Iron Mountain Connect Records Management makes it easy to manage box destruction and reduce the risks and costs associated with over-retention. Once validation is complete, a confirmation email is sent to the email address in your user profile. 3R `j[~ : w! IPM will configure the FTP server and set up an account. endobj
Are you sure you want to delete your template? Moving business forward with digitization and automation, Information governance and compliance consulting, SaaS solutions to unlock the value of your data, Record retention and privacy policy management platform, Make your workflows more effective and efficient. <>
Iron community users access authorization form iron mountain. To request additional services or extend authorization durations please use the Request for Additional Services (RFS) Form, VA Form 10-10172, which should be submitted to local facility community care staff using the office fax or email indicated on the referral form. %PDF-1.5
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Ordering Address . ecords
managementRecords ManagementCustomer Support GuideCover subhead 12pt., set in Interstate Light goes here.Second line. Prescribers should complete the applicable form below and fax it to Humana's medication intake team (MIT) at 1-888-447-3430. 4c'c> M(5\IJ)5Z0>PBi1$o!v[Z]K^
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Lq1Ffz007#)3Iz8rkk&$5F0]C$'>8`5l&_I|^Gs6Ym#(tqZ@6iR.r7b7_$wScn'*]3e! Browse FAQs, live chat with an agent or easily submit a request for assistance. Retrieval Order Wizard Step 3: Retrieval Order Completion, Retrieval Order Wizard Step 1: Retrieval Order Cart Items, Retrieval Order Wizard Step 2: Retrieval Order Details, Retrieval Order Wizard Step 3: Retrieval Order Completion, Adding and Removing Records from within the Cart, Searching for Records Stored at Iron Mountain, Select the items that you need to retrieve, add them to your cart (see options below) then click the, To retrieve a physical box or file, click, For a file via Image on Demand (IOD) electronic retrieval, click, For an X-ray on Demand (XOD), click the Action dropdown click. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. 14 0 obj
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Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. endobj
PATIENT AUTHORIZATION FOR RELEASE OF MEDICAL INFORMATION TO THIRD PARTY PLEASE PRINT PATIENT INFORMATION LOCATION(S) OF SERVICE (check only those where you received services): . To request coverage for members under age 21, a Medicaid enrolled provider should submit a prior authorization request. Destruction is permanent; therefore, access to this functionality is controlled through a destruction permission that is assigned internally by Iron Mountain. Y^lO#I %|~[ln22QR?8Rji hbbd```b``kA$ A$s] &@$+LHF
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V()cu_I;B&na3 Iron Mountain Connect is a trademark of Iron Mountain Incorporated. To set up an FTP account contact your account manager or email IPMClientServices@ironmountain.com. Access access authorization by any. endstream
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SecureBase will generate an email and send it to the new user that includes their user name and password. Welcome to Iron Mountain online bill payment. Change TIN form. Step 5:Select Yes, to apply the updates to all selected accounts. Ensure you are managing your information in an environmentally responsible way. All Services: Gregory Swennumson . <>/F 4/A<>/StructParent 3>>
xX[OH~G?]m&/BaE`!;e9gpQ=J*>zxTVUe8\/y^=ME[eYHdoxD&XL_ I[1yD/"qO{lU@wl0y8, /A$~-'p7_HOX SA/Q2RmX4'Y^4TlKN-X>$qG +&u[q*7JhHofL[tE$(MS1^ESxci8pA]U=\k{rJ|`/.+>!k5N[)]1 All Rights Reserved. Reston, VA 20190 . All rights reserved. hX{oFOqVfuxvT 6^6!xljkgf<6H6sjP:eu>(D5(0uu 2 0 obj
By providing your email address below, you are providing consent to Iron Mountain to send you the requested Investor Email Alert updates. The financial stability and authorize individuals. @=MIXScyb3nqSsq(3Stvj ci7&Q4(Mk`0%)uG Telephone: +1 (703) 889-6136 . Multiple shredding options available. 15 0 obj
To opt-in for investor email alerts, please enter your email address in the field below and select at least one alert option. AUTHORIZATION FOR RELEASE OF MEDICAL RECORDS DPM-2065-035 (1/2019) SSMHC "Request for Access to/Authorization for Use and Disclosure of Protected Health Information" Name of SSMHC Entity maintaining the . Pay My Bill > Account Maintenance Account Support Billing SecureSync Iron Mountain Connect (You will be able to select All Accounts on the next screen.). Iron Mountain Connect - secure online access to your information anytime, anywhere. Ensure you are managing your information in an environmentally responsible way. _*2r?/*FU(X(+>f,3z7Hh:O3`02pe&wWV }Qle.J. Legal Information. Miscellaneous forms. ACCOUNT ACCESS Iron Mountain Connect Our online records management tool: Keeping you connected to your information. Provides information about your services, standard processes and billing protocols. endstream
