Notice of Privacy Practices
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.
-
WE HAVE A LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION (PHI).
We are legally required to protect the privacy of your health information. We call this information
"protected health information," or "PHI" for short, and it includes information that can be used to
identify you that we've created or received about your past, present, or future health condition, the
provision of health care to you, or the payment for this health care. We must provide you with this
notice about our privacy practices that explains how, when, and why we use and disclose your
PHI. With some exceptions, we may not use or disclose any more of your PHI than is necessary to
accomplish the purpose of the use or disclosure. We are legally required to follow the privacy
practices that are described in this notice.
However, we reserve the right to change the terms of this notice and our privacy policies at any
time. Any changes will apply to the PHI we already have. Before we make an important change to
our policies, we will promptly change this notice. You can request a copy of this notice from the
contact person listed in Section IV below at any time.
-
HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION.
We use and disclose health information for many different reasons. For some of these uses or
disclosures, we need your specific authorization. Below, we describe the different categories of
uses and disclosure.
-
We may use and disclose your PHI without your authorization for the following reasons:
For treatment. We may disclose your PHI to hospitals, physicians, nurses, and other health
care personnel who provide you with health care services or are involved in your care. For
example, if you're being treated for sleep disorder, we may disclose your PHI to a CPAP
technician in order to coordinate your care.
To obtain payment for treatment. We may use and disclose your PHI in order to bill and
collect payment for the treatment and services provided to you. For example, we may provide
portions of your PHI to our billing department and your health plan to get paid for the health
care services we provided to you
For health care operations. We may disclose your PHI in order to operate this entity. For
example, we may use your PHI in order to evaluate the quality of health care services that you
received or to evaluate the performance of the health care professionals who provided health
care services to you. We may also provide your PHI to our accountants, attorneys,
consultants, and others in order to make sure we're complying with the laws that affect us.
When a disclosure is required by federal, state or local law, judicial or administrative
proceedings, or law enforcement. For example, we make disclosures when a law requires
that we report information to government agencies and law enforcement personnel about
victims of abuse, neglect, or domestic violence; when dealing with gunshot or other wounds,
or when ordered in a judicial or administrative proceeding.
For public health activities. For example, we report information about births, deaths, and
various diseases, to government officials in charge of collecting that information, and we
provide coroners, medical examiners, and funeral directors necessary information relating to
an individual's death.
For health oversight activities. For example, we will provide information to assist the
government when it conducts an investigation or inspection of a health care provider or
organization.
For research purposes. In certain circumstances, we may provide PHI in order to conduct
medical research.
To avoid harm. In order to avoid a serious threat to the health or safety of a person or the
public, we may provide PHI to law enforcement personnel or persons able to prevent or lessen
such harm.
For specific government functions. We may disclose PHI of military personnel and veterans
in certain situations. And we may disclose PHI for national security purposes, such as
protecting the President of the United States or conducting intelligence operations.
For workers' compensation purposes. We may provide PHI in order to comply with
workers' compensation laws.
Appointment reminders and health-related benefits or services. We may use PHI to
provide appointment reminders or give you information about treatment alternatives, or other
health care services or benefits we offer.
-
Uses and Disclosures Where You to Have the Opportunity to Object:
Disclosures to family, friends, or others. We may provide your PHI to a family member,
friend, or other person that you indicate is involved in your care or the payment for your
health care, unless you object in whole or in part.
-
All Other Uses and Disclosures Require Your Prior Written Authorization. In any other
situation not described above, we will ask for your written authorization before using or
disclosing any of your PHI. If you choose to sign an authorization to disclose your PHI, you
can later revoke that authorization in writing to stop any future uses and disclosures (to the
extent that we haven't taken any action relying on the authorization).
-
Incidental Uses and Disclosures. Incidental uses and disclosures of information may occur.
An incidental use or disclosure is a secondary use or disclosure that cannot reasonably be
prevented, is limited in nature, and that occurs as a by-product of an otherwise permitted use
or disclosure. However, such incidental uses or disclosure are permitted only to the extent that
we have applied reasonable safeguards and do not disclose any more of your PHI than is
necessary to accomplish the permitted use or disclosure. For example, disclosures about a
patient made by a home health provider in the patient's home that might be overheard by other
family members not involved in the patient's care would be permitted.
