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HIPAA COMPLIANCY - PATIENT PRIVACY ACT
BETHHAROLD HOME HEALTH CARE, INC. 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.
USE AND DISCLOSURE OF HEALTH INFORMATION
BethHarold Home Health Care, Inc. may use your health information, information that
constitutes protected health information as defined in the Privacy Rule of the
Administrative Simplification provisions of the Health Insurance Portability and
Accountability Act of 1996, for purposes of providing you treatment, obtaining payment
for your care and conducting health care operations. Your health information may be
used or disclosed only after the Agency has obtained your written consent. The Agency
has established policies to guard against unnecessary disclosure of your health
information.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER
WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE
USED AND DISCLOSED AFTER YOU HAVE PROVIDED YOUR WRITTEN
CONSENT:
To Provide Treatment.
The Agency may use your health information to
coordinate care within the Agency and with others involved in your care, such as your
attending physician and other health care professionals who have agreed to assist the
Agency in coordinating care. For example, physicians involved in your care will need
information about your symptoms in order to prescribe appropriate medications. The
Agency also may disclose your health care information to individuals outside of the
Agency involved in your care including family members, pharmacists, suppliers of
medical equipment or other health care professionals.
To Obtain Payment.
The Agency may include your health information in
invoices to collect payment from third parties for the care you receive from the Agency.
For example, the Agency may be required by your health insurer to provide information
regarding your health care status so that the insurer will reimburse you or the Agency.
The Agency also may need to obtain prior approval from your insurer a nd may need to
explain to the insurer your need for home care and the services that will be provided to
you.
To Conduct Health Care Operations.
The Agency may use and disclose
health information for its own operations in order to facilitate the function of the Agency
and as necessary to provide quality care to all of the Agency ‘s patients. Health care
operations includes such activities as:
- Quality assessment and improvement activities.
- Activities designed to improve health or reduce health care costs.
- Protocol development, case management and care coordination.
- Contacting health care providers and patients with information about
treatment alternatives and other related functions that do not include
treatment.
- Professional review and performance evaluation.
- Training programs including those in which students, trainees or practitioners
in health care learn under supervision.
- Training of non-health care professionals.
- Accreditation, certification, licensing or credentialing acti vities.
- Review and auditing, including compliance reviews, medical reviews, legal
services and compliance programs.
- Business planning and development including cost management and
planning related analyses and formulary development.
- Business management and general administrative activities of the Agency.
- Fundraising for the benefit of the Agency and certain marketing activities.
For example the Agency may use your health information to evaluate its staff
performance, combine your health information with other Agency patients in
evaluating how to more effectively serve all Agency patients, disclose your health
information to Agency staff and contracted personnel for training purposes, use
your health information to contact you as a reminder regarding a visit to you, or
contact you as part of general fundraising and community information mailings
(unless you tell us you do not want to be contacted).
For Fundraising Activities.
The Agency may use information about you including your
name, address, phone number and the dates you received care in order to contact you
to raise money for the Agency. The Agency may also release this information to a
related Agency foundation. If you do not want the Agency to contact you, notify HIPAA
Coordinator, BethHarold Home health Care, Inc. located at 15565 Northland Drive, Suite 403E, Southfield,
MI 48075; Tel. # 888-423-3301. and indicate that you do not wish to be contacted.
For Appointment Reminders.
The Agency may use and disclose your health
information to contact you as a reminder that you have an appointment for a home visit.
For Treatment Alternatives.
The Agency may use and disclose your health
information to tell you about or recommend possible treatment options or alternatives
that may be of interest to you.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND
PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED
WITHOUT FIRST RECEIVING YOUR WRITTEN CONSENT
When Legally Required.
The Agency will disclose your health information when
it is required to do so by any Federal, State or local law.
When There Are Risks to Public Health.
The Agency may disclose your health
information for public activities and purposes in order to:
- Prevent or control disease, injury or disability, report disease, injury, vital
events such as birth or death and the conduct of public health surveillance,
investigations and interventions.
- Report adverse events, product defects, to track products or enable product
recalls, repairs and replacements and to conduct post-marketing surveillance
and compliance with requirements of the Food and Drug Administration.
