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.
EncompassCare is required by law to provide you with this notice of our legal duties and privacy practices with respect to information we collect and maintain in your medical record so that you will understand how we may use or share your information. Your medical record includes financial and health information referred to in this notice as “Protected Health Information” (“PHI”) or “health information.”
This Notice describes the practices of EncompassCare. We are required to maintain the privacy and security of your health information and adhere to the terms of this notice. We will not use or disclose your health information without your authorization, except as described in this Notice, and we will notify you if a breach occurs that has compromised the privacy or security of your health information. If you have any questions about this Notice, please contact EncompassCare’s Privacy Officer, Linda Stratton at 419-302-5488.
Your Rights Regarding Your Protected Health Information
Although your health record is the property of EncompassCare, you have the following rights regarding your health information:
- Inspect and Copy. You can ask to review or get a paper or electronic copy of your health information, which will be provided to you in the timeframes established by law. You must submit your request to the Privacy Officer in writing. We may charge a fee for the costs of copying, mailing or other supplies associated with your request.
- Amend Your Record. If you feel that health information in your record is incorrect or incomplete, you may ask us to correct the information. You must submit your request in writing on the form provided by the Privacy Officer, and you must provide a reason for your request. We will allow all reasonable requests.
- Accounting of Disclosures. You can ask for an “accounting of disclosures,” or a list of how we have shared your health information and who we shared it with in the previous six (6) years. Accountings will not include disclosures made for treatment, payment, or health care operations, or pursuant to your authorization. You must submit your request in writing to the Privacy Officer. 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.
- Request Restrictions. You can ask us to restrict or limit the health information we use or disclose about you for treatment, payment, or our health care operations. We are not required to agree to your request, unless it relates to disclosures to your health care plan regarding a service for which you paid in full out of pocket. If we agree, we will comply with your request unless the information is needed to provide emergency treatment. You must submit your request in writing to the Privacy Officer.
- Request Alternate Communications. You can ask us to use alternative methods to communicate with you regarding your health information by submitting a request in writing to the Privacy Officer. We will not ask you the reason for your request. Your request must specify how or where you wish to be contacted. We will accommodate all reasonable requests.
- Paper Copy of This Notice. You have the right to a paper copy of this Notice even if you have agreed to receive the Notice electronically. You may also access and print a copy of our Notice from our website.
- Notice of Breach. You have the right to be notified in the event that there is an unauthorized use or disclosure of your health information.
How We May Use/Disclose Your Protected Health Information
The following categories describe the ways that we may use and disclose health information. Not every use or disclosure in a category will be listed. However, all of the ways that we are permitted to use and disclose information will fall into one of these categories:
- Treatment. We may use and disclose your health information to provide treatment to you. For example, our therapists may share information with each other in order to provide you with appropriate treatment or with your physician to advise him about your condition. We may also contact you regarding your treatment, to coordinate your care, and to recommend alternative treatments or tell you about health-related benefits or services.
- Payment. We may use and disclose your health information in order to bill you, a government program, an insurance company or other third party payers for the services we provide. For example, we may need to share information with your health plan about the services we provided to you to get paid for those services.
- Health Care Operations. We will use or disclose your health information for our regular health operations and to improve quality of care. For example, members of our staff may use information in your health record to assess the care and outcomes in your case and others like it in an effort to improve the effectiveness of the health care and service we provide. We may also disclose your health information for certain health care operations of other entities and with our business associates, such as our consultants, accountants, and attorneys.
- Notification. We may use or disclose your health information to notify or assist in notifying a family member, personal representative, or another person responsible for your care of your location and general condition. We may also disclose your health information to friends and family members involved in your care or payment for your care that information relevant to their involvement.
- Organ and Tissue Donation. If you are an organ donor, we may disclose health information to organizations that handle organ procurement to facilitate donation and transplantation.
Research. Under certain circumstances, we may use and disclose health information about you for research purposes.
- Workers’ Compensation. We may disclose health information about you for workers’ compensation or similar programs.
- Public Health and Safety. We may disclose health information about you for certain public health and safety purposes, including: prevention or control of disease, injury or disability; reporting reactions to medications or problems with products; notifying people of recalls of products; reporting suspected abuse, neglect or domestic violence; or to prevent or reduce a serious threat to your or another person’s health and safety.
- Required by Law. We may share your health information when it is required by state or federal laws and to demonstrate to the Department of Health and Human Services that we are complying with federal privacy law.
- Health Oversight Activities. We may disclose health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections.
- Lawsuits and Disputes. We may disclose your health information in response to a court or administrative order or in response to a subpoena, discovery request, or other lawful process.
- Law Enforcement. We may disclose your health information for law enforcement purposes and to a law enforcement official.
- Coroners, Medical Examiners, and Funeral Directors. We may disclose health information to a coroner, medical examiner, or funeral director to carry out their duties when someone dies.
- Government Functions. We may share your health information for special government functions, such as military, national security, presidential protective services, and correctional institutions.
- Fundraising Activities. EncompassCare may contact you for fundraising purposes, but you will be provided an opportunity to opt out of these communications.
Disclosures not described in this Notice will be made only with your written authorization. Most disclosures of psychotherapy notes (if we maintain them), disclosures for marketing purposes, and any sale of your health information will require your authorization. If you provide us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization. Of course, we are unable to take back any disclosures we have already made with your permission.
Changes to this Notice
We reserve the right to change our privacy practices and to make the new provisions effective for health information we already have about you as well as any information we receive in the future. We will post the new notice on our website and provide copies upon request.
If you believe your privacy rights have been violated, you may file a complaint with EncompassCare or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with EncompassCare, contact the Privacy Officer, Linda Stratton at email@example.com. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
The effective date of this Notice is 10/1/15.