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PRIVACY NOTICE USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION 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. This
Notice is effective beginning Professional
Home Care Services, Inc. (PHCS) is required by law to maintain the privacy of
protected health information and to provide you with notice of its legal duties
and privacy practices with respect to such information. PHCS will abide by the terms of the notice
currently in effect; however, PHCS reserves the right to change the terms of
this notice as well as make the new provisions effective for all protected
health information maintained. If there
is a change, PHCS will inform you of this change at your next scheduled
appointment or upon your request. In
addition, a copy of the effective notice will be posted at all times in the
office, with a date notifying you of the most recent update. As a patient
of PHCS, information about you must be used and disclosed to other parties for
purposes of treatment, payment, and health care operations. These uses and disclosures do not require
your consent, and include, but are not limited to, a release of information
contained in financial records, medical records, laboratory test results, medical history, treatment progress, or any other related
information to: 1.
Your insurance company, self-funded or third-party
health plan, Medicare, Medicaid, or any other person or entity that may be
responsible for paying or processing for payment any portion of your bill for
services; 2.
Any person or entity affiliated with or representing
for purposes of administration, billing, and quality and risk management; 3.
Any hospital, nursing home, or other health care
facility or health care agency to which you may be admitted to; 4.
Any assisted living or personal care facility of
which you are a resident; 5.
Any physician providing care to you; 6.
Any business associate of PHCS that agrees to abide
by the privacy requirements regarding your protected health information; and 7.
Licensing and accrediting bodies. In addition, PHCS may contact you: 1.
To provide appointment reminders or information about
other health activities we provide. PHCS is also permitted to use or
disclose information about you without consent or authorization in the
following circumstances; 1.
Where the use or disclosure is required by another
law, but only to the extent that it is required and complies with such other
law; 2.
For certain public health activities; 3.
Where PHCS reasonably believes you are a victim of
abuse, neglect, or domestic violence, but only to a government authority
authorized to receive abuse, neglect, or domestic violence; 4.
Health care oversight activities; 5.
Certain judicial and administrative proceedings; 6.
Certain law enforcement purposes; 7.
To coroners, medical examiners, and funeral
directors, in certain circumstances; 8.
For cadaver organ, eye, or tissue donation purposes; 9.
For certain research purposes; 10.
To avert a serious threat to health and safety; 11.
For specialized government functions, including
military and veterans’ activities, national security and intelligence
activities, protective services for the President and others, medical
suitability determinations, correctional institution and custodial situations;
and 12.
For workers’ compensation purposes. PHCS is permitted to use or
disclose information about you without consent or authorization provided you
are informed in advance and given the opportunity to agree to or prohibit or
restrict the disclosure in the following circumstances: 1.
To a family member, other close relative, close
personal friend, or other identified person, the information relevant to such
person’s involvement in your care or payment for care. 2.
To a public or private entity authorized by law or
charter to assist in disaster relief efforts, but only for the purpose of
coordinating with such entities. Other uses and disclosures not
specifically addressed earlier in this notice will be made only with your written
authorization. In addition, Examples of when authorization is
required for PHCS to use or disclose your protected health information include: 1.
Psychotherapy notes (notwithstanding the provisions
that allow the use and disclosure of protected health information without
consent and authorization for treatment, payment and healthcare operations, the
law specifically requires an authorization to use or disclose psychotherapy
notes); and 2.
Marketing, except if the communication is in the form
of a face-to-face communication made by NEPHCS to you or a promotional gift of
nominal value provided by NEPHCS; and 3.
Requests from an attorney. These authorizations may be revoked, in writing, at any
time, except in limited situations. YOUR
RIGHTS The Health
Insurance Portability Accountability Act gives you certain rights with regard
to your protected health information.
Any of these rights may be exercised by contacting PHCS and in some
situations, may require you to fill out a written request. You have the right, subject to certain conditions, to: 1.
Request restrictions on the use and disclosure of
information about you for treatment, payment, and healthcare operations, and to
friends and family involved in the individual’s care. However, PHCS is not required to agree to the
requested restriction; 2.
Receive confidential communication of protected
health information; 3.
Inspect and copy protected health information; 4.
Amend protected health information; 5.
Receive an accounting of disclosures of protected
health information; and 6.
Obtain a paper copy of this notice, even if you
agreed to receive this notice electronically. In addition, COMPLAINTS
If
you believe that your privacy rights have been violated, you may complain to
both PHCS and the Office of the Secretary at the U.S. Department of Health and
Human Services. There will be no
retaliation against you for filing a complaint.
Complaints may be made to the Privacy
Officer at Professional Home Care Services, Inc. at 1-800-253-3738. We
recommend that complaints be given to the Privacy Officer in writing, stating
the specific incident(s) in terms of subject, date, and other relevant matters. Mail to:
Privacy Officer
Professional Home Care Services, Inc.
Complaints to the Office of the
Secretary may be made in writing to the following address: The U.S. Department of Health and Human
Services, Office of the Secretary, PHCS
Privacy Notice |