- Notify a person who has been exposed to a communicable disease or who
may be at risk of contracting or spreading a disease.
- Notify an employer about an individual who is a member of the workforce as
legally required.
To Report Abuse, Neglect Or Domestic Violence.
The Agency is allowed to
notify government authorities if the Agency believes a patient is the victim of abuse,
neglect or domestic violence. The Agency will make this disclosure only when
specifically required or authorized by law or when the patient agrees to the disclosure.
To Conduct Health Oversight Activities.
The Agency may disclose your
health information to a health oversight agency for activities including audits, civil
administrative or criminal investigations, inspections, licensure or disciplinary action.
The Agency, however, may not disclose your health information if you are the subject of
an investigation and your health information is not directly related to your receipt of
health care or public benefits.
In Connection With Judicial And Administrative Proceedings.
The Agency
may disclose your health information in the course of any judicial or administrative
proceeding in response to an order of a court or administrative tribunal as expressly
authorized by such order or in response to a subpoena, discovery request or other
lawful process, but only when the Agency makes reasonable efforts to either notify you
about the request or to obtain an order protecting your health information.
For Law Enforcement Purposes. As permitted or required by State law, the
Agency may disclose your health information to a law enforcement official for certain
law enforcement purposes as follows:
- As required by law for reporting of certain types of wounds or other physical
injuries pursuant to the court order, warrant, subpoena or summons or similar
process.
- For the purpose of identifying or locating a suspect, fugitive, material witness
or missing person.
- Under certain limited circumstances, when you are the victim of a crime.
- To a law enforcement official if the Agency has a suspicion that your death
was the result of criminal conduct including criminal conduct at the Agency.
- In an emergency in order to report a crime.
To Coroners And Medical Examiners.
The Agency may disclose your health
information to coroners and medical examiners for purposes of determining your cause
of death or for other duties, as authorized by law.
To Funeral Directors.
The Agency may disclose your health information to
funeral directors consistent with applicable law and if necessary, to carry out their duties
with respect to your funeral arrangements. If necessary to carry out their duties, the
Agency may disclose your health information prior to and in reasonable anticipation of
your death.
For Organ, Eye Or Tissue Donation.
The Agency may use or disclose your
health information to organ procurement organizations or other entities engaged in the
procurement, banking or transplantation of organs, eyes or tissue for the purpose of
facilitating the donation and transplantation.
For Research Purposes.
The Agency may, under very select circumstances,
use your health information for research. Before the Agency discloses any of your
health information for such research purposes, the project will be subject to an
extensive approval process. The Agency will almost always request your written
authorization before granting access to your individually identifiable health information.
In the Event of A Serious Threat To Health Or Safety.
The Agency may,
consistent with applicable law and ethical standards of conduct, disclose your health
information if the Agency, in good faith, believes that such disclosure is necessary to
prevent or lessen a serious and imminent threat to your health or safety or to the health
and safety of the public.
For Specified Government Functions.
In certain circumstances, the Federal
regulations authorize the Agency to use or disclose your health information to facilitate
specified government functions relating to military and veterans, national security and
intelligence activities, protective services for the President and others, medical suitability
determinations and inmates and law enforcement custody.
For Worker's Compensation.
The Agency may release your health information
for worker's compensation or similar programs.
AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION
Other than is stated above, the Agency will not disclose your health information
other than with your written authorization. If you or your representative authorizes the
Agency to use or disclose your health information, you may revoke that authorization in
writing at any time.
YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
You have the following rights regarding your health information that the Agency
maintains:
Right to request restrictions.
You may request restrictions on certain uses and
disclosures of your health information. You have the right to request a limit on the
Agency ‘s disclosure of your health information to someone who is involved in your care
or the payment of your care. However, the Agency is not required to agree to your
request. If you wish to make a request for restrictions, please contact HIPAA
Coordinator, BethHarold Home health Care, Inc. located at 15565 Northland Drive, Suite 403E, Southfield,
MI 48075; Tel. # 888-423-3301.
Right to receive confidential communications.
