|
|
WHIP107 Patient Request To Inspect/Review PHI
Click image to enlarge
P R O D U C T D E T A I L S |
Product Info: | Health Portability and Accounting Act (HIPAA) form that meets the Protected Health Information (PHI) requirements.
The patient that request to inspect or review protected health information will be asked to complete this form that requires the patient to provide information reguarding which information and/or dates are being requested. The form, retained in the patient's medical record, also allows you to record when and how the records are reviewed, if the review is denied, the reason for the denial or the denial notification date. |
P R O D U C T P R I C I N G |
|
Parts |
Quantity |
1 |
100 | 20.00 | 200 | 39.00 | 300 | 63.00 | 400 | 69.00 | 500 | 87.00 | 600 | 103.00 | 700 | 121.00 | 800 | 120.00 | 900 | 135.00 | 1000 | 149.00 | 1100 | 165.00 | 1200 | 166.00 | 1300 | 180.00 | 1400 | 193.00 | 1500 | 205.00 |
|