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.
Q: What is Form ODM03398?
A: Form ODM03398 is a request for an accounting of disclosures of protected health information (PHI) made by a covered entity in Ohio.
Q: Who should use Form ODM03398?
A: Form ODM03398 should be used by individuals in Ohio who want to request an accounting of disclosures of their protected health information by a covered entity.
Q: What is an accounting of disclosures?
A: An accounting of disclosures is a record of instances where a covered entity has disclosed an individual's protected health information to third parties.
Q: Why would someone request an accounting of disclosures?
A: Someone may request an accounting of disclosures to have a better understanding of who has accessed their protected health information and for what purpose.
Form Details:
Download a fillable version of Form ODM03398 by clicking the link below or browse more documents and templates provided by the Ohio Department of Medicaid.