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Per HIPAA regulations, NMHC will not release Personal Health Information (PHI) to anyone other than the beneficiary, unless otherwise directed and authorized by the beneficiary to do so. If you would like to instruct NMHC to provide your PHI to someone other than yourself, you are required to print out and complete an Authorization for Release of Medical Information form (this requires the free Adobe Acrobat reader). Mail the completed form to: NMHC Attn: Legal Department 26 Harbor Park Drive Port Washington, NY 11050
You may also fax the completed form to: (516) 802-8095. We suggest you save a copy of all documents for your records. |
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