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Form ODM03398 Request for Accounting for Disclosure of Protected Health Information - Ohio
What Is Form ODM03398?
This is a legal form that was released by the Ohio Department of Medicaid - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form ODM03398?A: Form ODM03398 is a request for an accounting of disclosures of protected health information (PHI) made by a covered entity in Ohio.
Q: Who should use Form ODM03398?A: Form ODM03398 should be used by individuals in Ohio who want to request an accounting of disclosures of their protected health information by a covered entity.
Q: What is an accounting of disclosures?A: An accounting of disclosures is a record of instances where a covered entity has disclosed an individual's protected health information to third parties.
Q: Why would someone request an accounting of disclosures?A: Someone may request an accounting of disclosures to have a better understanding of who has accessed their protected health information and for what purpose.
Form Details:
- Released on June 1, 2021;
- The latest edition provided by the Ohio Department of Medicaid;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form ODM03398 by clicking the link below or browse more documents and templates provided by the Ohio Department of Medicaid.
