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

Kaiser HMO - HIPAA Authorization Form

DOWNLOAD

This is the Kaiser HMO - HIPAA Authorization Form.

File size: 78 K

PSW Benefit Resources - HIPAA Authorization Form

DOWNLOAD

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

DOWNLOAD

This is the Blue Cross HIPAA Authorization Form.

File size: 57 K

Delta Dental HIPAA Authorization Form

DOWNLOAD

This is the Delta Dental HIPAA Authorization Form.

File size: 14 K

Pacific Dental Benefits HIPAA Authorization Form

DOWNLOAD

This is the Pacific Dental Benefits HIPAA Authorization Form.

File size: 16 K

Website operated and maintained by PSW Benefit Resources.
Copyright (c) 2010 Peralta Benefits Information Center

Admin Login