Tracking Details - #124

Tracking Information
Case No: 77
Order Date: 08/25/2025
Due Date:
Template Packet: HIPAA Authorization Packet
Scope:
Location: 1199 SEIU Funds
498 Seventh Avenue
New York, NY 10018
Phone: (646) 473-9200 • Fax: Records.Retention@1199Funds.org
Patient: Brad Pitt
DOB: 11/13/2003 • SSN: ***-**-3018
1199 SEIU Funds
498 Seventh Avenue
New York, NY 10018
Phone: (646) 473-9200 • Fax: Records.Retention@1199Funds.org
Current packet matches the recommended template: HIPAA Authorization Packet.
Brad Pitt
DOB: 11/13/2003 • SSN: ***-**-3018
Requested Records
Record Status
Films Pending
Medical Pending
File Name Uploaded Date Uploaded By
HIPAA_Authorization_124_20250826172416.pdf 2025-08-26
Tracking Step Log
Step Due Date Remarks Publish Entered
Received Order, In Progress Yes 8/25/2025 4:58 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 9:24 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 9:41 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 9:45 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 9:48 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 9:58 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 10:16 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 10:23 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 10:29 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 10:43 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 10:46 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 10:51 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 10:53 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 10:59 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 11:02 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 11:43 PM
Generation Dept - Printed Packet 8/26/2025 Yes 8/26/2025 11:45 PM
Generation Dept - Printed Packet 8/27/2025 Yes 8/27/2025 12:04 AM
Generation Dept - Printed Packet 8/27/2025 Yes 8/27/2025 12:11 AM
Generation Dept - Printed Packet 8/27/2025 Yes 8/27/2025 12:13 AM
Generation Dept - Printed Packet 8/27/2025 Yes 8/27/2025 12:15 AM
Generation Dept - Printed Packet 8/27/2025 Yes 8/27/2025 4:04 AM
Generation Dept - Printed Packet 9/1/2025 Yes 9/1/2025 12:05 AM
FedEx to Custodian FedEx label saved. Tracking=794911398756; Path=D:\RecuperaRSFiles\FedExLabels\2025\09\08\label_1094_794911398756.pdf No 9/8/2025 1:10 PM
Delivered to custodian (carrier confirmed) 10/25/2025 Delivered (manual) No 10/25/2025 8:49 PM
Assigned To: 10/27/2025 Assigned To: UserNo=1005 [INITIAL] No 10/25/2025 8:49 PM
Called Facility Yes 11/28/2025 12:12 AM
Received Invoice From Custodian 2/26/2026 Yes 2/26/2026 5:01 PM
Facility invoice paid 3/9/2026 Yes 3/2/2026 12:00 AM
Loading request packet...