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We at Complete are dedicated to protecting personal information and we pledge to keep it confidential and secure, in accordance with the patient’s decisions 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. If you have any questions about this Notice please contact our Privacy Officer:
WHAT DOES A NOTICE OF PRIVACY PRACTICES TELL YOU The 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” (PHI)
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.
OUR SERVICES AND PLEDGE REGARDING YOUR HEALTH INFORMATION WHICH IS PRIVATE Complete Home Services Management Corporation (CHS) contracts with managed care organizations, to coordinate home health care options and provide a comprehensive solution for customers to receive healthcare in their home. We understand that the information we collect about you and your health is personal. We are committed to protecting your health information and following all laws regarding the use of your health information.
HOW WE MAY USE OR DISCLOSE YOUR HEALTH INFORMATION Your protected health information is usually sent to us by your physician, physician’s office staff or others outside of our office that are involved in your care and treatment, for the purpose of providing services to you. In turn we utilize this information to coordinate the delivery of care, receive payment for the services provided and to support the operations of Complete Home Services. The following are examples of the types of uses and disclosures of your protected health care information that CHS is permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office. Treatment: We will use and disclose your protected health information to provide, coordinate, or manage services in the home such as medical equipment, nursing, pharmacy, pharmacy supplies. This includes the coordination or management of your health care with a third party. We would disclose your protected health information, as necessary, to our network of providers that include home medical equipment companies, home care agencies and pharmacies who will be providing services to you. We may also disclose protected health information to physicians who may be treating you. For example, your protected health information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information. Our network of providers assigned to render services to you are responsible for safeguarding your privacy as required by law. Payment: Your protected health information will be used, as needed, to obtain payment for services provided to you. In addition, we may be required to report services provided to you, to your health plan, for utilization purposes. This may include certain activities that your health insurance plan may undertake before it approves or pays for the services provided such as; making a determination of eligibility or coverage for insurance benefits, reviewing services for medical necessity, and undertaking utilization review activities. For example, obtaining approval for certain medications or equipment may require that your relevant protected health information be disclosed to the health plan to obtain approval for services. Healthcare Operations: We may use or disclose, as-needed, your protected health information in order to support the business activities of the organization. These activities include, but are not limited to, accreditation, quality assessment, utilization review, employee reviews, training, licensing, marketing and fundraising activities, and conducting or arranging for other business activities. We may use or disclose your protected health information, as necessary, to contact you to schedule services and determine quality of care. We will share your protected health information with third party “business associates” that perform various activities. 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 that contains terms that will protect the privacy of your protected health information. We may use or disclose your protected health information, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may also use and disclose your protected health information for other marketing activities. For example, we may send you information about products or services that we believe may be beneficial to you. You may contact our Privacy Officer to request that these materials not be sent to you. We may use or disclose your demographic information in order to contact you for fundraising or wellness activities supported by our office. If you do not want to receive these materials, please contact our Privacy Officer and request that these fundraising materials not be sent to you. In addition, our office may post or share with others outside of CHS, thank you letters/cards and other holiday cards received from patients in lobby bulletin boards or other general areas.
WHAT IF MY INFORMATION NEEDS TO GO SOMEWHERE ELSE Other uses and disclosures of your protected health information will be made only with your written Authorization, unless otherwise permitted or required by law as described below. You may revoke this Authorization, at any time, in writing, except to the extent that we have taken an action in reliance on the use or disclosure indicated in the Authorization.
COULD MY HEALTH INFORMATION BE RELEASED WITHOUT MY PERMISSION We may use and disclose your protected health information to others involved in your health care. We may release medical information about you to a friend or family member who is involved in your medical care. We may also tell your family or friends your condition as directed by you. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status or location. We may also use or disclose your protected health information in an emergency treatment situation. Other Permitted and Required Uses and Disclosures That May Be
Made Without Your Authorization or Opportunity to Object:
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION You have the right to inspect and copy your protected health information. Usually this includes medical and billing records. To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to the Privacy Officer. 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. Under Federal law, however, you may not inspect or copy information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and protected health information that is subject to law that prohibits access to protected health information. Depending on the circumstances, a decision to deny access may be reviewed. Please contact our Privacy Officer if you have questions about access to your medical record. You have the right to request a restriction of your protected health information. This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply. CHS is not required to agree to your restriction request, especially if it believes it is not in your best interest. If we do agree to the requested restriction, we may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment. To request restrictions, please make request in writing to our Privacy Officer. Please indicate what information you want to limit, whether you want to limit use or disclosure or both and to whom you want the limits to apply, for examples, disclosures to your spouse. You have the right to request to receive confidential communications from us by alternative means or at an alternative location. We will accommodate reasonable requests. We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. Please make this request in writing to our Privacy Officer indicating how or where you wish to be contacted. You may have the right to have your physician amend your protected health information. This means you may request an amendment of protected health information if you feel that medical information we have about you is incorrect or incomplete. You have the right to request an amendment for as long as we maintain the information. An amendment request must be made in writing and submitted to the privacy officer. In addition, you must provide a reason that supports your request. We may deny your request if it is not in writing or does not include a reason to support the request, the information was not created by us, is not part of information kept by us, is not part of information which you would be permitted to inspect and copy or information is accurate and complete. You have the right to file a complaint in writing and we will prepare a written response to your complaint. Please contact our Privacy Officer if you have questions about amending your medical record. You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. This right applies to disclosures for purposes other than treatment, payment or healthcare operations as described in this Notice of Privacy Practices. You have the right to receive specific information regarding these disclosures that occurred after April 14, 2003. You may request a shorter timeframe. The right to receive this information is subject to certain exceptions, restrictions and limitations. You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice electronically.
QUESTIONS OR COMPLAINTS You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our Privacy Officer. We will not retaliate against you for filing a complaint. You may contact our Privacy Officer, for further information about the complaint process. This notice was published and becomes effective on April 14, 2003 |
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