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Primary Account - 1/5
Click here if you are a Healthcare Provider:
Industry:
Financial Services
Healthcare - Ambulance
Healthcare - Billing Service
Healthcare - Clinics
Healthcare - Health System
Healthcare - Home Health
Healthcare - Hospital
Healthcare - Medical and Diagnostic Laboratories
Healthcare - Nursing and Residential Care
Healthcare - Other Physician Support Services
Healthcare - Social Assistance
Insurance - Health & Medical
Insurance - Life
Insurance - Other
Law Firm
Law Firm - Non-Profit
Other General
Other Professional Services
Public Service
Release of Information Vendor
Record Retrieval
Government
Number of employees:
1-25
26-100
101-500
500-2000
2000+
Telephone:
Fax number:
Address - 2/5
Your Information - 3/5
Letter Of Representation - 4/5
What is the Letter of Representation?
This letter establishes a chain of authority for hxe to receive PHI based on an authorization your organization has. The HIPAA authorization allows your organization to receive PHI. The Letter of Representation allows hxe to receive that PHI on your behalf.
Without this, hxe would not be able to receive PHI on your behalf.
View Default Rep Letter
You can upload your own once your account is setup under your Organization Profile section.
Initials:
Agree (required):
Confirmation - 5/5
Your account is ready to be setup, just press "Sign Up" and you will get a confirmation email to verify your account.
By signing up, you agree to hxe's
Terms of Service.
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