Authorizations – Wis. Admin. Code Ins §25-73

A valid authorization to disclose nonpublic health information can be either written or in electronic format.  The authorization must include the following information:

• The identity of the consumer;
• A description of the nonpublic health information to be disclosed;
• General descriptions of the entities the insurer will disclose the information to, the purpose of the disclosure, and how it will be used;
• The signature of the consumer and date signed;

An authorization must specify the time period it is valid for.  A consumer has the right to revoke the authorization at any time.  The insurer must retain a copy of the authorization in the consumer’s record.