Form IHS-917 Request for Correction / Amendment of Protected Health Information

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Form IHS-917 Request for Correction / Amendment of Protected Health Information

What Is Form IHS-917?

This is a legal form that was released by the U.S. Department of Health and Human Services - Indian Health Service on April 1, 2009 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the Form IHS-917?A: The Form IHS-917 is used to request correction or amendment of protected health information.

Q: What is protected health information?A: Protected health information refers to any information related to an individual's health or healthcare that is protected under HIPAA.

Q: Who can use the Form IHS-917?A: Any individual who believes their protected health information is inaccurate or incomplete can use the Form IHS-917 to request correction or amendment.

Q: How can I submit the Form IHS-917?A: The Form IHS-917 can be submitted to the health information management department of the healthcare provider or health plan that holds the individual's health records.

Q: What information should be included in the Form IHS-917?A: The Form IHS-917 should include the individual's contact information, a description of the information to be corrected or amended, and the reason for the correction or amendment request.

Q: What happens after submitting the Form IHS-917?A: After submitting the Form IHS-917, the healthcare provider or health plan will review the request and respond within a specified timeframe as required by HIPAA.

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Form Details:

  • Released on April 1, 2009;
  • The latest available edition released by the U.S. Department of Health and Human Services - Indian Health Service;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form IHS-917 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the U.S. Department of Health and Human Services - Indian Health Service.

Download Form IHS-917 Request for Correction / Amendment of Protected Health Information

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