HIPAA Authorization Template | CMP105-1

$ 3.99

Included in these items:MORE SAVINGS

HR Policies and Procedures $ 495.00
HR Compliance Policies and Procedures Manual $ 129.99

Secure Your HR Data with the HR HIPAA Authorization Template Word


As an HR professional, you understand the importance of protecting sensitive employee information. The Health Insurance Portability and Accountability Act (HIPAA) sets strict guidelines for the handling of healthcare-related data, including employee health information. Failure to comply with HIPAA regulations can result in hefty fines and legal consequences.

The HR HIPAA Authorization Template Word from Bizmanualz provides a comprehensive solution for ensuring compliance with HIPAA regulations. This customizable template allows you to create authorization forms that meet the specific needs of your organization. The template includes all the necessary elements required by HIPAA, including:

  • Employee name and identification information
  • Description of the information to be disclosed
  • Purpose of the disclosure
  • Expiration date of the authorization
  • Signature of the employee or their authorized representative

Using the HR HIPAA Authorization Template Word is easy. Simply download the template, customize it to meet your organization’s needs, and distribute it to employees as needed. The template is compatible with Microsoft Word, making it easy to edit and print.

By using the HR HIPAA Authorization Template Word, you can ensure that your organization is in compliance with HIPAA regulations and that employee data is protected. Don’t risk the consequences of non-compliance – get the HR HIPAA Authorization Template Word today.

HIPAA Authorization Template

The HIPAA Authorization Template and the information requested should be kept in each employee record. CMP105-1 HIPAA AUTHORIZATION FORM authorizes the use or disclosure of the employee’s protected health information as described on the form. Access to employee medical records should be limited to managerial personnel with a need to know about restrictions or accommodations concerning an employee’s duties and first aid personnel where an employee’s medical condition might require special treatment.

The Benefit Coordinator should create a record or log for each set of records—medical, psychotherapy, and personnel. Names of those who accessed each set or records should be available. The patient, or employee, also has the right to know who accessed the records, when, and for what reason. To protect patient privacy, employees must take extra precautions, both in structures and in circumstances, not to inadvertently release patient information. Patients may choose to deny the provider from using their information for a variety of reasons. Patients can opt out of any portion of the notice.

HIPAA Authorization TemplateHIPAA Authorization Template Details

Pages: 01

Words: 382

Format: Microsoft Word 2013 (.docx)

Language: English

Manual: Human Resources

Category: Compliance

Procedure: Health Insurance Portability Accountability Procedure HIPAA CMP105

Type: Form



There are no reviews yet.

Be the first to review “HIPAA Authorization Template | CMP105-1”

Your email address will not be published. Required fields are marked *

You may also like…