PCFD requires a completed and signed HIPAA Compliant Authorization for Use and Disclosure Form before releasing any documents to anyone other than the patient.
You may submit your own form or download one: HIPAA ComplCompliant Authorization for Use and Disclosure Form.
- Complete an authorization form in its entirety.
- Please ensure the form is signed and dated by the patient or patient representative.
- If a patient representative signs the form, please ensure any necessary legal documents accompany the request (ex., Executor of Estate).
- Submit request via ChartSwap.com using the following steps:
- Register at http://www.chartswap.com/register as a Record Requestor
- Sign in and Search for a Provider, Enter Request Details, then Upload Supporting Documents.
- Once your request has been reviewed and records are available, you will receive a notification and invoice which you can pay with a check or credit/debit card.
- Please contact ChartSwap directly at 855-879-7927 if you need to register more than one user or if you would like to schedule training.
*Please allow up to 15 days to process and fulfill the request. If you have any questions, please contact PCFD at 303-838-5853.
*Attorney (or other 3rd Party) Requests for Billing Records received via email, fax, or mail, will be uploaded to ChartSwap and worked accordingly. Requesting outside of ChartSwap could result in further delay of fulfillment of your request.