Form ODM10159 Privacy Board - Application for Waiver or Alteration of Authorization - Ohio

What Is Form ODM10159?

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 ODM10159?
A: Form ODM10159 is the Privacy Board Application for Waiver or Alteration of Authorization in Ohio.

Q: What is the purpose of Form ODM10159?
A: The purpose of Form ODM10159 is to request a waiver or alteration of authorization for the use and disclosure of protected health information.

Q: Who can use Form ODM10159?
A: Form ODM10159 is used by individuals or entities in Ohio who need to request a waiver or alteration of authorization.

Q: What information is required in Form ODM10159?
A: Form ODM10159 requires information such as the reason for the waiver or alteration request, the specific protected health information involved, and any potential risks or benefits.

Q: Are there any fees associated with Form ODM10159?
A: There are no fees associated with submitting Form ODM10159.

Q: How long does it take to process Form ODM10159?
A: The processing time for Form ODM10159 may vary, but the Ohio Department of Medicaid aims to review and respond to requests in a timely manner.

Q: Who should I contact if I have questions about Form ODM10159?
A: If you have questions about Form ODM10159, you can contact the Privacy Board at the Ohio Department of Medicaid for assistance.