*AUTHORIZATION & CONFIDENTIALITY NOTICE*
Authorization to Release Records - By submitting a medical/billing authorization & request for records, it is understood that the requesting party is authorized to receive such records. It is understood that HCP charges for requested copies to cover the costs incurred in searching, handling, copying, and mailing documents/records. All fees are to be paid in advance, before the release of any records. Check payable to Health Claims Plus to the address above. Documents/Records will be received 7-14 days from our receipt. Attorneys should submit proof of representation with each request to include photo ID with signature of patient named in request. CONFIDENTIALITY NOTICE - This document may contain information covered under the Privacy Act, 5 USC 552(a), and/or the Health Insurance Portability and Accountability Act (PL104-191) and its various implementing regulations and must be protected in accordance with those provisions. Healthcare information is personal and sensitive and must be treated accordingly. If this correspondence contains healthcare information, it is being provided to you after appropriate authorization from the patient or under circumstances that don't require patient authorization. You, the recipient, are obligated to maintain it in a safe, secure and confidential manner. Re-discloser without additional patient consent or as permitted by law is prohibited. Unauthorized re- disclosure or failure to maintain confidentiality subjects you to application of appropriate sanction. Additionally, this electronic message and all contents and attachments contain proprietary information from Health Claims Plus, which may be privileged, confidential or otherwise protected from disclosure.The information is intended to be for the sole use of Health Claims Plus business and activities. Any disclosure, copy, disclosure. distribution or use of the message, or its contents or any of its attachments, is prohibited.