7 Common Reasons for a Release of Information

From seeing a specialist to applying for life insurance, here are 7 common reasons you might need to fill out a release of information form.

  • There are several common reasons for a release of information, including for medical treatment purposes, medical billing, insurance billing, health studies, legal proceedings, and marketing purposes.
  • Sometimes a third party — like an insurance company or an attorney — needs to request your medical information. In that case, you’ll have to sign a release of information authorization.
A diverse group of attorneys in a law office

The HIPAA Privacy Rule

The Health Insurance Portability and Accountability Act of 1996 gives you the right to access your own medical records. On top of that, HIPAA regulations limit who can review and receive your health information. They also require security for protected health information — PHI — in electronic form. 

As a result, healthcare providers like doctors, hospitals, and pharmacies are required to follow strict regulations to protect the confidentiality of your individually identifiable health information. The same goes for other covered entities like health plans and healthcare clearinghouses, as well as business partners like release of information services that streamline the medical record fulfillment process.

For example, they have to encrypt your PHI when storing, sending, and receiving it electronically. Plus, with some exceptions, they cannot share your PHI with other parties without your permission. If a covered entity doesn’t comply with these rules, the government can levy criminal penalties against it.

Of course, there are times when you might need to provide access to your medical records. Here are seven common reasons for a medical release of information.

1. To Ensure Continuity of Care

If your doctor refers you to a specialist, that specialist will need some information about your medical history to provide you with adequate treatment. For example, if you’re suffering from back ache, they’ll want to know if you’ve ever injured your back before. Once you’ve signed a medical records release form, they can easily review your medical history. Then they can determine what kinds of tests they need to perform before giving a diagnosis and deciding on a course of treatment.

2. For Medical Billing

If you’ve received treatment at a healthcare institution, its billing department will need to know how to bill you. Let’s say the specialist sent you for X-rays for your back and determined that you needed an operation. The visit to the specialist, the X-rays, and the operation are all items that need to be paid for. So the hospital’s billing department will need to know the details about how many X-rays were taken, what kind of operation it was, and what kind of aftercare you received.

3. For Health Insurance Billing

After you’ve received care from a healthcare provider, your health insurance company will need to know the details to determine how much of the treatment costs it will cover. For instance, it might require you to pay 30 percent of the cost of the operation and aftercare out of pocket.

4. To Determine Life Insurance Premiums

If you apply for life insurance, the life insurance company could request to see your medical record to determine what risk you represent, as Investopedia explains. This will help it calculate how high your premiums need to be.

Let’s say you’re a 30-year-old woman with type 1 diabetes. The life insurance company will likely review your medical history to find out what, if any, complications you’ve experienced. It will use this information to determine how your condition impacts your life expectancy.

5. To Provide Data for Health Studies

Research institutions need data to perform health studies and develop new medications or therapies. If you participate in a clinical trial for a new drug, you’ll have to fill out a medical release of information form so your doctor can share your PHI with the researchers.

6. To Provide Data for Legal Proceedings

When attorneys prepare for legal proceedings like medical malpractice suits, they need access to patients’ PHI. Let’s say the surgeon made a mistake during your back operation and now you’re unable to walk. Your attorney will need access to the PHI in your medical file. It will enable them to build your case and demonstrate that your current condition is the direct result of the surgeon’s error.

7. For Marketing Purposes

Sometimes healthcare institutions use patients’ stories and photographs in fundraising or marketing campaigns. For instance, if you were diagnosed with leukemia and were treated successfully, the hospital might ask to use your story for its latest marketing campaign. If you agree, you’ll have to sign a release of information.

Release of Information Authorization

Under the HIPAA Privacy Rule, when a release of information is intended for purposes other than medical treatment, healthcare operations, or payment, you’ll need to sign an authorization for ROI. The healthcare organization releasing your information will check that the authorization is valid during the ROI process. For example, if your attorney needs access to your medical history to represent you in court, they’ll need an authorization that details:

  • The PHI that will be disclosed 
  • The party that’s authorized to make the disclosure — like a hospital or clinic
  • The person to whom the party may make the disclosure — in this case, your attorney
  • An expiration date or event
  • Depending on the situation, the purpose why the PHI may be released

Keep in mind, however, that if you no longer want an authorized party to have access to your PHI, you can always revoke the authorization in writing before the expiration date or event.

Further reading:

Expanding Healthcare Information Access for Patients