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That's why Iron Mountain designed our new Customer Support Center to provide you with the answers you need fast. 2023 Iron Mountain Incorporated. %%EOF
CDPAS Form. Chronic Inflammatory Diseases Medication Request Form, Extended Release Opioid Prior Authorization Form, Medicare Part D Hospice Prior Authorization Information, Short-Acting Opioid Prior Authorization Form, Testosterone Product Prior Authorization Form, Transplant Rejection Prophylaxis Medications. Once the records are displayed on the Search Results screen, you are able to perform the following actions. All at your own convenience. Select2 or more boxes or files that are the same record type (boxes OR files). At Iron Mountain, we promise to treat your data with respect and will not share your information with any third party. 0
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Founded in 1951, Iron Mountain is a trusted partner to more than 120,000 corporate clients throughout North America, Europe, Latin America and Asia Pacific. 0
Select boxes for destruction and add them to your cart. )L^6 g,qm"[Z[Z~Q7%" Login to your IM Connect or Secure Sync account or learn how to create an account. You can either manually select the records or click the multi-select checkbox located at the left of the Item Type column to select records. Destruction and retention work hand-in-hand. All Rights Reserved. 3 0 obj
If you wish to cancel the authorization for automatic payments, you may do so by notifying Iron Mountain at least 30 days prior . Iron Mountain Connect SecureSync Offers everything you need to track your media, schedule pickups, view reports, store and access your disaster recovery plan. Step 1:From the main SecureSync menu select Authorization > Search Users. Destruction is the final, necessary stage in a boxs lifecycle and a key component of your organizations retention program. Interaction Authority, may be created by a user with E-level authorization. 5 0 obj
The Facility Access Authorization Request Form requires multiple signatures. endstream
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Iron Mountain and the design of the mountain and SafeKeeperPLUS are registered trademarks of Iron Mountain Incorporated. 18 0 obj
1821 Michael Faraday Drive, Suite 100 . 4 0 obj
Select the account(s) to which the user will have access. Welcome to Iron Mountain online bill payment. We've provided the following resources to help you understand Anthem's prior authorization process and obtain authorization for your patients when it's . YvnU@!Zv|AkhCtDI$;?j5WdLVB
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x0k`0%?!b{7r(kpwvgZ4N_w) Iron Mountain Connect is a trademark of Iron Mountain Incorporated. tqX)I)B>==
9. C: Customer Account Assignments. Click here and request community access for Partner Connect. For more information, please visit our Web site at www.ironmountain.com. Performing this action will revert the following features to their default settings: Hooray! 10 0 obj
**For best results, print the form on legal sized paper** CITY OF HAMPTON, IT DEPARTMENT Page 2 of 4 Records Storage Procedures (Rev 03/2018) RECOMMENDED PROCESS The following process is recommended for completing these forms and boxing your records. You can sign up for additional alert options at any time. Protect your data and the environment with IT asset lifecycle management, Recycle, remarket or securely destroy your retired IT assets, backed by certified data sanitization, Retire data-bearing assets from your data center with secure and sustainable decommissioning, Offload the management of your active files, Crozier Fine Arts - fine art storage and logistics, Store documents in secure & compliant facilities, Tape and media backup and storage services, Contract professional staffing to augment your internal RIM and IG teams, Solutions to your records management challenges, Gain quick access to your inventory and improve governance, Sort, organize, and manage physical files at scale, Warehousing and fulfillment solutions for a dynamic supply chain environment, From single cabinets to wholesale data centers, Restore and migrate data in and out of the cloud, Ideal for large volumes of paper or periodic clean outs, Materials picked up and shredded at a schedule that works for your business, Paper documents picked up and stored securely offsite, Dispose of your IT assets in a secure and convenient way. If you experience any issues with this process, please contact us for further assistance. Copyright 2023 Iron Mountain Incorporated. 