Which block requires the patient's authorization to release medical information to process a claim?

• A. Block 12
• B. Block 4
• C. Block 7
• D. Block 9

Answer: (A)

The key idea is obtaining consent to release protected health information for claims processing. Block 12 is the place on the form where the patient or an authorized person signs to authorize the release of medical information needed to process the claim. This signature gives permission for the provider to disclose PHI (such as diagnoses, dates of service, and billing details) to the payer so the claim can be reviewed and adjudicated. Other blocks collect demographics and policy information, but they don’t capture the authorization to release information. That signed authorization in this block ensures compliance with HIPAA requirements when information is being shared for billing purposes.