APPROPRIATE USE AGREEMENT

To request access to the DHMSO Provider Portal, please read the following requirements for use, complete the Contact Information section, and agree to these terms before submitting your request.

  • Protected Health Information (PHI) as defined under the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act, is any information that is acquired and/or used by DHMSO related to any patient, or health-plan beneficiary, physician, or other health care provider.
  • Confidential information may be disclosed only to persons or entities having a right to obtain access under applicable law, or whose contractual relationship with DHMSO provides for such access. Access of PHI is limited to the minimum necessary to accomplish the task or purpose for which access is authorized.
  • Medical information identifiable by patient, in addition to being confidential information, is subject to state and federal laws and regulations regarding the maintenance and confidentiality. All individuals provisioned access to this information must abide by and be bound to such laws and regulations.
  • Records or materials, whether in written or electronic form, containing confidential information, may not be removed from DHMSO systems, applications, or facilities.
  • I understand that DHMSO reserves the right to continuously monitor and audit user access, and that attempts to circumvent DHMSO security policies and procedures will constitute a violation of this agreement resulting in actions including, but not limited to, the revocation of access to the DHMSO Provider Portal or web-based forms and resources. DHMSO abides by all HIPAA requirements and failure to comply can result in civil and monetary penalties.
  • I understand that I am responsible for all account activity that occurs under my user name, and that I must log out of the DHMSO Provider Portal when I have finished accessing to prevent unauthorized access.
  • I understand that I must create a secure password that adheres to DHMSO’s complexity requirements, and that my password may not be shared with any other individual, written down, posted or stored in any written form, or stored electronically without encryption. Complexity requirements include:
    • Minimum of 9 characters
    • At least 3 of the following: Uppercase letter, lowercase letter, number or symbol
    • No part of your name or user name may be used
    • No easily guessed phrases or dictionary words
    • No reuse of last 4 passwords
  • DHMSO will be notified immediately when this access is no longer required

Contact Information / Provider Office

     
     

I have read, understand, and agree to abide by the requirements outlined above. I attest that as a provider, supervisor, manager, or administrator of this organization, I have full managerial oversight of administrative processes involving the exchange of patient information and will abide by all confidentiality requirements. I further attest that to obtain access to DHMSO’s web-based forms and other resources (e.g., Claims Look-up Took, Claims Status Look-up Tool, etc.), that I am employed or contracted with this organization and require access to DHMSO’s Provider Portal to complete my job function.

I agree to the terms and requirements as outlined above