Tracking Details - #42

Tracking Information
Case No: 11
Order Date: 03/07/2025
Due Date: 10/11/2025
Template Packet: HIPAA Authorization Packet
Scope:
Location: CMS Centers for Medicare & Medicaid Services - New York Regional Office
26 Federal Plaza, Room 38-130
New York, NY 10278
Phone: DO NOT CALL • Fax: BULK - PATRICIA
Patient: Meryl Streep
DOB: 09/24/1975 • SSN: ***-**-3284
CMS Centers for Medicare & Medicaid Services - New York Regional Office
26 Federal Plaza, Room 38-130
New York, NY 10278
Phone: DO NOT CALL • Fax: BULK - PATRICIA
Meryl Streep
DOB: 09/24/1975 • SSN: ***-**-3284
Requested Records

No records requested.

File Name Uploaded Date Uploaded By
HIPAA_Authorization_42_20250927033916.pdf 2025-09-27
Tracking Step Log
Step Due Date Remarks Publish Entered
Generation Dept - Printed Packet 9/27/2025 Yes 9/27/2025 7:40 AM
Sent - Fax to Custodian 9/27/2025 Sent Fax to none@concordsends.com. File=D:\RecuperaRSFiles\CaseFiles\11\RequestPackets\Tracking_42_RequestPacket.pdf No 9/27/2025 7:40 AM
Fax delivery confirmed 10/15/2025 Fax delivered (manual) No 10/15/2025 7:03 PM
Assigned To: 10/17/2025 Assigned To: UserNo=1006 [INITIAL] No 10/15/2025 7:03 PM
Fax sent 11/22/2025 Fax sent [RC:2734732633007] No 11/22/2025 3:32 AM
Sent Custodian additional Fax of Request Packet Faxed Request Packet to 2122131715 (RequestNo 2136) Yes 11/22/2025 3:32 AM
Order Closed Yes 11/28/2025 2:31 PM
Assigned To: 2/5/2026 Assigned To: UserNo=1006 [INITIAL] No 2/3/2026 12:32 AM
Received - All Records Received - Records Yes 3/2/2026 4:15 PM
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