We’ve made the process simple if you would like us to share your health information with someone other than yourself. By completing the Authorization for Disclosure of Protected Health Information form, you can specify what information we share and with whom.
Who can you authorize?
You can authorize anyone you choose—a friend, family member, employer, or potential employer. This ensures that the relevant individuals can access the information they need.
How to complete the process
- Access the form: You can fill out the Authorization for Disclosure of Protected Health Information form online or via Quartz MyChart.
- Specify your preferences: Clearly indicate the information you want to share and the person you’re authorizing to receive it.
- Submit the form: Once complete, return the form to Quartz.
Once we receive and process your authorization, we’ll update your account to include your outlined permissions. This means that the person you designated can access the requested information.
Can we release protected health information (PHI) without a member’s authorization?
There are specific circumstances under which we can disclose PHI without a member’s consent, including:
- Parents of a minor after verifying the parent’s identity and if permitted under the law.
- Health Insurance Portability and Accountability Act (HIPAA) enforcement purposes.
- For Quartz’s payment and health care operations purposes.
- When required by law (for example, a court order requires it).
Questions?
If you have any questions about the process, feel free to contact us for assistance. Your health information is important, and we want to help you share it safely and securely.