You have the right to request
that the Agency communicate with you in a certain way. For example, you may ask that
the Agency only conduct communications pertaining to your health information with you
privately with no other family members present. If you wish to receive confidential
communications, please contact HIPAA
Coordinator, BethHarold Home health Care, Inc. located at 15565 Northland Drive, Suite 403E, Southfield,
MI 48075; Tel. # 888-423-3301. The
Agency will not request that you provide any reasons for your request and will attempt
to honor your reasonable requests for confidential communications.
Right to inspect and copy your health information.
You have the right to
inspect and copy your health information, including billing records. A request to inspect
and copy records containing your health information may be made to HIPAA
Coordinator, BethHarold Home health Care, Inc. located at 15565 Northland Drive, Suite 403E, Southfield,
MI 48075; Tel. # 888-423-3301. If you request a copy of your health information,
the Agency may charge a reasonable fee for copying and assembling costs associated
with your request.
Right to amend health care information.
You or your representative have the
right to request that the Agency amend your records, if you believe that your health
information is incorrect or incomplete. That request may be made as long as the
information is maintained by the Agency. A request for an amendment of records must
be made in writing to HIPAA
Coordinator, BethHarold Home health Care, Inc. located at 15565 Northland Drive, Suite 403E, Southfield,
MI 48075; Tel. # 888-423-3301. The Agency may
deny the request if it is not in writing or does not include a reason for the amendment.
The request also may be denied if your health information records were not created by
the Agency, if the records you are requesting are not part of the Agency‘s records, if the
health information you wish to amend is not part of the health information you or your
representative are permitted to inspect and copy, or if, in the opinion of the Agency, the
records containing your health information are accurate and complete.
Right to an accounting.
You or your representative have the right to request an
accounting of disclosures of your health information made by the Agency for any reason
other than for treatment, payment or health operations. The request for an accounting
must be made in writing to HIPAA
Coordinator, BethHarold Home health Care, Inc. located at 15565 Northland Drive, Suite 403E, Southfield,
MI 48075; Tel. # 888-423-3301. The
request should specify the time period for the accounting starting on or after April 14,
2003. Accounting requests may not be made for periods of time in excess of six (6)
years. The Agency would provide the first accounting you request during any 12-month
period without charge. Subsequent accounting requests may be subject to a
reasonable cost-based fee.
Right to a paper copy of this notice.
You or your representative have a right to
a separate paper copy of this Notice at any time even if you or your representative have
received this Notice previously. To obtain a separate paper copy, please contact
HIPAA
Coordinator, BethHarold Home health Care, Inc. located at 15565 Northland Drive, Suite 403E, Southfield,
MI 48075; Tel. # 888-423-3301.
DUTIES OF THE AGENCY
The Agency is required by law to maintain the privacy of your health information
and to provide to you and your representative this Notice of its duties and privacy
practices. The Agency is required to abide by the terms of this Notice as may be
amended from time to time. The Agency reserves the right to change the terms of its
Notice and to make the new Notice provisions effective for all health information that it
maintains. If the Agency changes its Notice, the Agency will provide a copy of the
revised Notice to you or your appointed representative. You or your personal
representative have the right to express complaints to the Agency and to the Secretary
of DHHS if you or your representative believe that your privacy rights have been
violated. Any complaints to the Agency should be made in writing to HIPAA
Coordinator, BethHarold Home health Care, Inc. located at 15565 Northland Drive, Suite 403E, Southfield,
MI 48075; Tel. # 888-423-6699. The Agency encourages you to express any
concerns you may have regarding the privacy of your information. You will not be
retaliated against in any way for filing a complaint.
CONTACT PERSON
The Agency has designated the HIPAA Coordinator as its contact person for all
issues regarding patient privacy and your rights under the Federal privacy standards.
You may contact this person at 15565 Northland Drive, Suite 403E, Southfield,
MI 48075; Tel. # 888-423-3301.
EFFECTIVE DATE
This Notice is effective April 14, 2003.
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT
HIPAA
Coordinator, BethHarold Home Health Care, Inc. located at 15565 Northland Drive, Suite 403E, Southfield,
MI 48075; Tel. # 888-423-3301. |
