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PRIVACY NOTICE
I. Protected Health Information:
We are committed to the privacy and confidentiality of your health information whether created by us or maintained on these premises. State and federal regulations require that policies and procedures be implemented to safeguard your health information. Copies of all of our privacy policies are kept in this business office. Information about your past, present or future health condition, provisions of healthcare, or payment for treatment you receive is considered protected health information (PHI). We are required to provide you with a copy of this privacy notice that contains information regarding our privacy practices and how, when and why we may use or disclose your PHI and your rights regarding such disclosures. We reserve the right to change this notice at any time and will make the revised or changed notice effective immediately. We will post the updated copy in our lobby and make available an updated copy for your personal records as well.
II. Use and Disclosure of your Protected Health Information
There are a number of reasons we may use and/or disclose your PHI. We have a limited right to use and/or disclose your PHI for the purposes of treatment, payment, or for the operations of this facility. Other uses will require written authorization from you to release your PHI unless the law permits or requires us to make this use or disclosure without your authorization. If it becomes necessary to release your protected health information to an outside party, we will require that party to have a signed agreement with us stating they will extend the same degree of privacy protection for your information as we do. The following describes some different ways we may need to release or disclose your PHI without your consent or authorization. Where appropriate, we have included some examples to better explain the following:
1. Use and Disclosure Related to Treatment:
We may disclose your PHI to those involved in providing rehabilitation and medical care service sand treatments to you. For example, we may release health information about you to our medical Director, therapists, Therapy Assistants, etc. We may also disclose your PHI to outside entities related to your treatment such as physicians, home healths, hospice agencies, family members, etc.
2. Use and Disclosures Related to Payment:
We may use or disclose your PHI to bill and collect payment for services or treatment(s) we provide to you. For example, we may contact your insurance company, health plan or another third party to obtain payment for the services we provide to you.
3. Use and Disclosure Related to Health Care Operations:
We may use or disclose your PHI to perform certain functions within this facility. For example, we may take your photograph for the use to evaluate the effectiveness of the care and services you are receiving. We may disclose your PHI to our staff for auditing, care planning, treatment, and learning purposes. We may also combine your PHI with information from other healthcare providers to improve the care and services we are providing you and other clients. When using combined information for the purposes of other clients, we will remove all information that would identify you.
4. Use and Disclosure Related to Treatment Alternatives, Health related Benefits and Services:
We may use or disclose your PHI for purposes of contacting you to inform you of treatment alternatives or health related benefits and services that may be of interest to you. For example, newly released types of treatment that may have a direct relationship to the plan of care for your diagnosis.
III. Uses and Disclosures Requiring Your Written Authorization
For uses and disclosures of your PHI beyond treatment, payment and operation purposes, we are required to have your written authorization, except as permitted by law. You have the right to revoke an authorization at any time to stop future disclosures of your information except to the extent that we have already undertaken an action in reliance upon your authorization. Your revocation request must be provided to us in writing. The name, address, and telephone number of the person to contact is located on the last page of this document. You may use our form to submit your request. Copies of these forms are available in our office.
Examples of uses and disclosures that would require your written authorization include, but are not limited to:
1. A request to provide your PHI to an attorney for use in a civil litigation claim.
2. A request to provide your PHI to an insurance or pharmaceutical company for the purpose of providing you with information relative to benefits or new medications that may be useful or of interest to you.
3. A request to provide certain information to another individual or facility.
IV. Uses or Disclosures of Information Based Upon Your Verbal Agreement
We may disclose a limited amount of your PHI if we provide you with an advance oral or written notice and you do not object to such release or if law does not prohibit such release. However if there is an emergency situation, and you are unable to eject (because you were not present or you were incapacitated, etc) disclosure may be made if it is consistent with any prior expressed wishes and disclosure is determined to be in your best interest. If a disclosure is made based on these emergency situations, we will only disclose health information relevant to the person’s involvement in your care. For example, if you are sent to the emergency room, we may only inform the person that you suffered an apparent heart attack, stroke, etc. and/or we may provide information on your prognosis or progress. You will be informed and given an opportunity to object to further disclosures of such information as soon as you are able to do so.
V. Uses and Disclosures of Information That Do Not Require Your Authorization
The following is a list of uses and disclosures of your PHI we may make without your consent or authorization:
1. When Required by Law:
We may disclose your PHI when a federal, state, or local law requires that we report information about suspected abuse, neglect, or domestic violence, injury from health care, or in response to a court order or subpoena.
2. For Public Health Activities for the Purpose of Preventing or Controlling disease, Injury or Disability:
We may disclose your PHI when we are required to collect information about diseases or injury’s (e.g. your exposure to a disease or your risk for spreading or contracting a communicable disease) or to report vital statistics to public health authorities.
