Member Services
OSBH Approves New Standardized Medical Authorization Form
Oklahoma City, Okla. - The Oklahoma State Board of Health has approved a new standardized medical authorization form for use in sharing patient medical information among health care providers in Oklahoma.The form was developed to meet the need for uniformity and eliminate confusion regarding the authorization of release of patient information as required by state and federal privacy and privilege laws."We are hopeful that health care providers will move quickly to use this Oklahoma Standard Authorization Form whenever they use or share protected health information," said Michael Crutcher, secretary of health and commissioner of health. While health care providers are not required to use the form, they are required to honor it. 1) Oklahoma Standard Authorization to Use or Share Protected Health Information (PHI) FORM 2) PHI PATIENT INSTRUCTIONS 3) PHI REFERENCE GUIDE & PROVIDER INSTRUCTIONS 4) PHI APPENDIX 1 - AUTHORIZATION REQUIREMENTS FOR RECORDS RELEASERecommended Companies, Benefits, Representatives
The OOA proudly recommends the following companies, benefits and representatives:
Auto & Homeowners Insurance (Group Discount Available)
Liberty Mutual
Linda Champlin
(405) 720-6083 ext 217
Linda.Champlin@LibertyMutual.com
In Tulsa:
Josh Lakey (800) 207-7001 ext 225
(918) 299-7593 ext 59396
joshua.lakey@libertymutual.com
Credit Card
Bank of America Credit Card - AOA Program https://wwwa.applyonlinenow.com/USCCapp/Ctl/entry?sc=FACDGH&mc=A000002QGM
(800) 621-1773, ext. 8139
Disability Income Insurance
Northwestern Mutual Life
David Thompson, CLU, ChFC
(479) 443-1339
david.j.thompson@nmfn.com
Securian Advisors MidAmerica Inc.
Thom Bowen, CFP, CLU, ChFC
(918) 459-9356
(800) 685-0293 ext. 236
thom.bowen@securianmidamerica.com
Kreg Callery
(918) 459-9356 ext. 267
(800) 685-0293 ext. 267
(918) 607-7066 Cell
kreg.callery@securianmidamerica.com
Electronic Medical Records
e-MDs
Scott Perkins
(888) 344-9836
info@e-MDs.com
Medappz, LLC
Brian Lichtlin
Toll Free (877) 633-2779
brian@medappz.com
Legal Advice
Ed Kelsay, JD
(405) 720-9800
Verbal advice at no charge
Written statements provided at reasonable fee
Professional Liability Insurance
Rich & Cartmill, Inc. Ross Cooper, CPCU
(918) 743-8811
(800) 725-8811
rcooper@rcins.com