Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Univera Healthcare before sending sensitive documents. FaxFlow is not affiliated with this organization.
Univera Healthcare fax number
(315) 671-7079
Privacy/PHI (PHI authorization)
Used for: Submitting and processing authorization to disclose protected health information (PHI); often used to authorize release of medical records or HIV-related information.
Fax destination details
- Department
- Privacy/PHI (PHI authorization)
- Purpose
- Submitting and processing authorization to disclose protected health information (PHI); often used to authorize release of medical records or HIV-related information.
- Form
- Authorization Release Form (PHI) — Authorization to Disclose Protected Health Information (PHI)
- Address
- P.O. Box 211256, Eagan, MN 55121
- Voice phone
- 1-800-499-1275
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Complete Parts A–E on the form (member data, recipient, information to disclose, and signatures); return to Univera Healthcare by mail or fax. For NY HIV-related releases, a separate NY form is required as indicated on the form.
Review official form instructionsSources and verification
FaxFlow records the public sources found during directory research. A source link is useful evidence, but it is not a guarantee that a number still reaches the same team.
No public source link was saved with this record. Confirm the number directly with the organization before using it.