HIPAA Authorization and Waiver

By authorizing this HIPAA release, you hereby give permission to Homethrive, Inc. (“Homethrive”) to act as your designee and to disclose any necessary information, including information that may constitute protected heath information or “PHI” under the Health  Insurance Portability  and  Accountability Act  of 1996 (“HIPAA”), to the following categories of individuals in order to assist with setting up appropriate goods and services on your behalf: Other third parties, including medical practitioners, emergency service providers, home care or ADL service providers, pharmacies, other Homethrive service providers for the sole purpose of providing services for you or your loved one, or other corporate partners of Homethrive for the purposes of securing reimbursement for the Care Recipient.  

Homethrive is authorized to identify itself as your representative and will make disclosures at your request or for the purposes described in this document. You authorize Homethrive to use all means of communication including verbal communications, fax, internet, e-mail, web-portals, electronic services and telephonic methods. You understand Homethrive is not a health care provider and does not practice medicine. This authorization will remain active for the duration of the relationship between you and Homethrive. 

If any legislation, regulation, or government policy is passed or adopted, the effect of which would cause either party to be in violation of such laws, then this authorization shall immediately terminate. 

This authorization will expire upon termination of your relationship with Homethrive, which can be done by cancelling your account as outlined in the Terms of Service or sooner if communicated to Homethrive in writing.

If you are eligible for Homethrive services through your own health plan, signing this authorization is not a condition for obtaining health plan benefits.  
The information disclosed per the authorization may be subject to redisclosure and is no longer protected by HIPAA.

You understand that you may revoke this authorization at any time in writing and understands that Homethrive does not provide medical treatment and is not a health care provider.