Form ODM01952 Request for Amendment to Protected Health Information (Phi) - Ohio

What Is Form ODM01952?

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 ODM01952?
A: ODM01952 is a form used to request an amendment to Protected Health Information (PHI) in Ohio.

Q: What is Protected Health Information (PHI)?
A: Protected Health Information (PHI) includes any individually identifiable health information, such as medical records or payment information, that is held or maintained by a covered entity.

Q: Who can use ODM01952?
A: Anyone who wishes to request an amendment to their Protected Health Information (PHI) in Ohio can use ODM01952.

Q: How can I use ODM01952?
A: To use ODM01952, you need to fill out the form with your personal information and the information you want to amend. Then, you must submit the form to the appropriate entity, such as your healthcare provider or insurer.

Q: Is there a fee for using ODM01952?
A: There is no fee for using ODM01952 to request an amendment to your Protected Health Information (PHI) in Ohio.