HIPAA Policy for Primary Care 360 & Walk-in Clinics in Sherwood, AR, Hensley, AR & White Hall, AR
Notice of Primary Care 360 and Walk-In Clinics Privacy Practices
Effective Date: 07th June, 2018
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) requires us to maintain the privacy and security of your Protected Health Information (“PHI”). PHI includes information that we may have created or received regarding your health, or payment for services. It includes both the information contained in your medical records, and personal information such as your name, social security number, address, and phone number. We are required by law to follow our practices as described below, and to provide you with a copy of our Notice. By accepting the terms and conditions for joining Primary Care 360 and Walk-In Clinics, you are also acknowledging receipt of our Notice of Privacy Practices. You may request a paper copy of this Notice at any time, even if you have previously acknowledged receipt of this Notice.
Primary Care 360 and Walk-In Clinics, Inc. and each of the following Primary Care 360 and Walk-In Clinics affiliates, together, designate themselves as a single Affiliated Covered Entity (“ACE” or “Primary Care 360 and Walk-In Clinics”) for purposes of compliance with HIPAA. Each of the Primary Care 360 and Walk-In Clinics entities, sites, locations and care providers follow the terms of this Notice. In addition, the Primary Care 360 and Walk-In Clinics entities, sites, locations and care providers may share medical information with each other for the purposes of treatment, payment, or health care operations. This designation may be amended from time-to-time if there are new covered entities that are under common control with Primary Care 360 and Walk-In Clinics.
Primary Care 360 and Walk-In Clinics will notify you in writing if a breach occurs that may have compromised the privacy or security of your information.
Uses and Disclosures of Your Protected Health Information That Do Not Require Your Authorization
Primary Care 360 and Walk-In Clinics uses and discloses PHI in a number of ways connected to your treatment, payment for your care, and our health care operations. Some examples of how we may use or disclose your PHI without your authorization are listed below.
• Our physicians, nurses, and others involved in your health care or preventive health care may need to discuss your PHI in order to provide you with the appropriate treatment.
• Our providers may need to contact different departments to coordinate various aspects of your care, such as calling in prescriptions, ordering lab work or x-rays, or scheduling appointments with other providers.
• Our providers may need to contact other health care providers who are treating you who are not on our staff, such as dentists or other specialists. For example, if you are being treated for an injured knee, we may share your PHI with the orthopedic physician and the physical therapist to assist in providing proper care.
• We may use and share your health information to administer your health benefits policy or contract.
• We may use your health information to bill you for health care we have provided.
• We may disclose your health information to other organizations and providers for payment activities unless disclosure is prohibited by law.
• We can use and share your health information to administer and support our business activities or those of other health care organizations (as allowed by law), including providers and plans. For example, we may use your PHI to review and improve the care you receive and to provide training to our staff.
• We can use and share your health information with other individuals (such as consultants and attorneys) and organizations that help us with our business activities. (Note: If we share your PHI with other organizations for this purpose, they must agree to protect your privacy.)
We may use or disclose your PHI without your authorization for legal and/or governmental purposes in the following circumstances:
• Required by Law: We will disclose your PHI when we are required to do so by local, state or federal law.
• Worker’s Compensation: We may disclose your PHI to comply with worker’s compensation laws and other similar legally-established programs.
• Public Health and Safety Reporting: We may disclose your PHI to an authorized public health authority or individual to:
-Protect public health and safety -Prevent or control disease, injury, or disability
-Report vital statistics such as births or deaths
-Investigate or track problems with prescription drugs and medical devices (i.e. reporting issues to the FDA)
• Abuse or Neglect: We may disclose your PHI to a government entity authorized by law to receive reports regarding suspected abuse, neglect, or domestic violence.
• Oversight Agencies: We may disclose your PHI to health oversight agencies for certain activities authorized by law such as audits, investigations, or inspections.
• Legal Proceedings: We may disclose your PHI in the course of legal proceedings, in response to an order of a court or administrative agency, and in certain cases, in response to a subpoena, discovery request, or other lawful process.
• Law Enforcement: We may disclose your PHI to law enforcement officials in limited circumstances for law enforcement purposes. For example, disclosures may be made to identify or locate a suspect, witness, or missing person, to report a crime, or to provide information concerning victims of crimes.
• Military Activity and National Security: We may disclose your PHI in certain situations related to the military. We may disclose your PHI for national security and intelligence purposes.
