Authorization to Disclose and Release PHI
Health care information is protected by both federal and state law. For any information to be released, clients must give their written permission. For those clients who are having their sessions paid for by a third party, such as a church or friend of the family, permission must be given for MCO to release and discuss billing information. The following release authorizes MCO to release and discuss that billing information to the 3rd party person designated. No other information about the counseling will be provided to this 3rd party.