This notice describes how medical information about you may be used and disclosed and how you can gain access to this information. Please review it carefully.
If you have any questions about this Notice, our Privacy Contact Person is Frank Wells.
This Notice of Privacy Practices describes how we may use and disclose your Protected Health Information (PHI) to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your Protected Health Information (PHI). “Protected Health Information” is defined as information about you, including demographic information, which may identify you and that, relates to your past, present or future condition related to health care services.
HealthFirst/RapidCare, Inc. is required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice, at any time. The new notice will be effective for all Protected Health Information (PHI) that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices. You may call the office and request that a revised copy be sent to you in the mail or ask for one at the time of your next appointment.
1. Uses and Disclosures of Protected Health Information (PHI)
Your Protected Health Information (PHI) may be used and disclosed by your physician, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you. Your Protected Health Information (PHI) may also be used and disclosed in effort to gain payment for services and to support the operation of our practice.
Following are examples of the types of uses and disclosures of your Protected Health Information (PHI) that our office is permitted to make. Our usage is not limited to these examples, but they are intended to give you examples of the types of uses and disclosures that may be made.
Treatment: We will use and disclose your PHI to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, we would disclose your PHI, as necessary, to another physician or health care provider (e.g. your primary care physician, a specialist or a diagnostic laboratory) that we have referred you to, in order to ensure that the provider has the necessary information to diagnose or treat you.
Payment: Your PHI will be used, as needed, to obtain payment for the health care services you receive. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we recommend for you such as: making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities. For example, obtaining approval for a procedure may require that your relevant PHI be disclosed to the health plan to obtain approval before going forward with a recommended procedure.
Healthcare Operations: We may use or disclose, as needed, your PHI in order to support the business activities of our practice. These activities include, but are not limited to, quality assessment activities, business planning activities, and employee review activities. For example, we may disclose your PHI when performing chart audits for accuracy or reviewing specific services provided. In addition, we may call you by name in the waiting room when our physician is ready to see you. We may use or disclose your PHI, as necessary, when contacting you to remind you of an appointment or to discuss your medication needs.
We will share your PHI with third party “Business Associates” who perform various activities (e.g. Compliance Consulting Services, Collection Services, etc.) for the practice. Whenever an arrangement between our office and a Business Associate involves the use or disclosure of your PHI, we will have a written contract that contains terms that will protect the privacy of your PHI.
We may use or disclose your PHI, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may also use and disclose your PHI for other marketing activities. For example, your name and address may be used to send you a newsletter about our practice and the services we offer. We may also send you information about products or services that we believe may be beneficial to you. You may contact our Privacy Contact person, Frank Wells, to request that these materials not be sent to you.
Uses and Disclosures of Protected Health Information (PHI) Based upon Your Written Authorization
Other uses and disclosures of your Protected Health Information (PHI) will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke this authorization at any time, in writing, except to the extent that we have already taken an action in reliance on the use or disclosure indicated in the authorization.
Other Permitted and Required Uses and Disclosures That May Be Made with Your Consent, Authorization or Opportunity to Object
We may use and disclose your Protected Health Information (PHI) in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of your PHI. If you are not present or able to agree or object to the use or disclosure of the PHI, then your physician may, using professional judgment, determine whether the disclosure is in your best interest. In this case, only the PHI that is relevant to your health care will be disclosed.
Others Involved in Your Healthcare: Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your PHI that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We may use or disclose PHI to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care, of your location, general condition or death. Finally, we may use or disclose your PHI to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.
Emergencies: We may use or disclose your PHI in an emergency treatment situation. If this happens, our physician shall provide you with this Notice of Privacy Practices as soon as reasonably practicable after the delivery of treatment. If your physician is required by law to treat you, he may still use or disclose your PHI to treat you and will provide you with this Notice of Privacy Practices for your review and acknowledging signature as soon as reasonably possible.
Communication Barriers: We may use or disclose your PHI if our physician attempts to provide you with this Notice of Privacy Practices but is unable to communicate its meaning or obtain your acknowledging signature due to substantial communication barriers and our physician determines, using professional judgment, that you intend to consent to use or disclosure under the circumstances.
Other Permitted and Required Uses and Disclosures That May Be Made without Your Consent, Authorization, or Opportunity to Object
We may use or disclose your Protected Health Information (PHI) in the following situations without your consent or authorization. These situations include:
Required By Law: We may use or disclose your PHI to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures.
Public Health: We may disclose your PHI for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose of controlling disease, injury or disability.
Health Oversight: We may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.
Abuse or Neglect: We may disclose your PHI to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your PHI if we believe that you have been a victim of abuse, neglect or domestic violence to the government entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.
