Form ODM01953 Request for Amendment to Protected Health Information (Phi) - Ohio

What Is Form ODM01953?

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 ODM01953?
A: Form ODM01953 is a request for amendment to Protected Health Information (PHI) in the state of Ohio.

Q: What is the purpose of Form ODM01953?
A: Form ODM01953 is used to request changes or amendments to your Protected Health Information (PHI) in accordance with Ohio laws.

Q: Who can use Form ODM01953?
A: Form ODM01953 can be used by individuals in Ohio who want to request amendments to their Protected Health Information (PHI).

Q: What information do I need to provide on Form ODM01953?
A: On Form ODM01953, you will need to provide your personal information, the specific information you want to amend, and the reason for your request.

Q: Is there a deadline for submitting Form ODM01953?
A: There may not be a specific deadline mentioned on the form, but it is generally recommended to submit your request as soon as possible.

Q: Will there be any fees associated with submitting Form ODM01953?
A: There may be fees associated with the amendment request process, such as copying or administrative fees. You may need to check the instructions on the form or contact the relevant authorities for more information.