Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
WHO WE ARE
This Notice describes the privacy practices of Amend Healthcare. References to “Amend Healthcare,” “we,” “us,” or “our” in this Notice includes all of our facilities.
PROTECTED HEALTH INFORMATION
The privacy of your protected health information is important to us. We are required by federal and state laws, including, but not limited to, the Health Insurance Portability and Accountability Act (“HIPAA”), to protect the privacy of your protected health information. HIPAA provides for protection of your personal health information that we collect or obtain in providing services to you. The term “protected health information” refers to information which can be used to identify you, and which relates to your past, present or future medical condition, the provision of health care to you, or the payment for health care provided to you.
Federal and state laws impose certain obligations and duties upon us as a covered health care provider with respect to your protected health information:
- We are required by law to maintain the privacy and security of your protected health information
- We must provide you with notice of our legal duties and privacy practices with respect to the use and disclosure of your protected health information
- We will notify you if a breach occurs that may have compromised the privacy or security of your protected health information
- We will not use or share your protected health information other than as described in this Notice unless
you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information visit: https://www.hhs.gov/hipaa/for-individuals/notice-privacy-practices/index.html
HOW YOUR PROTECTED HEALTH INFORMATION MAY BE USED AND DISCLOSED
There are a number of purposes for which it may be necessary for us to use or disclose your protected health information. For some of these purposes, we are required to obtain your consent. In other specific instances, we may be required to obtain your individual authorization. And in a limited number of circumstances, we will be authorized by law to disclose your protected health information without your consent or authorization. A description of these uses and disclosures follows below. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
Uses and Disclosures Without Your Authorization for Purposes of Treatment, Payment, and Health Care Options
Treatment: We may use or disclose your protected health information for treatment purposes. For example, we may use or disclose protected health information about you when you need a prescription, lab work, an x-ray, or other health care services. It may be necessary for various personnel involved in your care to have access to your protected health information to provide you with quality care. This may also include communicating with other health care providers regarding your treatment and coordinating and managing the delivery of health services with others.
Payment: Your protected health information may be used or disclosed for payment purposes so that treatment and services provided by us may be billed and collected from you, your insurance company, or other third-party payor. For example, a bill may be sent to you or a third-party payer. We may disclose your information to your health insurance carrier to obtain prior approval for a service, or to your health insurance carrier upon its request for additional information necessary for it to determine whether a service is covered. We may also release your protected health information to another health care provider or individual or entity covered by the HIPAA regulations who has a relationship with you for their payment activities.
Health Care Operations: We may use or disclose protected health information about you to allow us to perform business functions. These uses and disclosures are necessary to run our practice and make sure that all of our clients receive quality care. For example, we may use and disclose health information in an accounting audit of our practice, in training new staff, or in conducting quality improvement activities. We may use and disclose health information to business associates or organized healthcare arrangements or accountable care organizations. We may use health information to review our services and to evaluate the performance of our staff in caring for you. We may also combine health information about many clients to decide what additional services we should offer, what services are not needed, whether certain new treatments are effective, or to compare how we are doing with others and to see where we can make improvements. We may remove information that identifies you from this set of health information so others may use it to study health care delivery without learning the identities of our specific clients.
Health-Related Services and Treatment Alternatives: We may use and disclose health information to tell you about health-related services or recommend possible treatment options or alternatives that may be of interest to you. Please let us know if you do not wish us to send you this information, or if you wish to have us use a different address to send this information to you.
Uses and Disclosures Without Your Authorization for Purposes of Treatment, Payment, and Health Care Options
As Required by Law: We may share your protected health information without your authorization as required or permitted by state or federal laws that may include but not limited to public health activities, legal proceedings or court order, law enforcement, organ donation, suspected abuse, neglect, or domestic violence, medical examiner/coroners, funeral director, special government functions, and workers compensation claims.
Public Health: We may share your protected health information for certain public health purposes. These purposes generally include, but are not limited to, the following:
- to prevent or control disease, injury, or disability
- to report deaths;
- to report reactions to medications or problems with products
- to notify people of recalls on products they may be using;
- to notify a person or organization required to receive information on FDA-regulated products; and
- to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
Abuse and Neglect: We may disclose your protected health information for the purpose of reporting abuse and neglect to public health authorities or other government authorities authorized by law to receive such reports.
