Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL/HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
We are required by law to maintain the privacy of your protected health information; to provide you this Notice of our legal duties and privacy practices relating to your protected health information; to provide you with notice following a breach of unsecured protected health information; and to abide by the terms of the Notice that are currently in effect.
I. USES AND DISCLOSURES FOR TREATMENT, PAYMENT AND HEALTH CARE OPERATIONS
The following lists various ways in which we may use or disclose your protected health information for purposes of treatment, payment and health care operations.
FOR TREATMENT: We will use and disclose your protected health information to provide, coordinate, or manage your health care services. For example, we disclose your health information, as necessary, to your physician.
FOR PAYMENT: We may use and disclose your protected health information for billing and payment purposes. We may disclose your protected information to your representative, or to an insurance or managed care company, Medicare or another third party payer. For example, we may contact Medicare or your health plan to confirm your coverage and benefits.
FOR HEALTH CARE OPERATIONS: We may use and disclose your protected information as necessary for health care operations, such as management, personnel evaluation, education and training and to monitor our quality of care. For example, we may use your protected health information to assess quality of care and improve the services we provide.
FRIENDS OR CLOSE FRIENDS: Unless you object, we may disclose protected information about you to a family member, close personal friend or other person you expressly identify who is involved in your care.
EMERGENCIES: We may use or disclose your protected information as necessary in emergency treatment situations.
AS REQUIRED BY LAW: We may use or disclose your protected information when required by law to do so.
BUSINESS ASSOCIATES: We may disclose your protected information to a contractor or business associate who needs the information to perform services for the Company. Our business associates are committed to preserving the confidentiality of this information, and have signed an agreement with the Company that holds them to certain privacy standards.
PUBLIC HEALTH ACTIVITIES: We may disclose your protected information for public health activities. These activities may include, for example, reporting to a public health authority for preventing or controlling disease, injury or disability, reporting child abuse or neglect or reporting births and deaths.
REPORTING VICTIMS OF ABUSE, NEGLECT OR DOMESTIC VIOLENCE: If we believe that you have been a victim of abuse, neglect or domestic violence, we may use and disclose your protected information to notify a government authority, if authorized by law or if you agree to the report.
HEALTH OVERSIGHT ACTIVITIES: We may disclose your protected information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections and licensure actions or for activities involving government oversight of the healthcare system.
TO AVERT A SERIOUS THREAT TO HEALTH OR SAFETY: When necessary to prevent a serious threat to your health or safety or the health or safety of the public or another person, we may use or disclose protected information, limiting disclosures to someone able to help lessen or prevent the threatened harm.
JUDICIAL AND ADMINISTRATIVE PROCEEDINGS: We may disclose your protected information in response to a court or administrative order. We also may disclose information in response to a subpoena, discovery request, or other lawful process; efforts will be made to contact you about the request or to obtain an order or agreement protecting the information.
LAW ENFORCEMENT: We may disclose your protected information for certain law enforcement purposes, including, for example, to comply with reporting requirements; to comply with a court order, warrant, or similar legal process; or to answer certain requests for information concerning crimes.
RESEARCH: We may use or disclose your protected information for research purposes if the privacy aspects of the research have been reviewed and approved, if the researcher is collecting information in preparing a research proposal, if the research occurs after your death, or if you authorize the use or disclosure.
CORONERS, MEDICAL EXAMINERS, FUNERAL DIRECTORS, ORGAN PROCUREMENT ORGANIZATIONS: We may release your protected information to a coroner, medical examiner, funeral director or, if you are an organ donor, to an organization involved in the donation of organs and tissue.
DISASTER RELIEF: We may disclose protected information about you to a disaster relief organization.
MILITARY, VETERANS AND OTHER SPECIFIC GOVERNMENT FUNCTIONS: If you are a member of the armed forces, we may use and disclose your protected information as required by military command authorities. We may disclose protected information for national security purposes or as needed to protect the President of the United States or certain other officials or to conduct certain special investigations.