3. For Health Oversight Activities:
We may disclose your PHI to a health agency such as a protection and advocacy agency, the state agency responsible for inspecting our facility or to other agencies responsible for monitoring this facility for purposes as reporting or investigating unusual incidents or to ensure we are in compliance with all applicable state and federal laws and regulations and civil right issues.
4. To Coroners, and Medical Examiners:
We may disclose your PHI to a coroner or medical examiner for the purpose of identifying a deceased individual or to aide in the determination for the cause of death. And in the unlikelihood, we may disclose your PHI to a Funeral director for the purpose of carrying out your wishes and to perform his/her necessary duties.
5. To Avert a Serious Threat to Health or Safety:
We may disclose your PHI to avoid a serious threat to your health or safety or to the health or safety of others. When such disclosure is necessary, information will only be released to those law enforcement agencies or individuals who have the ability or authority to prevent o r lessen the threat of harm.
6. Specific Government Functions:
We may disclose PHI of military personnel and veterans, when requested by military command authorities, to authorized federal authorities for the purpose of intelligence, counterintelligence, and other national security activities.
VI. Your Rights Regarding Your Protected Health Information
You have the following rights concerning the use or disclosure of your protected health information that we created and/or maintain(ed) on these premises.
1. To Request Restrictions on Uses and Disclosures of Your Protected Health Information:
You have the right to request that we limit how we use or disclose your PHI or treatment, payment or health care operations. You have the right to request a limit on the health information we disclose about you to someone who is involve din your care or the payment for your care services. For example, you could request that we not disclose to family and/or friends information about the treatment you receive. If you wish to place such a restriction on your PHI, you must submit this in writing to our HIPAA Compliance Officer. You may wish to submit this on one of our request forms. These forms are available to you in our office.
2. The right to Inspect and Copy Your Medical and Billing Records:
You have the right to inspect and copy your PHI, such as medical and billing records that we use to make decisions about your care and services. In order to inspect and/or copy your PHI, you must submit this request to us in wiring. If you request a copy of your records, we may charge you a reasonable fee for the paper, labor, mailing and/or retrieval costs involved. You may wish to submit your request on one of our forms. These forms are available to you in our office. We will respond to your request within thirty (30) days of receipt of your request. Should we deny your request, we must send you written notification of denial and the reasons for the denial as permitted by law.
3. The Right to Amend or Correct Your Health Information:
You have the right to request that your PHI be amended or corrected if you have reason to believe that certain information is incomplete or incorrect. You have the right to make such request for as long as we maintain/retain your health information. You must submit this request in writing. We will respond to your request within sixty (60) days of receiving the written request. Should we approve such request, we will make the necessary agreed amendments/corrections and notify you of the changes.
We may deny your request if:
a. Your request was not submitted in writing
b. Your written request does not contain a reason to support your request
c. We did not create your information
d. It is not part of the health information kept by this facility
e. The information is already accurate and complete
If your request is denied, we will provide you with a written notice of the reason(s) for such denial and your rights to have the request, denial and any written response you may have relative to the information and denial process appended to your health information.
4. The Right to Request Confidential Communication:
You have the right to request we communicate with you about your PHI. For example, you may request that we not send any health information about you to a family member’s address. We will agree to your request as long as it is reasonable for us to do so. You are not required to reveal your reasons for such a request, not will we ask you. To request confidential communication, you must:
a. Notify us in writing
b. Indicate what information you wish to limit
c. Indicate whether or not you wish to limit or restrict our use or disclosure of such information
d. Identify to whom the restrictions apply (e.g. which family members, agency, etc.)
5. The Right to Request an Accounting of Disclosures of Protected Health Information:
You have the right to request we provide you with a listing of when, to whom, for what purpose, and what content of you PHI we have released over a specified period of time. This accounting will not include any information we have made for the purposes of payment, treatment, or health care operations or information released to you, your family, or disclosures made for national security purposes, or any releases pursuant to your authorization. Your request must be submitted in writing and must indicate the time period for which you wish the information (e.g. May 1, 2003 through August 31, 2005). Your request may not include releases for more than six (6) years prior to the date of your request and may not include releases prior to April 14, 2003. Your request must also indicate the form (e.g. printed copy, email) in which you wish to receive this information. We will respond to your request within sixty (60) days of receipt of your written request. Should additional time be needed to fulfill your request, you will be notified by us of the necessary extension required to process such request. We will also notify you of any reasonable fee involved for processing your request. You may choose to withdraw your request prior to any costs being charged to you.
6. The right to Receive a Paper Copy of This Notice
How to file a Complaint About Our Privacy Practices
If you have reason to believe that we might have violated your privacy rights, or you disagree with a decision made concerning access to your PHI, you have the right to file a complaint with us or to TDH or to The Secretary of the Department of Health and Human Services. Complaints may be filed without fear of retaliation in any form.
Complaints may be submitted to:
Jennifer Griffith, HIPAA Compliance Officer
3300 N McColl, SteA
McAllen, Texas 78501
(956) 661-0475
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