Health Oversight Activities: We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Respond to Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
Law Enforcement: We may release health information if asked to do so by a law enforcement official:
- in reporting certain injuries, as required by law, such as gunshot wounds, burns, or injuries to perpetrators of crime;
- in response to a court order, subpoena, warrant, summons or similar process;
- to identify or locate a suspect, fugitive, material witness, or missing person limited to the name, address, date or place of birth, social security number, blood type or rh factor, type of injury, date and time of treatment and/or death (if applicable), and a description of distinguishing physical characteristics;
- about the victim of a crime, if the victim agrees to disclosure or, under certain limited circumstances, we are unable to obtain the person’s agreement;
- about a death we believe may be the result of criminal conduct
- about criminal conduct at our facility; and
- in emergency circumstances to report a crime; the location of the crime or victims; or the identity, description, or location of the person who committed the crime.
Coroners, Health Examiners and Funeral Directors: We may release health information to a coroner, health examiner, or funeral director. For example, to identify a deceased person or determine the cause of death.
For Research: Under certain circumstances, we may use and disclose your protected health information for research purposes. Research projects that use protected health information must meet stringent laws and requirements through special approval processes. Before we use or disclose health information for research, the project will have been approved through this research approval process; but we may disclose health information about you to people preparing to conduct a research project.
To Avert a Serious Threat to Health or Safety: We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety, or the health and safety of the public or another person. Any disclosures, however, would only disclose information to someone able to help prevent the threat.
Military and Veterans: If you are a member of the armed forces or separated/discharged from military services, we may release health information about you as required by military command authorities or the Department of Veterans Affairs as may be applicable. We may also release health information about foreign military personnel to the appropriate foreign military authorities.
National Security and Intelligence Activities: We may release health information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Protective Services for the President and Others: We may disclose health information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release health information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.
Workers’ Compensation: We may release health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Fundraising: Your Protected Health Information may be used to contact you for fundraising purposes. We never share or sell your information for marketing or fundraising activities unless you give us written permission. You have the right to opt out of receiving communications for fundraising purposes. Please notify us in writing if you do not wish to be contacted for fundraising activities.
Uses and Disclosures Which Require Your Authorization
Uses and Disclosures You Specifically Authorize: You may give us written authorization to use your protected health information or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it in writing at any time. If you revoke your authorization, we will stop using or disclosing your protected health information; however, your revocation will not affect any uses or disclosures permitted by your authorization while it was in effect.
Psychotherapy Notes: We must obtain an authorization for any use or disclosure of psychotherapy notes, except in limited circumstances as allowed or required by law.
Marketing: We must obtain an authorization for any use or disclosure of protected health information for marketing (as defined under HIPAA), except if the communication is in the form of a face-to-face communication made by us to an individual, or a promotional gift of nominal value provided by us. If the marketing involves financial remuneration (as defined in paragraph (3) of the definition of marketing at 45 C.F.R. § 164.501) to us from a third-party, the authorization must state that such remuneration is involved.
Sale of Protected Health Information: Except in limited circumstances covered by the transition provisions in 45 C.F.R. § 164.532, we must obtain an authorization for any disclosure of protected health information which is a sale of protected health information (as defined in 45 C.F.R. § 164.501). Such authorization must state that the disclosure will result in remuneration to Amend Healthcare.
Other Uses and Disclosures. Other uses and disclosures of your protected health information not covered in this Notice will be made only with your written authorization. If you give us an authorization, you may revoke it in writing at any time. If you revoke your authorization, we will stop using or disclosing your protected health information; however, your revocation will not affect any uses or disclosures permitted by your authorization while it was in effect.
Right to Access and Copy Your Protected Health Information. You have the right to access and receive a copy or a summary of your protected health information contained in clinical, billing and other records that we maintain and use to make decisions about you. We ask that your request be made in writing. We may charge a reasonable fee. There might be limited situations in which we may deny your request. Under these situations, we will respond to you in writing, stating why we cannot grant your request and describing your rights to request a review of our denial.
