HIPAA Notice of Privacy Practices of ActiveCare Network™
NOTICE EFFECTIVE DATE: June 18, 2007
REVISION DATE: July 17, 2008
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.
CONTACT INFORMATION:
If you have any questions about this notice, please contact the Privacy Officer, ActiveCare Network, 7420 Goodlett Farm Parkway, Suite 110, Cordova, TN 38016, telephone number 1-877-943-7712.
ActiveCare Network understands that information about you and your health is personal and we are committed to protecting this information. This notice is to explain the rules around the privacy of your own health records and our legal duties to protect the privacy of the information we create or receive.
We are legally required to safeguard your health information by: a) maintaining the privacy of your protected health information and providing you with notice of our legal duties and privacy practices with respect to protected health information; b) complying with the terms of the Notice that is currently in effect; and c) notifying you that we reserve the right to change our privacy practices for all protected health information that we maintain and will make the revised Notice available to you.
This Notice will inform you of how we may use and disclose your health information. In addition, it describes your rights and certain obligations regarding the use and disclosure of this information.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:
The following categories describe the various ways that we use or disclose health information. For each category we will explain what we mean and try to provide an example. Please note that not every use or disclosure will be listed. However, all of the ways we are permitted to use and disclose the information will fall into one of the categories.
Treatment
We may use or disclose your health information in the normal course of providing you with necessary services or supplies. For example, we may review your health information in order to provide you with services or supplies that were prescribed by your physician.
Payment
We may use or disclose your health information so that the services or supplies that you received may be billed for and payment may be collected from you, an insurance company, or a third party. For example, we may need to provide your insurance plan with information that identifies you, your diagnosis, and the services or supplies provided.
Health Care Operations
We may use or disclose your health information for performing business activities or health care operations. For example, your health information may be used for quality improvement purposes to evaluate the performance of the staff providing the services as well as the quality of the services that were provided to you. This is to continually monitor and improve the effectiveness and quality of the services you receive.
Appointment Reminders
We may use and disclose health information to contact you as a reminder that you have an appointment for treatment or services at a specific facility.
Individuals Involved in Your Care or Payment for Your Care
We may disclose health information to a friend or family member who is involved in your care.
Individuals Involved in Disaster Relief
Should a disaster occur, we may disclose health information about you to an agency assisting in disaster relief.
Research
We may disclose your health information for research purposes when an authorization has been signed by you, or with institutional review board or privacy board approval.
As Required by Law
We may disclose your health information when required to do so by federal, state or local law.
To Avert a Serious Threat or Health or Safety
We may use or disclose your health information when necessary to prevent a serious threat to the health and safety of you, the general public, or any other person. Any such disclosure would only be to an individual able to help prevent the threat.
Public Health Risks
We may use or disclose your health information for public health activities. These activities generally include the following: to prevent or control disease, injury or disability; to report births and deaths; to report child abuse or neglect; to report reactions to medications or problems with products; to notify people of recalls of products they may be using; to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; to notify the appropriate government authority if we believe a consumer has been the victim of abuse, neglect, or domestic violence.
Health Oversight
We may disclose your health information to a health oversight agency for activities authorized by law. These oversight activities may include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Lawsuits and Disputes
If you are involved in a lawsuit or dispute, we may disclose your health information in response to a court order or administrative order.
Law Enforcement
We may disclose your health information if requested to do so by a law enforcement official; however, if the material is protected by 42 CFR Part 2 (a federal law protecting the confidentiality of drug and alcohol abuse treatment records), a court order is required. We may disclose limited health information: 1) to identify or locate a suspect, fugitive, material witness or missing person; 2) about the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement; 3) about a death if there is reason to believe it may be the result of a criminal act; 4) about criminal conduct occurring at any of our facilities; and 5) in emergency circumstances, to report a crime, the location of the crime or victims, and the identity, description and/or location of the person who committed the crime.
Coroners, Medical Examiners and Funeral Directors
We may disclose your health information to a coroner, medical examiner or funeral director to assist them in performing their duties.
Other Uses and Disclosures
Any other uses or disclosures of your health information than those listed in this Notice will be made only with your written authorization. The authorization may be revoked at any time.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the following rights regarding the health information we maintain about you:
- The right to inspect and copy your health information with the exception of psychotherapy notes and information compiled in anticipation of litigation;
- The right to request an amendment of the health information if you feel that the information we have about you is incorrect or incomplete. We may deny your request if the information was not created by us; the information is not part of the records used to make decisions about you; we believe the information is correct and complete; or the information is not part of the information you would be allowed to see;
- The right to an accounting of disclosures or a list of the disclosures made by the facility of your health information;
- The right to request restrictions or limitations on the health information we use or disclose about you for treatment, payment or health care operations;
- The right to request we confidentially communicate with you about health matters in a certain way or a certain location; and
- The right to a paper copy of this Notice in addition to viewing it on our website.
If you need to exercise any of these rights, please submit in writing to the Privacy Officer.
CHANGES TO THIS NOTICE
We reserve the right to change this notice. We may make the revised notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice on our website at www.activecarenetwork.com. The notice will contain on the first page the effective date.
COMPLAINTS
If you believe that your privacy rights have been violated, you may file a complaint with ActiveCare Network or with the Secretary of the Department of Health and Human Services. All complaints must be in writing. ActiveCare Network will promptly and thoroughly investigate all claims. You will not be retaliated against for filing a protected health information-related complaint.
