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Disclaimer

The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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When Patient Authorization in Not Required

A healthcare practice may use or disclose protected health information without the written authorization of the individual, or the opportunity for the individual to agree or object as in the situations covered below.

When the healthcare practice is required to inform the individual of, or when the individual may agree to, a use or disclosure permitted, the provider’s information and the individual's agreement may be given orally.

Public Health Activities

    • Public Health Authority
    • Food and Drug Administration
    • Employer
    • School
    • Permitted Uses

Victims of Abuse, Neglect or Domestic Violence

    • Permitted Disclosures
    • Informing the Individual

Health Oversight Activities

    • Permitted Disclosures
    • Exceptions
    • Joint Activities or Investigations
    • Permitted Uses

Judicial and Administrative Proceedings

    • Permitted Disclosures
    • Other Uses and Disclosures

Avert a Serious Threat to Health or Safety

    • Permitted Disclosures
    • Use or Disclosure not permitted
    • Limit on Information that may be Disclosed
    • Presumption of Good Faith Belief


Law Enforcement Purposes

    • Pursuant to process and as otherwise required by law
    • Limited information for identification and location purposes
    • Victims of a crime
    • Decedents
    • Crime on premises
    • Reporting crime in emergencies

Decedents

    • Coroners and medical examiners
    • Funeral directors

Cadaveric Organ, Eye or Tissue Donation Purposes

Research Purposes

    • Board approval of a waiver of authorization
    • Documentation of waiver approval

    Specialized Government Functions

      • Military and Veterans Activities
      • National security and intelligence activities
      • Protective services for the President and others
      • Medical suitability determinations
      • Correctional institutions and other law enforcement custodial situations
      • Covered entities that are government programs providing public benefits
      • National Instant Criminal Background Check System

    Workers' Compensation


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