Right to Request an Amendment of Your Protected Health Information. You have the right to request amendments to the protected health information about you that we maintain and use to make decisions about you. We ask that your request be made in writing and must explain, in as much detail as possible, your reason(s) for the amendment and, when appropriate, provide supporting documentation. Under limited circumstances we may deny your request. If we deny your request, we will respond to you in writing stating the reasons for the denial. You may file a statement of disagreement with us. You may also ask that any future disclosures of the protected health information under dispute include your requested amendment and our denial to your request.
Right to Request Restrictions on Uses and Disclosures of Your Protected Health Information. You have the right to request that we restrict our use or disclosure of your protected health information. We ask that your request be made in writing. We are not required to agree to your request for a restriction, and we will notify you of our decision. However, if we do agree, we will comply with our agreement, unless there is an emergency or we are otherwise required to use or disclose the information.
Right to Request Confidential Communications. Periodically, we will contact you by phone, email, postcard reminders, or other means to the location identified in our records with appointment reminders, alumni events, follow-up surveys, or other correspondence as identifying you as having received services. You have the right to request that we communicate with you in a specific way or at a specific location. For example, you may request that we contact you at your work address or phone number or by e-mail. We ask that your request be made in writing. While we are not required to agree with your request, we will make efforts to accommodate reasonable requests.
Right to Request an Accounting of Disclosures of Protected Health Information. You have the right to request a listing of certain disclosures we have made of your protected health information. We ask that your request be made in writing. You may ask for disclosures made up to six (6) years before the date of your request. We will provide you one accounting in any 12-month period free of charge.
Right to Receive a Copy of This Notice. You have the right to request and receive a paper copy of this Notice at any time. We will make this Notice available in electronic form and post it in our web site.
Right to Limit Sharing of Information with Health Plan. If you have paid for your services out-of-pocket in full at or before the date of service, and at your request, we will not share information about those services with a health plan for purposes of payment or health care operations. “Health plan” means an organization that pays for your medical care.
Right to Notice of Breach. You have the right to notice of a “Breach” involving any of your “Unsecured PHI” as these terms are defined under the federal law commonly known as the HITECH Act. Not all unauthorized uses or disclosure of your protected health information will be considered a Breach under the law. This notice will be sent as required under the law. If you authorize us to communicate with you by e-mail we may e-mail you notice of any Breach. In most other cases we will send you the required notice in writing and by mail.
Right to Electronic Copy of “Electronic Health Record.” If we maintain your “Electronic Health Record,” you have the right to ask for an accounting of disclosures of where we disclosed your protected health information. You may request an accounting for a period of three (3) years prior to the date the accounting is requested. You also have the right to ask our business associates for an accounting of their disclosures. In addition, if you have an “Electronic Health Record” with us, you have a right to request an electronic copy of your Electronic Health Record. Not all healthcare information stored electronically is considered an Electronic Health Record. The term ‘‘Electronic Health Record’’ means an electronic record of health-related information on an individual that is created, gathered, managed, and consulted by authorized health care clinicians and staff.
For certain health information, you may tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
If you are not able to tell us your preference, for example, if you are unconscious, we may share your information if we believe it is in your best interest. As noted above, we may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, you have both the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your care.
- Share information in a disaster relief situation.
- Include your information in a directory.
In these cases, we may not share your information unless you give us written permission:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
In the case of fundraising:
- We may contact you for fundraising efforts, but you can tell us not to contact you again.
QUESTIONS AND COMPLAINTS
If you want more information about our privacy practices, or have questions or concerns, please contact our Privacy Officer listed below. If you are concerned that your privacy rights have been violated, you may file a complaint with our Privacy Officer listed below. Any complaints to us should be made in writing to our Privacy Officer at the address listed below. You may also submit a written complaint to the U.S. Department of Health and Human Services at the address listed below. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request. We support your right to the privacy of your protected health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.
To view the contact information of our Privacy Officer and the U.S. Department of Health and Human Services, please see page 7 of the document linked here.
CHANGES TO THE TERMS OF THIS NOTICE
We reserve the right to change the terms of this Notice and will apply to all information we have about you. A current notice of our privacy practices will be available upon request, in our office, or our website at amendhealthcare.com.
This Notice is effective on November 8th, 2022.
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