President Bill Clinton signed The Health Insurance Portability and Accountability Act into law on Aug 21, 1996. To illustrate more, it promises to protect a patient’s medical records and other related sensitive pieces of information. It also ensures a protected and secure flow of individual information in order to provide the best healthcare service. And you can protect the shared documents by using a HIPAA-compliant Fax Cover Sheet. Although it's not mentioned directly in the HIPAA rules but not adding a cover sheet may lead to external factors resulting in violation of other rules.

The HIPAA Fax Cover Sheet should contain the following:

  • HIPAA Fax Disclaimer
  • Date and Time of sent Fax
  • Fax number and Name of the Receiver
  • Company’s Name, Number, and Name of the Sender
  • Name of the Patient and their Reference number (if required)

A HIPAA-compliant Fax Cover Sheet must contain a disclaimer indicating that the documents contain Protected Health Information or PHI/ePHI. And, it should also contain a warning for the unintended receiver. PHI is an individual's health information. And, to be specific if it contains one of the 18 listed identifiers. So, any person who gets hold of such documents or information is legally responsible for its disclosure. Furthermore, an ePHI is just an electronic version of PHI that is stored in a hard drive or any other device.

Here is a sample format of a HIPAA Fax Cover Sheet:

To,


Name:

Phone:

Organization:

Fax:

From,


Name:

Phone:

Organization:

Fax:


Pages: (Including Cover Sheet)

Comments:


Disclaimer: The information contained within these documents is protected under the federal Health Insurance Portability & Accountability Act (HIPAA) privacy rule. And it’s intended for the addressed individual. Additionally, the documents may contain private and sensitive information that should not be disclosed or shared under any circumstances.

If you have received this by accident, you must contact the sender’s number and discuss the return process. Additionally, any damages to the documents may result in legal action.

So, if you are in charge of sending such confidential healthcare documents, it’s important to add a fax cover sheet that is in compliance with the privacy rules. You can either use the templates available in Microsoft Word Office or download them from the internet and edit accordingly. Make sure it contains a disclaimer or a confidentiality notice.

Now, the question is, why do you need to add a HIPAA-compliant fax cover sheet? And the answer is, in order to protect an individual’s information. Also, you should make sure of the following safety checkpoints:

  • Fax numbers of both the sender and receiver should be verified
  • The Fax machine used to send the documents should be in a secure place
  • Informing the receiving party that an important document is on the way is also a good safety measure
  • And the cover sheet must contain a notice that conveys the importance of the documents and implications in case of any wrongful disclosure.

Furthermore, the actions mentioned below can lead to legal action against you:

  • Disclosure or Wrongful access to PHI
  • Acquiring PHI using a false claim
  • Utilizing PHI for profit

Hopefully, the information and resources provided here will be helpful.

HIPPA Fax Cover Sheet
JPG PDF