Food and Drug Administration: We may disclose your PHI to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, or track products to enable product recalls, to make repairs or replacements, or to conduct post marketing surveillance, as required.
Legal Proceedings: We may disclose PHI in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), in certain conditions, in response to a subpoena, discovery request or other lawful process.
Law Enforcement: We may also disclose PHI, so long as applicable legal requirements are met, for law enforcement purposes. These law enforcement purposes include (1) legal processes and otherwise required by law, (2) limited information requests for identification and location purposes, (3) pertaining to victims of a crime, (4) suspicion that death has occurred as a result of criminal conduct, (5) in the event that a crime occurs on the premises of the practice, and (6) medical emergency (not on the Practice’s premises) and it is likely that a crime has occurred.
Coroners, Funeral Directors, and Organ Donation: We may disclose PHI to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose PHI to a funder director, as authorized by law, in order to permit the funeral director to carry out their duties. We may disclose such information in reasonable anticipation of death. PHI may be used and disclosed for cadaveric organ, eye or tissue donation purposes.
Research: We may disclose your PHI to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your PHI.
Criminal Activity: Consistent with applicable federal and state laws, we may disclose your PHI if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose PHI if it is necessary for law enforcement authorities to identify or apprehend an individual.
Military Activity and National Security: When the appropriate conditions apply, we may use or disclose PHI of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities, (2) for the purpose of a determination by the Department of Veterans Affairs for your eligibility for benefits, or (3) to foreign military authority if you are a member of that foreign military services. We may also disclose your PHI to authorized federal officials for conducting nation security and intelligence activities, including for the provision of protective services to the President or others legally authorized.
Workers’ Compensation: Your PHI may be disclosed by us as authorized to comply with workers’ compensation laws and other similar legally-established programs.
Inmates: We may use or disclose your PHI if you are an inmate of a correctional facility and our physician created or received your PHI in the course of providing care to you.
Required Uses and Disclosures: Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500 et. seq.
2. Your Rights
Following is a statement of your rights with respect to your Protected Health Information (PHI) and a brief description of how you may exercise these rights.
You have the right to inspect and copy your Protected Health Information (PHI). This means you may inspect and obtain a copy of your PHI about you that is contained in a designated record set for as long as we maintain the PHI. A “designated record set” contains medical and billing records and any other records that our physician and the practice uses for making decisions about you.
Under federal law, however, you may not inspect a copy of the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and protected health information that is subject to law that prohibits access to PHI. Depending on the circumstances, a decision to deny access may be reviewable. In some circumstances, you may have a right to have this decision reviewed. Please contact our Privacy Contact, Frank Wells, if you have questions about access to your medical record.
You have the right to request a restriction of your Protected Health Information (PHI). This means you may ask us not to use or disclose any part of your PHI for the purposes of treatment, payment or healthcare operations. You may also request that any part of your PHI not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply.
Our physician is not required to agree to a restriction that you may request. If he believes it is in your best interest to permit use and disclosure of your PHI, your PHI will not be restricted. If our physician does agree to the requested restriction, we may not use or disclose your PHI in violation of that restriction unless it is needed to provide emergency treatment. With this in mind, please discuss any restriction you wish to request with our physician. You may request a restriction by filling out our request form. You may obtain this form from our Contact Person, Frank Wells, or requesting it at our front desk.
You have the right to request to receive confidential communications from us by alternative means or at an alternative location. We will accommodate reasonable requests. We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. We will not request an explanation from you as to the basis for the request. Please make this request in writing to our Privacy Contact.
You may have the right to have your physician amend your Protected Health Information (PHI). This means you may request an amendment of PHI about you in a designated record set for as long as we maintain this information. In certain cases, we may deny your request for an amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. Please contact our Privacy Contact, Frank Wells, to determine if you have questions about amending your medical record.
You have the right to receive an accounting of certain disclosures we have made, if any, of your Protected Health Information (PHI). This right applies to disclosures for purposes other than treatment, payment or healthcare operations as described in this Notice of Privacy Practices. It excludes disclosures we may have made to you, to family members or friends involved in your care, or for which an authorization was obtained. You have the right to receive specific information regarding these disclosures that occurred after April 14, 2003. You may request a shorter timeframe. The right to receive this information is subject to certain exceptions, restrictions and limitations.
You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice electronically.
You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us either anonymously or in person. You may do so by filling out the complaint form located in our waiting room and returning it to our Privacy Contact, Frank Wells, or mailing it to our office as indicated on the form. We will not retaliate against you for filing a complaint.
You may contact our Privacy Contact, Frank Wells, at our office directly or by phone at 843-572-5990 for further information about this Notice of Privacy Practices or the complaint process.
This notice was published and becomes effective upon the opening of our practice on July 1, 2004. It has been amended and supersedes prior versions effective October 1, 2013.