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HIPAA Compliance Materials
HIPAA is the acronym for the Health Insurance Portability and Accountability Act of 1996. These authorization forms will need to be completed everytime you engage our broker's services (PSW Benefit Resources) for claim or service related resolution. Please print the required document, complete it in its entirety and fax to 877-876-5667.
Downloads
 PSW Benefit Resources - HIPAA Authorization Form  
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This is the PSW Benefit Resources HIPAA Authorization Form to be used each time their services are utilized. Note: PSW Benefit Resources is Peralta's Insurance Broker.
  File size: 21 K

 Blue Cross HIPAA Authorization Form  
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This is the Blue Cross HIPAA Authorization Form.
  File size: 57 K

 CoreSource HIPAA Authorization Form  
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This is the CoreSource HIPAA Authorization Form.
  File size: 88 K

 Kaiser HMO - HIPAA Authorization Form  
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DOWNLOAD
This is the Kaiser HMO HIPAA Authorization Form.
  File size: 78 K


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