Form F-13147 Wisconsin Medicaid HIPAA Privacy Restriction Request - Wisconsin

What Is Form F-13147?

This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form F-13147?
A: Form F-13147 is a Wisconsin Medicaid HIPAA Privacy Restriction Request.

Q: What is the purpose of Form F-13147?
A: The purpose of Form F-13147 is to request restrictions on the use and disclosure of personal health information by Wisconsin Medicaid.

Q: Who can use Form F-13147?
A: Anyone who participates in Wisconsin Medicaid can use Form F-13147 to request privacy restrictions.

Q: What information is required on Form F-13147?
A: Form F-13147 requires personal information, contact details, and a description of the requested privacy restrictions.

Q: Is there a fee for submitting Form F-13147?
A: No, there is no fee for submitting Form F-13147.

Q: How long does it take to process Form F-13147?
A: The processing time may vary, but Wisconsin Medicaid aims to respond to privacy restriction requests within 30 days.

Q: Can I revoke or modify the privacy restrictions requested on Form F-13147?
A: Yes, you can revoke or modify the privacy restrictions by submitting a new Form F-13147.