Website HIPAA Statement
The Health Insurance Portability and Accountability Act, also known as HIPAA, was created in 1996 by the US Congress to protect the privacy of your health information. The act prohibits your health care providers from releasing your health care information unless you have provided your health care provider with a HIPAA release form.
You have almost certainly signed a HIPAA agreement with your doctor. In order for you to take advantage of the Annual Wellness Visit with the assistance of AWVSolution.com, we ask you to complete a “HIPAA Release of Information Authorization Form” with BeneMedical, LLC and AWVSolution.com as well.
We at BeneMedical, LLC are committed to maintaining the privacy and security of our customers’ personal information. BeneMedical, LLC wants to assure you of our commitment to privacy and security. Your participation with us is voluntary and you may opt out of our program either before or after you begin the Health Risk Assessment.
We use state-of-the-art, secure technology. Our website and all data are maintained within an encryption protected digital environment. Our electronic communications are encrypted and secured with industry-leading certification protocols. All of our data storage and email are fully compliant with HIPAA regulations.
So you may fully understand your privacy rights, a copy of our HIPAA release is provided below:
HIPAA Release of Information AUTHORIZATION FORM
By selecting “Agree,” below I hereby authorize BeneMedical, LLC and its affiliates, its employees and agents, to release to my personal healthcare provider as identified by me on this website, AWVSolution.com, my personal health information maintained by BeneMedical, LLC and its affiliates, its employees and agents, and identified by my unique identifier as provided by AWVSolution.com. I further authorize BeneMedical, LLC to release, at my specific instruction, from time-to-time, e-mails containing my personal health information to be sent to certain individuals and/or healthcare providers, whom I will identify at my sole discretion. I understand that any personal health information or other information released to the person or organization identified above may be subject to re-disclosure by such person/organization and may no longer be protected by applicable federal and state privacy laws.
In the event of discovery of a breach of my protected health information, I understand BeneMedical, LLC will notify me by e-mail; my acknowledgement below includes my agreement to receive such notices electronically. If I wish to be notified of a breach of my protected health information in written form by first-class mail, I will notify BeneMedical, LLC by sending my mailing address to: email@example.com. I further understand that BeneMedical, LLC will notify me according to the procedures outlined in their Privacy Notice included herewith and otherwise approved by me.
This authorization is effective from the time of my selection of “Agree” below until I revoke this authorization by providing written notice to BeneMedical, LLC at 402 Central Avenue, Suite 207, Laurel, MS 39440. I also understand that I have a right to have a copy of this authorization which I may receive by selecting “Print” below. I further understand that this authorization is voluntary and that I may refuse to acknowledge this authorization. Such refusal will preclude from my participation in the AWVSolution.com Annual Wellness Visit program.