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.
PURPOSE OF THE NOTICE
PreCare is committed to preserving the privacy and confidentiality of your health information that is created and/or maintained by our company. State and federal laws and regulations require us to implement policies and procedures to safeguard the privacy of your health information. This notice will provide you with information regarding our privacy practices in regards to your personal health information, including the ways in which we may use or disclose the information. It also describes your rights and our obligations concerning such uses or disclosures.
We get information about you prior to and during your first visit with us. It may include your name, date of birth, gender, ways to contact you, your social security number, financial information, insurance information and other personal information. We also collect information regarding your condition, diagnosis and treatment. Along with collecting this information from you, we also get enrollment and eligibility status from your health insurer and medical information from other health care providers.
OUR PRIVACY COMMITMENT TO YOU
The information we collect about you is private. Only people who have both the need and the legal right may see your information. Unless you give us permission in writing, we will only disclose your information for purposes of treatment, payment, business operations, when we are required by law to do so, or for the other reasons listed below.
- Treatment We may use or disclose medical information about you to provide and coordinate your health care. For example, during each week that you are in treatment, we usually send an update to your referring physician regarding your treatment.
- Payment We may use and disclose information so the care you get can be properly billed and paid for. For example, we may send your health insurer a bill for our services that explains what treatment we gave you and why.
- Business Operations We may need to use and disclose information for our business operations. For example, in order to improve activity necessary to run the business (reviewing the quality of care that you and others get from us.)
- Exceptions For certain kinds of records, your permission may be needed, even for release for treatment, payment and business operations. We have authorization and consent forms that you will need to sign in order for us to release certain information.
- Phone Messages/E-mails We may contact you via phone, answering machine or e-mail to give you authorization, referral, and billing information. You may request in writing if you do not wish for this information to be left with a person other than yourself over the phone, or on the answering machine, or sent via e-mail.
- As Required By Law and for Other Government Functions We will release information when we are required by law to do so or for other government functions. Examples of such releases would be for law enforcement, subpoenas or other court orders, for national security purposes, communicable disease reporting, disaster relief, review of our activities by government agencies, to avert a serious threat to health or safety or in other kinds of emergencies.
- Public Health and Safety We may use or disclose information about you as necessary to prevent or reduce a serious threat to the health or safety of a person or the public. For example, we will have to disclose information about certain diseases (and immunizations) to public health officials.
- Family and Friends We may disclose your information to family members, friends or others you identify to the extent it is relevant to their involvement with your care or payment for your care, or to let them know about where you are and your condition.
- Worker's Compensation We may disclose your health information to worker's compensation programs and personnel when your health condition arises out of a work related injury or illness.
- With Your Permission If you give us permission in writing, we may use and disclose your personal information for purposes you list. If you give us permission, you have the right to change your mind and revoke it. This must be in writing, as well. We cannot take back any uses or disclosures already made with your permission.
- Research We may use or disclose your health information for research purposes under certain limited circumstances. For example, we may analyze the results of your therapy together with other participants in order to develop optimal treatment programs for the future.
You have the following rights regarding the health information that we have about you. You may exercise each of these rights by providing us with a signed letter requesting such a right. The letter must be addressed to the Director of Human Resources, 1151 Broadway, Suite 201, Sonoma, CA 95476. We are committed to ensuring that you receive information regarding your rights as a patient here at PreCare.
- Your Right to Inspect and Copy In most cases, you have the right to look at or get copies of your medical records upon signing our Medical Record Release form, and in some cases paying a fee if we need to get them out of our storage facility. Please call ahead to ensure that we have your records available for you.
- Your Right to Amend You may ask us to change your records if you feel that there is a mistake. We can deny your request for certain reasons, but we must give you a written reason for our denial.
- Your Right to a List of Disclosures You have the right to ask for a list of certain disclosures made after April 14, 2003. This list will not include the times that information was disclosed for treatment, payment, or health care operations. The list will not include information provided directly to you or your family, or information that was sent with your permission. It will not include information released without your name or other data that would identify you.
- Your Right to Request Restrictions on Our Use or Disclosure of Information You can ask for limits on how your information is used or disclosed. We are not required to agree to such request, but can if we believe it is reasonable to do so.
- Your Right to Request Confidential Communications You have the right to ask that we share information with you in a certain way or in a certain place. For example, you may ask us to contact you only at home, or by e-mail. We will do our best to accommodate such a request.
- Right to a Paper Copy of this Notice You have the right to receive a paper copy of this Notice at any time.
CHANGES TO THIS NOTICE
We reserve the right to revise this notice. A revised notice will be effective for medical information we already have about you as well as any information we may receive in the future. We are required by law to comply with whatever notice is currently in effect. If the changes are material, a new notice will be posted.
Complaints/Questions If you believe that your privacy rights have been violated or you wish to express your concern regarding non-compliance of our privacy policies and procedures, you may file a complaint by writing to the address above. We will require a written complaint. You will not be penalized for filing a complaint.
HIPAA is the Health Insurance Portability and Accountability Act of 1996. The revised and updated Privacy Rule portion of HIPAA, including many of the policies described in this notice, went into effect on April 14, 2003. You may further research the policies and guidelines of HIPAA via the Internet.
A copy of this Notice of Privacy Policies will be posted on our website, www.precareinc.com. You will need to acknowledge via signature that you have received a copy of these privacy policies and procedures. This copy will be saved along with your other electronic medical record.