HIPAA AUTHORIZATION

 

HIPAA AUTHORIZATION

Overseas Medical Travel (Global Wellness Group, INC.) offers facilitation and logistical services with regard to aspects of medical travel. These services can include, but are not limited to sharing information provided by healthcare providers and professionals, connecting you to international hospitals and clinics, providing healthcare records to healthcare providers and physicians, booking travel arrangements, and providing logistical services. In providing these services, Overseas Medical Travel (Global Wellness Group, INC.) may collect, use, share, and exchange your health history forms and other health-related information with Your Healthcare Providers. Under a federal law called the Health Insurance Portability and Accountability Act (“HIPAA”), some of this health and health-related information may be considered “protected health information” or “PHI” if such information is received from or on behalf of Your Healthcare Providers.

HIPAA protects the privacy and security of your PHI by limiting the uses and disclosures of PHI by most healthcare providers and by health plans (called “Covered Entities”) as well as companies, like Overseas Medical Travel, that provide certain types of assistance to Covered Entities (called “Business Associates”). Under certain circumstances described in HIPAA, an individual needs to sign an Authorization form before a Covered Entity, like Your Healthcare Provider(s), can disclose protected health information to a third party.

Please review Overseas Medical Travel’s Privacy Policy for more information on how we process and share information not covered by HIPAA.

This HIPAA Authorization (“Authorization”) is to request your written permission to allow Overseas Medical Travel  to use and disclose your PHI in the same way as we use and disclose your Non-PHI. When Overseas Medical Travel acts as a Business Associate of a healthcare provider, Overseas Medical Travel requires your Authorization to be able to use and disclose your PHI in the same way it can currently use and disclose your Non-PHI when Overseas Medical Travel is not working on behalf of Your Healthcare Providers, but is instead working on its own behalf. Overseas Medical Travel relies on this Authorization, and uses and discloses PHI as described in this Authorization, when not working as a Business Associate and the HIPAA requirements that apply to Business Associates will not apply to such uses and disclosures.