Insurance Form Description Of Authority Or Personal Representative

Subject to certain exceptions the privacy rule at 45 cfr 164 502 g requires covered entities to treat an individual s personal representative as the individual with respect to uses and disclosures of the individual s protected health information as well as the individual s rights under the rule.

Insurance form description of authority or personal representative. This provision applies to persons with legal guardianship power of attorney or other documented legal authority to act on behalf of a member. Description of personal representative s authority specialty pharmacy consent this acknowledges that my physician has prescribed medication s for me and that bioplus specialty pharmacy services inc. And their network of pharmacies medscripts medical pharmacy river medical pharmacy or route 300 medical pharmacy each pharmacy will. A duly appointed personal representative is a fiduciary standing in a position of trust to the estate and its beneficiaries and is personally responsible to the creditors including the taxing authorities and beneficiaries of the decedent s estate for a proper administration.

The personal representative stands in the shoes of the individual and has the ability to act for the individual and exercise the individual s rights. Personal representative request form this form identifies a person who has legal authority to act on a member s behalf in making decisions related to the member s health care. Personal representatives serve as fiduciaries of the beneficiaries.