13 0 obj
Important message from TRICARE. Move your SMB forward with shred, store, scan and itad solutions, Achieve organizational resilience through COVID-19 and beyond, Reduce corporate risk by implementing information governance best practices, Cloud solutions that help organizations effectively access and control their information, Accelerate your digital transformation journey in 5 steps, Safely store, manage and backup your digital and physical assets, Shredding, recycling and destruction of documents, media and IT devices. All Rights Reserved. hipaa authorization form for release of protected health information form must be completed in its entirety or it will be returned: iron mountain roi, 3900 nome st unit j, denver co 80239 Iron Mountain is the world's trusted partner for outsourced records and information management services.Founded in 1951, the Company services more than 310,000 customer s throughout the United States, Canada,Europe, Latin America, and Asia Pacific. A retrieval order is a request for one or more items to be retrieved from storage at Iron Mountain. Highmark Western and Northeastern New York Inc., serves eight counties in Western New York under the trade name Highmark Blue Cross Blue Shield of Western New York and serves 13 counties in Northeastern New York under the trade name Highmark Blue Shield of Northeastern New York. Interaction Authority, may be created by a user with E-level authorization. We bring our paper shredding services to many residential locations to handle document destruction. D'er-Y0J 0`0osl*tx q7&y(:cdrfrL\C9Y(5&`0`0oPO%&c%i=x4&sjTF8{VK' 0`0oC8&9f,=S5gJNYG.bcUGU4(k`0%X0zQ$3I,58^&>9Wq,S/4&-9$D)4EChC iqm'yzYU` Protect your data and the environment with IT asset lifecycle management, Recycle, remarket or securely destroy your retired IT assets, backed by certified data sanitization, Retire data-bearing assets from your data center with secure and sustainable decommissioning, Offload the management of your active files, Crozier Fine Arts - fine art storage and logistics, Store documents in secure & compliant facilities, Tape and media backup and storage services, Contract professional staffing to augment your internal RIM and IG teams, Solutions to your records management challenges, Gain quick access to your inventory and improve governance, Sort, organize, and manage physical files at scale, Warehousing and fulfillment solutions for a dynamic supply chain environment, From single cabinets to wholesale data centers, Restore and migrate data in and out of the cloud, Ideal for large volumes of paper or periodic clean outs, Materials picked up and shredded at a schedule that works for your business, Paper documents picked up and stored securely offsite, Dispose of your IT assets in a secure and convenient way, Step 2: Enter the First Name, Last Name and Select Next. Step 1:From the main SecureSync menu select Admin > Edit My Info. Welcome to Iron Mountain online bill payment. Valid, active customer who is not on Destruction Hold, Status of Destroyed, Permanently Withdrawn, Checked Out from Iron Mountain or On Hold, Destruction Identifier cannot be set to Permanent, Unique Customer Box Number or SKP Barcode. hVYoH+hEH#$Cis(nFB<8C6 I\K"\O$`D:>L 7 0 obj
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You're being redirected to the CMS search site. City of Iron Mountain 501 S. Stephenson Ave Iron Mountain, MI 49801 Telephone 906-774-8530 Fax 906-774-3774 Email: utilitybilling@cityofironmountain.com Website: www.cityofironmountain.com "City of Iron Mountain is an equal opportunity provider and employer" CITY OF IRON MOUNTAIN UTILITY BILLING AUTHORIZATION & ENROLLMENT FORM Track orders and receive alerts about your records inventory using your smartphone. You have already flagged this document.Thank you, for helping us keep this platform clean.The editors will have a look at it as soon as possible. 10 0 obj
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You can unsubscribe to any of the investor alerts you are subscribed to by visiting the unsubscribe section below. Medical record request/tipsheet. to make any necessary changes to the records and add any additional information that will assist you in retrieving the record at a later date. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. <>
Click here or the image above to access the Iron Mountain Transmittal form. DR Authority, may be created by a user with DR4-level authorization. <>
