Your Password to Privacy: Standard Authorization Form

Your Password to Privacy: Standard Authorization Form

Your Password to Privacy: Standard Authorization Form

Blue Cross and Blue Shield of New Mexico (BCBSNM) protects its members in this same way. All members can keep their PHI safe by using a Standand Authorization Form.

Recently I called the hospital after a family member had surgery. When I reached the nurse’s station, I was asked for the patient’s password. Password? I only wanted to know how everything went. I said my name. No, not it. The patient’s name? Nope. The hospital? No. Three strikes and I was out of luck. When I asked what just happened the nurse explained this was all about guarding the patient’s protected health information (PHI). He said they only give patient PHI to those with the password the patient chose.

Using a Standard Authorization Form is always your choice. You don’t have to use it, and if you do, you can change – or cancel – your form at any time.

Completing Your Standard Authorization Form
When you’re ready, you’ll see the form has five pages. After reading all instructions, the last two pages ask you to:

Section I - Enter your information
Section II - List who can get your health information
Section III - Confirm what’s shared
Section IV - Set a timeline
Section V - Sign form to validate

Your Standard Authorization Form
A Standard Authorization Form lets you decide how BCBSNM can share your PHI. You can list all the names you’d like and set a timeline so we know when this permission ends. You can also choose what information is released.

For example, if a family member is helping with your care, you can add their names to your form. Others could be:

  • A friend
  • Your spouse
  • A lawyer

We suggest keeping a copy of your final form before mailing. You can always visit Blue Access for MembersSM (BAM) to print new copies of the Standard Authorization Form.

Do you have questions about your health insurance plan? Ask us in the comments. We might even write a blog post about it!

Most recent update: 1/25/2018