NOTICE OF PRIVACY PRACTICES

 

 

This notice describes how protected health information about you may be used and disclosed and how you can gain access to this information.  Please review it carefully.

 

If you have any questions about this Notice, please contact: The Region IV Area Agency on Aging (R4AAA), Privacy Officer at (269) 983-0177 or 1-800-442-2803

 

This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations, and for other purposes that are permitted or required by law.  It also describes your rights to access and control your protected health information.  “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services.

 

We are required to abide by the terms of this Notice of Privacy Practices.  We will provide you with any revised Notice of Privacy Practices if you call our office and request that a revised copy be sent to you in the mail or if you ask for a copy at your next reassessment. 

 

     USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION

       

I.    Uses and Disclosures of Protected Health Information Based upon Your Written Consent

You will be asked by your care manager to sign a consent form.  Once you have consented to the use and disclosure of your protected health information for treatment, payment and health care operations by signing the consent form, your care manager will use or disclose your protected health information as described in this Section (I.).  Your protected health information may also be used and disclosed to pay your health care bills and to submit claims to Medicaid, Medicare or third party insurers for reimbursement.  Following are example of the types of uses and disclosures of your protected health information that R4AAA is permitted to make once you have signed our consent form.  These examples are meant to describe the types of uses and disclosures that may be made once consent is provided, but may not necessarily be disclosed for you:

 

TREATMENT

We will use and disclose your protected health information to provide, coordinate or manage your health care and any related services.  This includes the coordination or management of your treatment plan with our network of service providers.  For example, we would disclose your protected health information with a home health agency that will provide personal care to you.  A listing of your providers (a care plan report) will be discussed with you at each reassessment, and you may request a copy of the care plan report at the reassessment.    In addition, we may disclose your protected health information from time-to-time with your physician or other specialist who becomes involved in your care by providing assistance with your health care diagnosis or treatment plan.

 

PAYMENT

Your protected health information will be used, as needed, to obtain payment for your health care services.  This may include certain activities that Medicaid, Medicare or another health insurance plan may undertake before it approves or pays for your health care services such as making a determination of your eligibility or reviewing services provided to you as appropriate and necessary, and undertaking utilization review activities. 

 

HEALTHCARE OPERATIONS

We may use or disclose, as needed, your protected health information in order to support business activities including, but not limited to, quality assurance reviews, care manager trainings, peer reviews, Medicaid or Medicare or other health insurance plan audit reviews, and independent financial audits.

 

For example, we may disclose your protected health information with third party “business associates” that perform various activities like billing or claim submission services for R4AAA.  Whenever an arrangement between our office and a business associate involves the use or disclosure of your protected health information, we will have a written contract with the business associate that will protect the privacy of your protected health information.

 

We may disclose your protected health information, as necessary, to contact you monthly to check on your health status, to arrange for your next home visit by your care manager or to remind you of your next appointment for a home visit.  We may also call you by name in our waiting room if you visit R4AAA to see your care manager.

 

We may also send you information about services we feel may be beneficial to you, notify you about our fundraising efforts or send you our newsletters.  You may contact our Privacy Contact Person to request that these materials not be sent to you.

 

We may use or disclose your protected health information that directly relates to the provision of your health care in your home to an individual or agency from our pool of service providers. Only the protected health information that is relevant for the provider to deliver comprehensive health care service(s) will be disclosed.

 

INDIVIDUALS INVOLVED IN YOUR CARE OR PAYMENT FOR YOUR CARE.  

We may release protected health information about you to a friend or family member who is involved in your medical care.  We may also give information to someone who helps pay for your care.  We may also tell your family or friends your conditions and that you are involved with our program.  In addition we may disclose protected health information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status, and location.

 

RESEARCH

Under certain circumstances, we may use and disclose protected health information about you for research purposes.  For example, a research project may involve comparing the health and recovery of all participants who received one medication to those who received another, for the same condition.  All research projects, however, are subject to a special approval process.  This process evaluates a proposed research project and its use of protected health information, trying to balance the research needs with participants’ need for privacy of their protected health information.  Before we use or disclose protected health information for research, the project will have been approved through this research approval process, but we may, however, disclose protected health information about you to people preparing to conduct a research project, for example, to help them look for patients with specific medical needs, so long as the protected health information they review does not leave the agency.  We will almost always ask for your specific permission or authorization if the researcher will have access to your name, address or other information that reveals who you are, or will be involved in your care at the agency.

 

II.   Uses and Disclosures of Protected Health Information Based upon your Written Authorization

Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law.  You may revoke any written authorization at any time in writing, except to the extent that your care manager has taken an action already in progress in reliance on the use or disclosure indicated in the previously signed authorization.

 

III.  Other Permitted and Required Uses and Disclosures that May Be Made with Your Consent, Authorization or Opportunity to Object

You have the opportunity to agree or object to the use or disclosure of all or part of your protected health information.  If you are not present or able to agree or object to the use or disclosure of the protected health information, then your care manager may, using professional judgment, determine whether the disclosure is in your best interest.  In this case, only the protected health information that is relevant to your health care will be disclosed.

 

YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION  ABOUT YOU

 

I.    You have the following rights regarding protected health information we maintain about you:

 

RIGHT TO INSPECT AND COPY

You have the right to inspect and copy protected health information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes. To inspect and copy protected health information that may be used to make decisions about you, you must submit your request in writing to the agency.  If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request.  We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another supervisor or director chosen by the agency will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

 

RIGHT TO AMEND

If you feel that protected health information  we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the agency.  To request an amendment, your request must be made in writing and submitted to the agency.  In addition, you must provide a reason that supports your request.  We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that was not created by us, unless the person or entity that created the information is no longer available to make the amendment or that is not part of the protected health information kept by or for the agency, or is not part of the information which you would be permitted to inspect and copy, or that is accurate and complete.

 

RIGHT TO AN ACCOUNTING OF DISCLOSURES

You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of protected health information  about you.  To request this list or accounting of disclosures, you must submit your request in writing to the agency.   Your request must state a time period which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically, by mail). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

 

RIGHT TO REQUEST RESTRICTIONS

You have the right to request a restriction or limitation on the protected health information  we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the protected health information  we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you may not want your spouse to know anything about your services unless it’s an emergency.  We are not required to agree to your request.  If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.  To request restrictions, you must make your request in writing to the agency.   In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.

 

RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS.

You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.  To request confidential communications, you must make your request in writing to the agency.   We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

 

RIGHT TO A PAPER COPY OF THIS NOTICE

You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.  To obtain a paper copy of this notice, call the agency at (269) 983-0177 or 1-800-442-2803.

 

RIGHT TO FILE A COMPLAINT

You have the right to file a formal complaint if you believe your privacy rights have been violated, You may file a complaint with this agency or with the secretary of the department of health and human services.  To file a complaint with this agency, please contact the Privacy Officer,  at (269) 983-0177 or 1-800-442-2803.  All complaints must be submitted in writing.   You will not be penalized for filing a complaint. 

 

 

Changes To This Notice

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for protected 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 in our office and on our website. The notice will contain the effective date on the bottom right corner of the actual notice, and on the main page on the website. 

 

 

 

04/07/03