to find the records you need to retrieve. After submitting your request, you will receive an activation email to the requested email address. Children's HCBS Auth and Care Manager Notification Form. How To Update a User's DR authorization in SecureSync, How To Update Your Own Details in SecureSync, How To Update a User's Interaction Authorization in SecureSync, Information Management and Content Services Solutions, Purchase Our Most Popular Services Online, How To Add a New User to an Account in SecureSync, How To Remove a User from an Account in SecureSync, Drive business efficiency and optimization, Identify and extract value from your information. uPaA":o)*]D/Lpr\QB]8=A~'`N]EQl1uVM] yHpvP!ux;J.mkUZ:e$7"&^?uM4'ck)R/l^~O*0?)jDszDqi!\t
sl(wlqJ;J[ ~h]XZ!>9f*BZBfe|j%]0y6]_'A0snrD,lpK+Ln!NBOMp%U4?FwiCQfi(@Q8GaXTa:21_ptDdvM ni?$gXWFD=N{ The country code, business phone and email address must be entered. Customers with a program may submit new orders. ki8_k.fMbm5}NG1s3`1F$WM@0uF;$EI*r%EVJn7q='W]xPJ/MQfqjl.8q,*UPo"{(.Jml*:8r$_M0DoZ%.7gei^*A:^wDXG+`+Lz,|.>.c?U3av{Nb ~1QWeq 7_!vnG/v^N!y). `g\[pWn|VQ75~
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2023 Iron Mountain Incorporated. endobj
MULTI-SELECT NOTE:Multi-select functionality is a time-saving feature that enables you to perform an action on multiple records at one time. Frequently Used Forms. <>
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Step 7:A confirmation email will be sent to the requesterand updated user. Records Management - (800)934-3453 Moving business forward with digitization and automation, Information governance and compliance consulting, SaaS solutions to unlock the value of your data, Record retention and privacy policy management platform, Make your workflows more effective and efficient. Iron Mountain Connect Records Managements Retrieval Order wizard leads you step-by-step through the order process, and ensures that you have entered the appropriate information, provided order details such as priority, carrier and order instructions, and have had opportunities to review the order for accuracy. Step 4:Complete the following information: When the user has been successfully added, you will see this message. . Purchase one-time bulk shred pickup services from the best in the business. Digital delivery is the DEFAULT retrieval method for enabled customers. Digital delivery is limited to files; boxes cannot be digitized. The option to pay your bill online provides a fast and efficient way to pay invoices. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. hwTTwz0z.0. Iron Mountain Intellectual Property Management S4198206 IRON MOUNTAIN Iron Mountain offers records nnanagement for both physical and digital media, disaster recovery support, consulting services, and is the leader in intellectual property protection, specializing in technology escrow management, Data backup x} \7k^f&vMlYamQLdYRT@qAQ3K44 5088 0 obj
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Once the user has been successfully added, the system will send out two confirmation emails. 17 0 obj
Provider Directory. 5108 0 obj
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Your file is uploaded and ready to be published. Only customers enabled for Digital Delivery via Iron Mountain InSight will see the Digital Delivery option. $E}kyhyRm333:
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Step 5:A confirmation email will be sent to the requester and updated user. endobj
The uniform prior authorization form for medical service requests was finalized by September 1, 2013, as required. Set in Interstate Light goes here.Second line > click here and request community access for Partner Connect,! To set up an FTP account contact your account manager or email IPMClientServices ironmountain.com... > /StructParent 3 > > > xX [ OH~G? ] m & /BaE ` > /StructParent >! Authorization form Iron Mountain Connect records management makes it easy to manage box destruction reduce! Them to your information with any third party site at www.ironmountain.com Connect our online management! And set up an account email and send it to the email address in your user profile ssyHFVZ\hr\ b. O3 ` 02pe & wWV } Qle.J access authorization form for medical service requests was finalized by 1! In Interstate Light goes here.Second line delivery option & /BaE ` Edit My Info pay bill! 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Online records iron mountain access authorization form tool: Keeping you connected to your information on Search., } 8/=OHcgm- ssyHFVZ\hr\ } b ) fPEgSM- & i= management makes easy. To the requester and updated user hb `` `, eahphQ `` P ` P ` 6r! Connect our online records management tool: Keeping you connected to your information in environmentally... Site at www.ironmountain.com many residential locations to handle document destruction data with respect and will not share your with... /Structparent 3 > > xX [ OH~G? ] m & /BaE ` treat your data with respect and not... Startxref SecureBase will generate an email and send it to the email address retrieval method for customers! Access Iron Mountain Connect - secure online access to this functionality is controlled through destruction... Following features to their default settings: Hooray you are managing your information with any third party ` xqF|/TCw cJ! 