• Inmates: If you are an inmate in a correctional facility, we may disclose your PHI to the correctional facility for certain purposes, such as providing health care to you or protecting your health and safety, or that of others.
• Coroners, Funeral Directors, and Organ Donation: We may disclose your PHI to a coroner or medical examiner, funeral director, or an organ donation organization as authorized by law, in order for these individuals or agencies to perform or carry out their duties.
• Other Required Uses and Disclosures: Under the law, we must make disclosures when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of these laws.
Uses and Disclosures in Which You Have an Opportunity to Object
• Others Involved in Your Healthcare: Unless you object, we may disclose PHI to a member of your family, a relative, or any other person you identify as being directly involved in your health care. We may disclose this information if we determine that it is in your best interest based on our professional judgment. For example, we may disclose PHI to a friend who brings you to the emergency room.
• Visitors and Facility Directory: We may disclose limited PHI, such as location and general condition to individuals who ask for you by name. Unless you object, we will maintain your religious affiliation for use by clergy members of the same religious affiliation.
• Treatment Alternatives and Plan Description: We may communicate with you about treatment services, options, or alternatives, as well as health-related benefits or services that may be of interest to you, or to describe our health plan and providers to you.
• Disaster Relief: Your PHI may be disclosed to an authorized public or private entity for disaster relief purposes. For example, we might disclose your PHI to help notify family members of your location or general condition.
Uses and Disclosures of Your Protected Health Information That Require Us to Obtain Your Authorization
Except in the situations listed in the sections above, we will use and disclose your PHI only with your written authorization. This means we will not use your PHI in the following cases, unless you give us written permission:
• Use and disclosure of your PHI for marketing purposes
• Disclosures that constitute the sale of your PHI
• Use and disclosure of psychotherapy notes
In some situations, federal and state laws provide special protections for specific kinds of PHI and require authorization from you before we can disclose that specially protected PHI. In these situations, we will contact you for the necessary authorization. Please notify us immediately if you choose to revoke your authorization.
Your Rights Regarding Protected Health Information
You have the right to:
• Request restrictions by asking that we limit the way we use or disclose your PHI for treatment, payment, or health care operations. You may also ask that we limit the information we give to someone who is involved in your care, such as a family or friend. Please note that we are not required to agree to your request, except when a restriction has been requested regarding a disclosure to a health plan in situations where the patient has paid for services in full, and where the purpose of the disclosure is for payment or healthcare operations.
• Ask that we communicate with you by another means. For example, if you want us to communicate with you at a different address, we can usually accommodate that request. We may ask that you make your request to us in writing. We will agree to reasonable requests.
• Request an electronic or paper copy of your PHI. We may ask you to make this request in writing and we may charge a reasonable fee for the cost of producing and mailing the copy, which you will receive usually within 30 days. In certain situations, we may deny your request and will tell you why we are denying it. In some cases, you may have the right to ask for a review of our denial.
• Request an amendment of your health information that you think is incorrect or incomplete. Your request for an amendment must be in writing and provide the reason for your request. In certain cases, we may deny your request, and send you our response in writing. You may respond by filing a written statement of disagreement with us and ask that the statement be included with your PHI.
• Seek an accounting of certain disclosures by asking us for a list of the times we have disclosed your PHI. Your request must be in writing and give us the specific information we need in order to respond to your request. You may request disclosures made up to six years before your request. You may receive one list per year at no charge. If you request another list during the same year, we may charge you a reasonable fee. These lists will not include disclosures to other organizations that might pay for your care provided by Primary Care 360 and Walk-In Clinics.
• Request a paper copy of this Notice.
• File a complaint if you believe your privacy rights have been violated. You can file a written complaint with us at the email address below or with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints.
By utilizing our services or replying to our emails, you acknowledge that you are aware that email is not a secure method of communication, and that you agree to the risks. If you would prefer not to communicate via email, please notify us at firstname.lastname@example.org
Changes to Privacy Practices
Primary Care 360 and Walk-In Clinics may change the terms of this Notice at any time. The revised Notice would apply to all PHI that we maintain and will be available upon request, at our locations, and on our website.
Questions and Complaints
If you have any questions about this Notice, or think that we may have violated your privacy rights, or you disagree with a decision we made about access to your PHI, you may call the Privacy Officer at 501-804-8564 or send a written complaint to the Privacy Officer at email@example.com