Its time to file a HIPAA complaint against the OC. Remember to attach copies of all letters you sent to the CRAs, the CA and the OC (attach green cards), the same applies for all letters you have received and their green cards.
HIPAA Complaint
Print out the PDF form, fill it out and attach the letter below with all of the info above.
HIPAA HEALTH INFORMATION PRIVACY COMPLAINT FORM
- Your full name
- Address
- City
- State
- Zip
- Phone number
- Fax number
- Email address
- Date
- ----------------------------------------------
- Name: Name of Original Health Care Provider
- Address
- Phone number
- Date of violation; Date of change of your CRA entry or Date of letter from
CRA advising of verification from OC or CA
- ----------------------------------------------
- On (date) , I (or name of patient) was provided health services by
(name of OC).
- On or about (date of violation) and subsequent to 04/13/2003 (OC)
communicated private health care information to one or more unauthorized
parties without any permissible purpose under HIPAA privacy rules, and absent
my signed authorization.
- Since there is NO balance due on this account, there is NO permitted business
purpose under the HIPAA privacy rules.
- This unauthorized dissemination of private health care information has been,
and continues to be of great detriment to my wellfare, and is a violation of
the HIPAA privacy rules.
- I have entered this complaint after exhausting all possible means of
prevailing upon (OC) to cease and desist the continued dissemination of
private health information to unauthorized parties and after (OC) has refused
my requests to comply with the privacy rules of HIPAA.
- I am including with this complaint, copies of the return receipts from (OC)
acknowledging receipt of these letters requesting compliance (copies enclosed)
- Enclosed please find the dated proof of the continued illegal dissemination
of this private health information.
- Include copy of letter from CRA stating they have verified or have investigated or have changed the
entry in ANY WAY
- Good Luck!
- If you wish to CC the OC, that's fine. Only include the above letter and PDF complaint form filled out.
