NOTICE OF PRIVACY PRACTICES
This Notice of Privacy Practices (“Notice”) describes how we, Halifax Health Express Care, may use and disclose your protected health information (“PHI”), as well as how you obtain access to such PHI. 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.
HOW WE MAY USE AND DISCLOSE YOUR PHI
We may use and disclose PHI without your prior authorization for purposes of Treatment, Payment or Healthcare Operations. Note that some categories of information, such as HIV/AIDS information, genetic information, and information of state Medicaid recipients may be subject to more stringent confidentiality protections under applicable state or federal laws, and we will abide by these special protections.
USES AND DISCLOSURES OF PHI THAT DO NOT REQUIRE YOUR PRIOR AUTHORIZATION
The following are the primary circumstances under which we may use and disclose your PHI without a signed Authorization:
Treatment. We may use or disclose PHI as necessary to treat you or perform services in connection with your treatment or to allow another covered entity or healthcare provider to treat you. For example, we may disclose PHI to your pharmacist for dispensing prescription medications or to a specialist physician, or other health care providers or facility to help coordinate your care and make sure that everyone who is involved in your care has the information that they need about you to meet your health care needs.
Payment. We may use or disclose your PHI as necessary to receive reimbursement or compensation for services provided. We may contact an insurer to get payment authorization for services provided, and we are permitted to use PHI to bill you for the cost of the services provided. For example, we may need to release medical or other information about you to your insurance to process claims for health care services we have rendered. We may also disclose PHI as necessary for another covered entity’s payment activities.
Healthcare Operations. We may use or disclose PHI for healthcare operations, such as use in your health records, to provide appointment reminders or for our own internal quality and other business purposes. For example, we may use your PHI to review our services and to evaluate the performance of our staff. We may use your PHI as part of our efforts to continually improve the quality and effectiveness of the health care products and services we provide. We may also use your PHI for strategic planning, claims reporting and in developing and testing our information systems and programs. You expressly authorize us to disclose PHI to our affiliate, Halifax Hospital Medical Center (“Halifax Health”), for purposes of compiling statistical data and analyzing healthcare operations, including a continuum of care at affiliated Halifax Health facilities.
Communications About Halifax Health Affiliates, Treatment Options, Health-Related Benefits, and Other Services. We may use or disclose PHI to tell you about our affiliates (including Halifax Health and its affiliates) and their services, treatment options and health-related benefits that might be of interest to you. You have the right to decline these communications.
Uses and disclosures other than those described in this Notice will require your written authorization. Your written authorization is required for: most uses and disclosures of psychotherapy notes; uses and disclosures of PHI for marketing purposes; and disclosures that are a sale of PHI. You may revoke your authorization at any time.
OTHER USES OR DISCLOSURES OF MEDICAL INFORMATION
- As Required by Federal, State or Local Law, including in cases of abuse or neglect, for state registries, or for workplace related medical surveillance
- Public Health Activities including prevention or control of disease, reports of births and deaths, or reports of abuse or neglect
- Health Oversight, for example, in connection with government audits, investigations, inspections or licensing
- If you are a member of the Military or Special Government Forces as required by military command authorities or to determine eligibility for veteran’s benefits
- Research purposes, but only if the researcher makes representations that information will not be disclosed outside the research facility unless all identifying information has been removed, and if required by law, we will ask for your specific permission if the researcher has access to your name, address or other specific identifiers
- For purposes of Workers’ Compensation or similar programs that provide benefits for work related injury or illness
- Judicial & Administrative Proceedings in response to a subpoena, a discovery request, or other lawful process but only if efforts are made to tell you about the request or to obtain an order protecting the information requested
- To coroners or medical examiners as necessary to identify a deceased person, to determine cause of death, or to otherwise permit a funeral director to carry out their duties
- To prevent Serious Threat to Health or Safety of the public but only to a person able to respond to the threat
YOUR HEALTH INFORMATION RIGHTS
You have the following rights regarding your medical information that we maintain about your care:
- Request a restriction on certain uses and disclosures of your health information for treatment, payment, health care operations, or other permitted purposes. We are not required to agree to a requested restriction unless the disclosure is for the purpose of carrying out payment or health care operations, it is not otherwise required by law, and the information pertains solely to an item or service for which you, or person other than a health plan on your behalf, have paid fully.
- Receive confidential communications of your health information
- Inspect and copy your health record
- Amend your health record
- Receive an accounting of disclosures of your health information
- Obtain a paper copy of this health notice of information practices upon request
RESPONSIBILITIES OF HALIFAX HEALTH EXPRESS CARE
We are required by law to:
- Maintain the privacy of your health information
- Provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
- Abide by the terms of this notice of health information practices currently in effect
- Notify you of any breach of your health information that we are required by law to report to you
A patient who believes that we have violated his or her privacy rights may file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, 200 Independence Avenue, S. W., Washington, DC 20201 and/or with us at the address listed below. We will promptly investigate any complaints in an effort to resolve the matter. We may not penalize or retaliate against you for filing such a complaint.
If you have a question about this Notice, wish to exercise your rights described in this Notice, or believe your rights have been violated, you may contact us at:
Halifax Health Express Care
Kimberly Hamilton, Director of Operations