HIPAA Employee Confidentiality Agreement

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The HIPAA employee confidentiality agreement is a form used to ensure that an employee of a health organization (or other organization with access to medical records) will maintain the secrecy of the personal information they are given access to through their association with the organization. The Privacy Rule of the Health Insurance Portability and Accountability Act of 1996 requires that covered entities with access to individual’s protected health information (PHI) maintain the confidentiality of the sensitive personal and medical information. The purpose of the rule is to ensure that medical information remains protected while allowing the flow of information required to provide the highest level of healthcare. Furthermore, the confidentiality agreement limits the employee’s access to healthcare information.

Laws – 45 CFR Part 160 and Part 164

Independent HIPAA Contractor Agreement – For use between medical offices and an independent contractor that will have access to medical records.

  • Subcontractor HIPAA Agreement – For any individual or company hired by an independent contractor to assist in a project involving medical records.

Patient HIPAA Release Form – A release that allows the sharing of a patient’s medical records from one physician or hospital to another.

How to Write

Step 1 – Download in Adobe PDF, Microsoft Word (.docx), or Open Document Text (.odt).

Step 2 – The date the agreement is being entered into can be supplied first. The name of the Healthcare Facility and the name of the Employee will also be needed.

Step 3 – The State whose laws will govern the agreement must be specified.

Step 4 – The date, signature, and printed name of the employee are needed at the bottom of the form.