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Where can I fill out a HIPAA authorization?

For someone else to view your health information (including claims data, dates of service, and care provided to you) you’ll have to give permission first. This is because of the Health Insurance Portability and Accountability Act or HIPAA, which protects your medical records and personal health information from being accessed by anyone else without your consent. 

Please complete the Release of Health Information Form and follow the submission instructions on the form.

If you require assistance, please contact ConciergeCare at:
ConciergeCare U.S. +1-855-773-7810 
ConciergeCare International: +1-786-453-4008 (collect)
Email: conciergecare@payerfusion.com

 

This material is for informational purposes only and is subject to change. Please refer to your Policy Terms and Conditions for a complete description of the benefits, conditions, limitations and exclusions of coverage. Products and services may not be available in all jurisdictions and are expressly excluded where prohibited by applicable law.

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