PhoenixWay to Holistic Natural Health: HIPAA Notice
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.
Right to Notice
As a customer of PhoenixWay you have the right to adequate notice of how the agency uses and discloses to others your protected health information and your individual rights and the agency’s legal duties with respect to protected health information.
If the agency provides you with direct service/support, this Notice will be provided to you no later than the date of the first service delivery, including service delivered electronically. If the first service delivery to you is delivered electronically, the agency will provide electronic Notice automatically in response to your first request for service. In an emergency treatment situation, the Notice will be provided as soon as reasonably practicable after the emergency treatment situation. And, except in an emergency treatment situation, the agency will make a good faith effort to obtain a written acknowledgment of receipt of the Notice. If it is not obtained, the agency will document its good faith efforts to obtain such acknowledgment and the reason why the acknowledgment was not obtained. The Notice will be available at each service delivery site for individuals to request to take with them. The Notice will be posted in a clear and prominent location where it is reasonable to expect individuals seeking service from the agency to be able to read the Notice. Whenever the Notice is revised, the agency will make the Notice available upon request on or after the effective date of the revision.
Protected Health Information (PHI) is:
The primary reasons the agency is allowed to use or disclose your PHI without your authorization are:
Other reasons the agency may use or disclose your PHI without your authorization:
Other uses and disclosures of your PHI will be made only when you have given us written authorization. You may revoke this authorization at any time, as long as it is done in writing.
Your Rights
When a use or disclosure for any purpose described in this Notice is not allowed or materially limited by another law, we will follow the more stringent law. You have the following rights with respect to your PHI. Contact your therapist or other qualified professional in order to exercise one of these rights.
OUR DUTIES:
Complaints:
You may complain to Ken Pataky at PhoenixWay, or to the Secretary of the Office of Civil Rights if you think that your privacy rights have been violated. Any staff member will assist you in filing a complaint utilizing the Participant Grievance Policy. You will not be treated unfairly for filing a complaint. For further information, contact PhoenixWay at [email protected].
Further Provision of Notice
Right to Notice
As a customer of PhoenixWay you have the right to adequate notice of how the agency uses and discloses to others your protected health information and your individual rights and the agency’s legal duties with respect to protected health information.
If the agency provides you with direct service/support, this Notice will be provided to you no later than the date of the first service delivery, including service delivered electronically. If the first service delivery to you is delivered electronically, the agency will provide electronic Notice automatically in response to your first request for service. In an emergency treatment situation, the Notice will be provided as soon as reasonably practicable after the emergency treatment situation. And, except in an emergency treatment situation, the agency will make a good faith effort to obtain a written acknowledgment of receipt of the Notice. If it is not obtained, the agency will document its good faith efforts to obtain such acknowledgment and the reason why the acknowledgment was not obtained. The Notice will be available at each service delivery site for individuals to request to take with them. The Notice will be posted in a clear and prominent location where it is reasonable to expect individuals seeking service from the agency to be able to read the Notice. Whenever the Notice is revised, the agency will make the Notice available upon request on or after the effective date of the revision.
Protected Health Information (PHI) is:
- Individually identifiable health information
- Health information, including demographic information
- Relates to your physical or mental health condition or the provision of or billing/payment for health care.
- It identifies you.
- PhoenixWay may use or disclose in any form or medium by us or other agencies that we have identified as Business Associates.
The primary reasons the agency is allowed to use or disclose your PHI without your authorization are:
- Treatment: To provide, coordinate or manage your health care. Examples of this include:
- Sharing information between staff of the agency so that you may receive the services and supports that you request.
- Sharing information with an LME so that you may receive the services and supports that you request.
- Sharing information with another provider of your care as part of the referral process.
- Payment: To obtain payment or be reimbursed for the service/support that is provided to you. An example:
- Your diagnosis and dates of attendance may be sent to your insurance company.
