Form F-13153 HIPAA Privacy Authorization for Use or Disclosure - Wisconsin Chronic Disease Program (Wcdp) - Wisconsin

What Is Form F-13153?

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-13153?
A: Form F-13153 is the HIPAA Privacy Authorization for Use or Disclosure form.

Q: What is HIPAA?
A: HIPAA stands for the Health Insurance Portability and Accountability Act, a federal law that protects the privacy of personal health information.

Q: What is the Wisconsin Chronic Disease Program (WCDP)?
A: The Wisconsin Chronic Disease Program (WCDP) is a program that provides financial assistance to Wisconsin residents with certain chronic diseases to help them pay for their medical expenses.

Q: Why is Form F-13153 used for the WCDP?
A: Form F-13153 is used in the WCDP to obtain authorization from individuals to use or disclose their personal health information for purposes related to the program.

Q: Who needs to complete Form F-13153?
A: Individuals participating in the WCDP who wish to authorize the use or disclosure of their personal health information need to complete Form F-13153.

Q: What information is required on Form F-13153?
A: Form F-13153 requires the individual's name, contact information, the purpose of the disclosure, and a signature to authorize the use or disclosure of personal health information.

Q: Is completing Form F-13153 mandatory for participation in the WCDP?
A: Yes, completing Form F-13153 is mandatory for individuals who wish to authorize the use or disclosure of their personal health information in the WCDP.

Q: Can Form F-13153 be used for other purposes outside of the WCDP?
A: No, Form F-13153 is specifically designed for use in the Wisconsin Chronic Disease Program (WCDP) and cannot be used for other purposes.

Q: Is the information on Form F-13153 protected under HIPAA?
A: Yes, the information on Form F-13153 is protected under HIPAA and will be treated confidentially and securely.