request for Confidential Communication (HHSA-L-5)
•  Providing the Notice of Privacy Practices (HHSA-L-6)
•  Disclosures to the Secretary of the United States Department of Health and Human Services (HHSA-L-7)
•  Use & Disclosure of Protected Health Information to Carry Out Treatment, Payment, and Health Care Operations(HHSA-L-8)
•  Authorization For Use & Disclosure of Protected Health Information (HHSA-L-9)
  • Authorization to Use or Disclose Protected Health Information (Form 23-07) Spanish
  • Revocation of Authorization to Use or Disclose Protected Health Information (Form 23-08) Spanish
•  Use & Disclosure of Psychotherapy Notes (HHSA-L-10)
•  Facility Directories (HHSA-L-11)
•  Disclosure of Information to Family Members and Friends of A Patient(HHSA-L-12)
•  Uses and Disclosures for Which An Authorization or Opportunity to Agree or Object Is Not Required
  (HHSA-L-13)
•  Fundraising (HHSA-L-14)
•  Marketing (HHSA-L-15)
•  Minimum Necessary Uses of Protected Health Information (HHSA-L-16)
•  Minimum Necessary Disclosures of Protected Health Information (HHSA-L-17)
•  Complaint Process for Privacy Issues (HHSA-L-18)
  • Protected Health Information (PHI) Privacy Complaint Filing Form (Form 23-09) Spanish
•  Non-Retaliation Against Patients or Workforce Members and Others Who Report Privacy Violations
  (HHSA-L-19)
•  Clerical & Copy Fees for Protected Health Information (HHSA-L-20)
•  Limited Data Sets and De-Identification of Protected Health Information (HHSA-L-21)
•  Privacy Training (HHSA-L-22)

For more information send us an email or phone 619-515-4243.