- Health Care Operations
- Administrative, financial, legal and quality improvement activities
- Operations necessary to run the agency and to support core functions of treatment and payment
- Quality assessment and improvement activities
- Training, accreditation, certification, credentialing, licensing, reviewing competence, evaluating performance
- Fraud and abuse detection
- Underwriting, rating, other activities relating to the creation, renewal or replacement of a contract of health insurance or benefits
- Conducting or arranging for medical review, legal services or auditing
- Business planning and development
- Business management and general administrative activities
- An example: in order to train a staff member on how to deliver the service/support that you have requested, we must share what we know about you in order to deliver the highest quality of care.
Other reasons the agency may use or disclose your PHI without your authorization:
- To communicate with you
- To aid the federal department of Health and Human Services/Office of Civil Rights to determine if we are following their rules.
- If you are not present or not able to give permission in writing, using professional judgment and knowledge/history about your desires, to make a decision about your care that it is in your best interest.
- Public policy purposes:
- As required by law
- For public health
- About victims of abuse, neglect or domestic violence
- For health oversight activities
- For judicial and administrative proceedings
- For law enforcement purposes
- About decedents (to coroners, medical examiners, funeral directors)
- For research purposes
- To avert a serious threat to health or safety
- For specialized government functions (military, veterans, national security, protective services, State Department, correctional)
- For workers’ compensation by special provision
- For cadaveric organ, eye or tissue donations
- To share limited data for research, public health, health care operations purposes when you have not received direct care/treatment with the following conditions:
- Direct identifiers will be removed
- Zip codes and dates will be included
- A Data Use Agreement is put in place with the person/agency that receives the information that states that the information cannot be used for other purposes or to identify, or try to identify, or contact you.
Other uses and disclosures of your PHI will be made only when you have given us written authorization. You may revoke this authorization at any time, as long as it is done in writing.
Your Rights
When a use or disclosure for any purpose described in this Notice is not allowed or materially limited by another law, we will follow the more stringent law. You have the following rights with respect to your PHI. Contact your therapist or other qualified professional in order to exercise one of these rights.
- To request restrictions on certain uses and disclosures of PHI to carry out treatment, payment or health care operations. However, the agency does not need to agree to your request. In addition, when an emergency arises, the agency may use or disclose the restricted information for the delivery of emergency treatment. Under the emergency situation, the agency shall ask the health care provider not to further use or disclose the information.
- To receive confidential communications of PHI by alternative means or at alternative locations when reasonable when you have requested this in writing. It is not required that you tell us the reason.
- To look at and obtain a copy of your PHI when you ask in writing. This right does not apply to psychotherapy notes, PHI compiled for use in a civil, criminal or administrative action or proceeding and information subject to the Clinical Laboratory Improvements Amendments.
- To amend your PHI when placed in writing with a reason to support the request.
- To receive an accounting of disclosures of your PHI made by the agency in the six years prior to the date on which the accounting is requested except for disclosures: to carry out treatment, payment and health care operations; those made to you; incident to a use or disclosure; in accordance with an authorization; for the facility’s directory or to person involved in your care or other notification purposes for national security or intelligence purposes; to correctional institution or law enforcement officials; as part of a limited data set; that occurred prior April 14, 2003; and
- To obtain a paper copy of this Notice from the agency upon request.
OUR DUTIES:
- PhoenixWay is required by law to maintain the privacy of PHI and to provide individuals with notice of its legal duties and privacy practices.
- The agency is required to abide by the terms of the Notice that is currently in effect.
- PhoenixWay reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all PHI that it maintains. When privacy practices change, these changes will apply to PHI that the agency created or received prior to issuing the revised Notice. The agency will take every step possible, and practical, to provide you with a revised notice.
Complaints:
You may complain to Ken Pataky at PhoenixWay, or to the Secretary of the Office of Civil Rights if you think that your privacy rights have been violated. Any staff member will assist you in filing a complaint utilizing the Participant Grievance Policy. You will not be treated unfairly for filing a complaint. For further information, contact PhoenixWay at [email protected].
Further Provision of Notice
- The agency will make this Notice available on request to any person.