WHAT RIGHTS YOU HAVE REGARDING YOUR PHI.
The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask
that we limit how we use and disclose your PHI. We will consider your request but are not legally
required to accept it. If we accept your request, we will put any limits in writing and abide by
them except in emergency situations. You may not limit the uses and disclosures that we are
legally required or allowed to make.
The Right to Choose How We Send PHI to You. You have the right to ask that we send
information to you to an alternate address (for example, sending information to your work address
rather than your home address) or by alternate means (for example, e-mail instead of regular
mail). We must agree to your request so long as we can easily provide it in the format you
requested.
The Right to See and Get Copies of Your PHI. In most cases, you have the right to look at or
get copies of your PHI that we have, but you must make the request in writing. If we don't have
your PHI but we know who does, we will tell you how to get it. We will respond to you within 30
days after receiving your written request. In certain situations, we may deny your request. If we
do, we will tell you, in writing, our reasons for the denial and explain your right to have the denial
reviewed.
If you request copies of your PHI, we will charge you $1.00 for each page. Instead of providing
the PHI you requested, we may provide you with a summary or explanation of the PHI as long as
you agree to that and to the cost in advance.
The Right to Get a List of the Disclosures We Have Made. You have the right to get a list of
instances in which we have disclosed your PHI. The list will not include uses or disclosures made
for treatment, payment, or health care operations, directly to you, to your family, or in our facility
directory, or pursuant to a valid authorization. The list also won't include uses and disclosures
made for national security purposes, to corrections or law enforcement personnel, or before April
1, 2003.
We will respond within 60 days of receiving your request. The list we will give you will include
disclosures made in the last six years unless you request a shorter time. The list will include the
date of the disclosure, to whom PHI was disclosed (including their address, if known), a
description of the information disclosed, and the reason for the disclosure. We will provide the list
to you at no charge, but if you make more than one request in the same year, we will charge you
$25 for each additional request.
The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI or
that a piece of important information is missing, you have the right to request that we correct the
existing information or add the missing information. We will respond within 60 days of receiving
your request in writing. You must provide the request and your reason for the request in writing.
We may deny your request in writing if the PHI is (i) correct and complete, (ii) not created by us,
(iii) not allowed to be disclosed, or (iv) not part of our records. Our written denial will state the
reasons for the denial and explain your right to file a written statement of disagreement with the
denial. If you don't file one, you have the right to request that your request and our denial be
attached to all future disclosures of your PHI. If we approve your request, we will make the
change to your PHI, tell you that we have done it, and tell others that need to know about the
change to your PHI.
The Right to Get This Notice by E-Mail. You have the right to get a copy of this notice by email.
Even if you have agreed to receive notice via e-mail, you also have the right to request a
paper copy of this notice.
HOW TO COMPLAIN ABOUT OUR PRIVACY PRACTICES .
If you think that we may have violated your privacy rights, or you disagree with a decision we
made about access to your PHI, you may file a complaint with the person listed in Section VI
below. You also may send a written complaint to the Secretary of the Department of Health and
Human Services at 200 Independence Ave., S.W.; Room 615F; Washington, DC 20201. We will
take no retaliatory action against you if you file a complaint about our privacy practices.
PERSON TO CONTACT FOR INFORMATION ABOUT THIS NOTICE OR TO
COMPLAIN ABOUT OUR PRIVACY PRACTICES.
If you have any questions about this notice or any complaints about our privacy practices, or
would like to know how to file a complaint with the Secretary of the Department of Health and
Human Services, please contact: Dan Fawvor, Compliance Officer, Health Management Services,
Inc., 9100 SW Freeway, Suite 114, Houston, TX 77074, 713-541-2727, ext. 22.
EFFECTIVE DATE OF THIS NOTICE
This Notice is Effective April 1, 2003
Revised January 12, 2004
|