WORKERS’ COMPENSATION: We may use or disclose your protected information to comply with laws relating to workers’ compensation or similar programs.
INMATES/LAW ENFORCEMENT CUSTODY: If you are under the custody of a law enforcement official or a correctional institution, we may disclose your protected information to the institution or official for certain purposes including the health and safety of you and others.
TREATMENT ALTERNATIVES AND HEALTH-RELATED BENEFITS AND SERVICES. We may use or disclose your protected information to inform you about treatment alternatives and health-related benefits and services that may be of interest to you.
II. USES AND DISCLOSURES WITH YOUR AUTHORIZATION
Except as described in this Notice, we will use and disclose your protected information only with your written authorization. You may revoke an Authorization in writing at any time. If you revoke an Authorization, we will no longer use or disclose your protected information for the purposes covered by that Authorization, except where we have already relied on the Authorization.
III. YOUR RIGHTS REGARDING YOUR PROTECTED INFORMATION
Listed below are your rights regarding your protected information. Each of these rights is subject to certain requirements, limitations and exceptions. Exercise of these rights may require submitting a written request to the Company. At your request, the Company will supply you with the appropriate form to complete. You have the right to:
REQUEST RESTRICTIONS: You have the right to request restrictions on our use or disclosure of your protected information. You also have the right to request restrictions on the protected information we disclose about you to a family member, friend or other person who is involved in your care or the payment for your care. We are not required to agree to your requested restriction (except that if you are competent you may restrict disclosures to family members or friends). If we do agree to accept your requested restriction, we will comply with your request except as needed to provide you emergency treatment.
ACCESS TO PERSONAL PROTECTED INFORMATION: You have the right to inspect and obtain a copy of your clinical or billing records or other written information that may be used to make decisions about your care, subject to some exceptions. Your request must be made in writing. In most cases, we may charge a reasonable fee for our costs in copying and mailing your requested information.
REQUEST AMENDMENT: You have the right to request amendments of your protected information maintained by the Company for as long as the information is kept by or for the Company if you believe it is incorrect or incomplete. Your request must be made in writing and must state the reason for the requested amendment. We may deny your request for amendment, but will inform you of the reasons for the denial and the right to submit a written statement disagreeing with the denial.
REQUEST AN ACCOUNTING OF DISCLOSURES: You have the right to request an “accounting” of certain disclosures of your protected information. This is a listing of disclosures made by the Company or by others on our behalf, but does not include disclosures for treatment, payment and health care operations, disclosure made pursuant to your Authorization, and certain other exceptions. To request an accounting of disclosures, you must submit a request in writing, stating a time period that is within six (6) years from the date of your request. The first accounting provided within a 12-month period will be free; for further requests, we may charge you our costs.
REQUEST A PAPER COPY OF THIS NOTICE: You have the right to obtain a paper copy of this Notice, even if you have agreed to receive this Notice electronically. You may request a copy of this Notice at any time. In addition, you may obtain a copy of this notice at our website, www.NeuLinehealth.com.
REQUEST CONFIDENTIAL COMMUNICATIONS: You have the right to request that we communicate with you concerning your health matters in a certain manner. We will accommodate your reasonable requests.
IV. FOR FURTHER INFORMATION OR TO FILE A COMPLAINT
If you have any questions about this Notice or would like further information concerning your privacy rights, please contact our Privacy Officer at 866.329.8177 or support@NeuLinehealth.com. If you believe that your privacy rights have been violated, you may file a complaint in writing with the Company using the contact information listed above or with the Office of Civil Rights in the U.S. Department of Health and Human Services. We will not retaliate against you if you file a complaint.
V. CHANGES TO THIS NOTICE
We reserve the right to change this Notice and to make the revised or new Notice provisions effective for all protected information already received and maintained by the Company as well as for all protected information we receive in the future. We will provide a copy of the revised Notice upon request.