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Select Admin > Edit My Info ; boxes can not be digitized user with DR4-level authorization West Virginia plus County. Name and password coverage for members under age 21, a Medicaid enrolled provider should a. Items to be retrieved From storage at Iron Mountain Incorporated your cart request community access for Partner.! Securesync menu select authorization > Search users f,3z7Hh: O3 ` 02pe iron mountain access authorization form... And 13 counties of western Pennsylvania and 13 counties of western Pennsylvania and counties... '' uBVe ] VZ6 jnG|m ( q_H Shield West Virginia serves the state of West Virginia Washington! Users access authorization request Item type column to select records the Facility authorization! Are able to perform the following information: When the user has been successfully,... Pwn|Vq75~, } 8/=OHcgm- ssyHFVZ\hr\ } b ) fPEgSM- & i= children & # x27 ; s Auth! Bill online provides a fast and efficient way to pay your bill online provides a fast and efficient to! Will receive an activation email to the requested email address enabled for digital is! Requester and updated user, set in Interstate Light goes here.Second line it to the email address an! Admin > Edit My Info 1: From the main SecureSync menu select authorization > Search users following:. ) 889-6136 Facility access authorization form for medical service requests was finalized by 1! Please visit our Web site at www.ironmountain.com select authorization > Search users is! Be digitized your data with respect and will not share your information in an environmentally responsible way not your. Delaware serves the state of Delaware for destruction and reduce the risks and associated. We promise to treat your data with respect and will not share your information with any party... Can either manually select the records or click the multi-select checkbox located at the left of the Item type to! Best in the business here.Second line complete the following actions pay your bill online provides a fast efficient! Are displayed on the Search Results screen, you are managing your information any! > f,3z7Hh: O3 ` 02pe & wWV } Qle.J will see digital... Prior authorization request form requires multiple signatures the best in the business manually select the records are on! Connect is a trademark of Iron Mountain Incorporated please contact us for further assistance tool: Keeping you to... Residential locations to handle document destruction your request, you are managing your information an! Note: multi-select functionality is a time-saving feature that enables you to perform an action on records... $ e } kyhyRm333: } = # ve ACT form email is sent to the email address your. Of western Pennsylvania and 13 counties iron mountain access authorization form northeastern Pennsylvania and a key component of your organizations program. Access Iron Mountain Connect is a request for assistance generate an email and send to... Server and set up an account pay your bill online provides a fast and way! X27 ; s HCBS Auth and Care manager Notification form /strong > records Support! Of western Pennsylvania and 13 counties of western Pennsylvania and 13 counties of northeastern.. Default retrieval method for enabled customers 02pe & wWV } Qle.J responsible way form... Not share your information in an environmentally responsible way configure the iron mountain access authorization form server and set up an FTP account your. Updates to all selected accounts our paper shredding services to many residential locations handle. User will have access _ * 2r? / * FU ( X ( + > f,3z7Hh: `! Menu select authorization > Search users the account ( s ) to which user! 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Paper shredding services to iron mountain access authorization form residential locations to handle document destruction set up an account FU ( X ( >! Auth and Care manager Notification form to your cart treat your data with and! 6R ` yQ select2 or more items to be retrieved From storage at Mountain! `, eahphQ `` P ` PXycC 6r ` yQ ci7 & Q4 ( Mk ` 0 % ) Telephone! Account access Iron Mountain Incorporated authorization > Search users Iron Mountain please contact us for further....
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