What exactly am I agreeing to here?

I filled out the paperwork for my new therapist and at the end I had to give my insurance information. At the bottom, I have to sign under:

"I AUTHORIZE any physician, medical practitioner, hospital, clinic, other medical or medically related facility, insurance or reinsuring company, the Medical Information Bureau, Inc., consumer reporting agency, employer or third party administrator having information available as to diagnosis, treatment and prognosis with respect to any physical or mental condition and/or treatment of me or my dependents and any other non-medical information of me or my dependents to give my employer, third party administrator, my third party carrier or its legal representative, any and all such information."

I understand that this is so she is paid for her services, but I don't want to sign something that allows third parties or ESPECIALLY MY EMPLOYER to receive information about my treatment. I want my medical information to remain as confidential as possible.

Also, what is this about consumer reporting agencies? What kind of information am I agreeing to be shared and with whom?!?

All of this is making me really uncomfortable! Has anyone had to sign something like this?

I authorize [the world] having information [about me and mine] to give [everyone else] all information.

I would not sign that.

"I AUTHORIZE [...] having information available as to diagnosis, treatment and prognosis with respect to any physical or mental condition and/or treatment of me or my dependents and any other non-medical information of me or my dependents to give my employer, third party administrator, my third party carrier or its legal representative, any and all such information."

I think this sounds way too all-inclusive. I definitely think you are doing right to question it. I have no legal training or experience though.

I would NOT want to sign that, since it said "consumer reporting agency, employer, insurance agency, etc. Those are NOT necessary. The ONLY ones necessary are the MEDICAL community for BILLING purposes and diagnostic purposes. I'd tell them where to stick that one. Tell them if they want something signed, to make another one up with the proper ones listed, and nothing else!

is this still the same paperwork for that same T?
no, I would not sign that. Maybe you can ask the T if you can have one appointment to talk about confidentiality and paperwork to voice your concerns.

This is a very (overly) broad form authorizing any information for you and for your dependents to be shared with your employer, your insurance company, and the company that administers your insurance plan (processes your claims, authorizes services, etc).

I doubt very much that it is HIPAA compliant because it is too broad and includes medical and non-medical categories.
http://www.hhs.gov/hipaafaq/use/index.html

and a good sample is available here: http://www.fitzharrisinsurance.com/f...-info-form.php

You do not have to use the form as printed. You can revise it and include the names of those who you are authorizing to release information as well as the names (company, doctor, hospital, etc) of those who may receive this information. You can also limit the information to the most specific information the requester needs. You can cross out, write in, or make changes in some other way. I would not sign until I was comfortable that the information is needed *at this time*, and is necessary *to making decisions about treatment*. There is nothing wrong with refusing to release information either.
Much of the information could be provided verbally during the course of treatment. If some kind of verification is being sought, the reason for the verification needs to be clear to you and acceptable to you.

That waiver sounds awfully broad to me. It also sounds like a canned waiver that is used on lots of forms. It's a "CYA" move on the part of the t. Just a guess but the employer part at the beginning might be in there for disability purposes or taking extended time off from work. Some employers require doctor's notes when people use "sick" days or request a medical leave of absence. I would ask the t to go through the statement with you and explain why each section is in there. If she won't do that, find someone else. You have a right to know what you are signing and why.

Is that the one who wants your credit card too?

Aren't you btw, sign it with your own blood and authorize her to sell your soul to the highest bidder.

I am distrustful and bit paranoid, but this sounds like sketch onion (one layer of sketchiness upon another).

Glory to heroes!

HATEFREE CULTURE

I definitely would not sign this w/o some changes or at least some clarification. I'm with venus, it's a sketch onion and appears, at face value, to go way beyond a HIPAA release.

I agree that that sounds way too broad, comprehensive, all-inclusive, and probably outside of HIPAA compliance, because it's asking you to agree to give up so much of your rights/expectations of privacy/confidentiality or be willing to potentially give them up, at any rate. Nope, don't like it and would be skeptical and questioning of it myself.

You have a right to edit the release. I've done it. At the hospital for a surgery, I was editing the release and the nurse had a FIT. She went and got the doctor. I discussed it with her and she agreed to the changes and we both initialed them.