CONFIDENTIALITY AGREEMENT AND RELEASE FOR CLAIM HISTORYConfidentiality Agreement and Release • November 9th, 2015
The purpose of the Confidentiality Agreement and Release of Claim History Form is to comply with a directive from the Missouri Medical Malpractice Joint Underwriting Association (MMMJUA) that a request for release of information be HIPAA compliant regarding the confidentiality of protected health information such as may be found in a claims history. In addition the MMMJUA and its representatives should be indemnified in writing regarding the accuracy and completeness of the information they release. Most third party releases signed by physicians or risk managers do not specifically indemnify the MMMJUA and its representatives in this regard.
CONFIDENTIALITY AGREEMENT AND RELEASEConfidentiality Agreement and Release • July 9th, 2021
This Confidentiality Agreement and Release (“Agreement”) is made and entered into by and between Health Network Solutions, Inc. (“HNS”) and the undersigned participating practitioner (“Participant”), and shall be effective upon execution (“Date of Execution”) on the day and year hereinafter written, when signed by both the parties’ duly authorized representatives.
CONFIDENTIALITY AGREEMENT AND RELEASEConfidentiality Agreement and Release • January 4th, 2023
CONFIDENTIALITY AGREEMENT AND RELEASEConfidentiality Agreement and Release • May 31st, 2016
Establishes the terms and conditions under which the parties agree to exchange or disclose certain confidential information which may be confidential and proprietary and subject to restrictions on use and disclosure that are expressed in this Agreement.
