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Member Rights, Responsibilities, and Privacy

  • Health Information Exchange
  • Member Rights and Responsibilities (PDF)
  • Notice of Privacy Practices (PDF)
  • Personal representative form (English) (PDF)
  • Personal representative form (Spanish) (PDF)
  • Report fraud, waste, or abuse

HIPAA Authorization

  • HIPAA Authorization Letter and Form (English) (PDF)
  • HIPAA Authorization Letter and Form (Spanish) (PDF)
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