Form ODM10221 Standard Authorization Form - Ohio

What Is Form ODM10221?

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 the ODM10221 Standard Authorization Form?
A: The ODM10221 Standard Authorization Form is a standardized authorization form used in Ohio for the release of medical records.

Q: Who uses the ODM10221 Standard Authorization Form?
A: The ODM10221 Standard Authorization Form is used by individuals in Ohio who need to authorize the release of their medical records.

Q: What information is included in the ODM10221 Standard Authorization Form?
A: The ODM10221 Standard Authorization Form includes information such as the patient's name, date of birth, health insurance information, the purpose of the release, and the entities authorized to receive the records.

Q: Can the ODM10221 Standard Authorization Form be used for multiple purposes?
A: Yes, the ODM10221 Standard Authorization Form can be used to authorize the release of medical records for multiple purposes, such as for treatment, payment, and healthcare operations.

Q: Is the ODM10221 Standard Authorization Form specific to Ohio?
A: Yes, the ODM10221 Standard Authorization Form is specific to Ohio and may not be valid in other states.

Q: Are there any fees associated with submitting the ODM10221 Standard Authorization Form?
A: Fees for releasing medical records may vary depending on the healthcare provider or facility. It is best to inquire about any associated fees when submitting the form.

Q: How long does it take for medical records to be released after submitting the ODM10221 Standard Authorization Form?
A: The time it takes for medical records to be released can vary. It is recommended to contact your healthcare provider or medical records department for more information on the timeline.