Request Data Deletion

This page is the form for exercising the right described in the HIPAA notice: asking IM65 to delete or redact protected health information it holds about you, under 45 CFR 164.526.

It asks for the type of record — a Scope of Appointment record or a doctor referral record — and that record's ID number, then your name, email, phone and the reason for the request. Submitting it returns a reference number. The Privacy Officer reviews the request, verifies your identity and your relationship to the record, processes the deletion or redaction, and notifies you of the outcome in writing within thirty days.

Read the limit before you file. Some records cannot be removed outright, because retention is required of us: Scope of Appointment records must be kept for ten years under CMS rules, and audit logs for six years under HIPAA. Where that applies, your identifying details are redacted and the empty record structure is kept. So the honest answer to "will it all be gone" is sometimes no, and the page says so rather than promising otherwise.

Note also what it does not cover. It handles those two record types, so it is not a general account-closure form, and it neither quotes coverage nor cancels a policy — a carrier handles that directly.