HIPAA Notice of Privacy Practices Revised January 2020
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED OR DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION AS REQUIRED BY THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA). PLEASE REVIEW IT CAREFULLY.
If you have any questions about this notice or if you need more information, please contact the compliance officer.
About this Notice This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or healthcare operations and for other purposes that are permitted or required by law. We are dedicated to protecting your medical information. We are required by law to maintain the privacy of protected health information and to provide you with this notice of our legal duties and privacy practices with respect to protected health information. This notice applies to all of the records of your care generated by the Practice. If the Practice revises the terms of this notice, it will post a revised notice in this office and will make paper copies of this Notice of Privacy Practices for Protected Health Information available upon request.
What is Protected Health Information? Protected Health Information is information that individually identifies you and that we create or get from you or from another health care provider, a health plan, your employer, or a health care clearinghouse and that relates to (1) your past, present, or future physical or mental health or conditions, (2) the provision of health care to you, or (3) the past, present, or future payment for your healthcare.
How We May Use and Disclose Your Protected Health Information Your PHI may be used and disclosed by our physicians, 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 PHI may also be used and disclosed to obtain payment for services provided to you and to support the operation of our practice.
The following are examples of the types of uses and disclosures of your PHI that our office is permitted to make under HIPAA. These examples are not meant to be exhaustive, but describe some of the types of uses and disclosures that may be made by our office for treatment, payment and health care operations.
For Treatment: We may use PHI to give you medical treatment or services and to manage and coordinate your medical care. For example, we may disclose PHI to doctors, nurses, technicians, or other personnel who are involved in taking care of you, including physicians or health care providers outside our practice, such as referring or specialist physicians or laboratories.
For Payment: Your PHI will be used, as needed, to obtain payment for your health care services from you, your family members or your health insurance provider. 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 for insurance benefits, reviewing services provided to you for medical necessity and undertaking utilization review activities.
For Health Care Operations: We may use and disclose PHI for our health care operations. For example, we may use PHI for our general business management activities, for checking on the performance of our staff in caring for you, for our cost-management activities, for audits, or to get legal services. We may give PHI to other health care entities for their health care operations, for example, to your health insurer for its quality review purposes.
All disclosures of your PHI will be limited to the minimum necessary or that which is contained in a limited data set (e.g. PHI that excludes certain identifiers including demographic information, photographs, etc.). We will not sell your PHI without specific, individual authorization.
The Practice may also use and/or disclose your medical information in accordance with federal and state laws for the following purposes:
- To contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
- When required by the U.S. Department of Health and Human Services as part of an investigation or determination of compliance by the Practice with relevant laws.
- Unless you object, the Practice may disclose to family members, or other relatives, or close personal friends the medical information directly relevant to such person’s involvement with your care. The Practice may also give relevant information to an individual who helps pay for your care.
- To public or private entity for the purpose of coordinating with that entity to assist in disaster relief efforts.
- For public health activities, including the reporting of disease, injury, vital events, and the conduct of public health surveillance, investigation and/or intervention, or to a health oversight agency for oversight activities authorized by law, including audits, investigations, inspections, licensure or disciplinary actions, and administrative and/or legal proceedings.
- If you are involved in a lawsuit, claim, potential claim, or dispute, we may disclose medical information about you to attorneys, investigators, insurance companies, and related entities representing the interests of or insuring the doctors and/or other personnel affiliated with the Practice. We may also disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
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Right to a Paper Copy of This Notice: You have the right to 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. You can get a copy of this Notice at our website: https://www.usahomedialysis.com/
Complaints If you believe your privacy rights have been violated, you may file a complaint with this Practice and/or the Secretary of the Department of Health and Human Services. To file a complaint with this Practice, please contact our Privacy Officer at (847) 257-1237 or you can mail your complaint to: 304 Wainwright Drive, Northbrook, IL 60062 You will not be penalized for filing a complaint.
This notice is effective as of April 14, 2003