Terry Reilly Health Services
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.
Effective Date: April 14, 2003
We understand that health information about you and the health care you receive is personal. We are committed to protecting your personal health information. This notice tells you about the ways in which we may use and disclose your personal health information. This notice also describes your rights with respect to the health information that we keep about you and the obligations that we have when we use and disclose your health information. We are required by law to make sure that health information that identifies you is kept private in accordance with relevant law; to give you this notice of our legal duties and privacy practices with respect to your personal health information; and, to follow the terms of the notice that is currently in effect for all of your personal health information. We reserve the right to change this notice and to make the changed notice effective for all of the health information that we maintain about you, whether it is information that we previously received about you or information we may receive about you in the future. We will post a copy of our current notice in our facility. We will also give you a copy of our current notice upon request.
Use and Disclosure of Health Information:
We may use and disclose your personal health information without specific written authorization for the following purposes:
For Treatment. We may use and disclose your health information to provide, manage or coordinate your heath care and any related services. For example, the clinicians may confer about your needs to determine an appropriate course of action, to provide coverage, or to coordinate services you may be receiving from more than one provider. We may also disclose your protected health information to make a referral or to enlist additional services, such as a specialist, labs, x-rays, polygraphs, or prescriptions.
For Payment. We may use and disclose health information about you to bill and collect payment from you, your insurance company, including Medicaid and Medicare, or other third party that may be available to reimburse us for some or all of your health care. For example, we may need to share information about your office visit with your health plan in order for your health plan to pay us or reimburse you for the visit. We may also tell your health plan about treatment that you need in order to obtain your health plan’s prior approval or to determine whether your plan will cover the treatment.
For Health Care Operations. We may use and disclose health information about you for daily operations of our clinics. These uses and disclosures are necessary to run Terry Reilly Health Services and to ensure that all of our patients receive quality care. For example, we may use health information to review the services that we provide and to evaluate the performance of our staff. We may also combine health information about our patients to decide what additional services Terry Reilly Health Services should offer, what services are not needed, whether new treatments are effective, or to see where we can make improvements.
Appointment Reminders. We may use and disclose health information about you to contact you as a reminder that you have an appointment.
Health-Related Services and Treatment Alternatives. We may use and disclose health information to tell you about health-related services or recommend treatment options or alternatives that may be of interest to you.
Research. Under certain circumstances, we may use and disclose health information about you for research purposes. For example, a research project may involve comparing the health and recovery of all patients 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 health information, trying to balance the research needs with a patient’s need for privacy. Before we use or disclose health information for research, the project will have been approved through this special approval process.
Organ and Tissue Donation. If you are an organ donor, we may disclose health information about you to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
As Required By Law. We will disclose health information about you when required to do so by federal, state or local law.
To Avert a Serious Threat to Health or Safety. We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
Military and Veterans. If you are a member of the armed forces or separated/ discharged from military services, we may release health information about you as required by military command authorities or the Department of Veterans Affairs as may be applicable. We may also release health information about foreign military personnel to the appropriate foreign military authorities.
Workers’ Compensation. We may release health information about you for workers’ compensation or similar programs if we are providing care as the result of a work related accident or injury. These programs provide benefits for work-related injuries or illness.
Public Health Activities. We may disclose health information about you for public health activities to a public health authority permitted by law to collect or receive this information. Public health activities generally include preventing or controlling disease, injury or disability; reporting births and deaths; reporting child abuse or neglect; reporting reactions to medications or problems with products; notifying people of recalls of products; notifying a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
Abuse or Neglect. We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect if we believe that you have been a victim of abuse, neglect or domestic violence. Such disclosures will be made consistent with federal and state laws.
Health Oversight Activities. We may disclose health information about you to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections and licensure. These activities are necessary for the government to monitor the health care system, government programs and compliance with civil rights laws.
Lawsuits and Disputes. We may disclose health information about you in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request or other lawful process that is not accompanied by a court or administrative order, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
Law Enforcement. We may release health information about you if asked to do so by a law enforcement official if such disclosure is required by law; in response to a court order, subpoena, warrant, summons or similar process; to identify or locate a suspect, fugitive, material witness or missing person; under certain limited circumstances, about the victim of a crime; about a death we believe may be the result of criminal conduct; about criminal conduct at Terry Reilly Health Service; or in emergency circumstances to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.
Coroners, Health Examiners and Funeral Directors. We may release health information about our patients to a coroner or health examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release health information to funeral directors as may be necessary for them to carry out their duties.
National Security and Intelligence Activities. We may release health information about you to authorized federal officials for intelligence, counterintelligence and other national security activities as authorized by law.
Protective Services for the President and Others. We may disclose health information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release health information about you to the corrections institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care, (2) to protect your health and safety or the health and safety of others, or (3) for the safety and security of the correctional institution.
Emergencies. Using our professional judgment, we may use or disclose your protected health information in an emergency situation if we determine that the disclosure is in your best interest. We will try to obtain your consent as soon as reasonably practicable. For example, we may need to notify or assist in notifying a family member, personal representative, or individual responsible for your care of your location, condition or death. We may need to provide information to an authorized entity to assist in disaster relief efforts.
Other Uses and Disclosures of Your Protected Health Information: Other uses and disclosures of personal health information not covered by this notice or applicable law will be made only with your written authorization. If you give us your written authorization to use or disclose your personal health information, you may revoke your authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose your personal health information for the reasons covered by your written authorization. You understand that we are unable to take back any uses and disclosures that we have already made with your authorization, and that we are required to retain our records of the care that we have provided to you.
Patient Rights:
You have certain rights with respect to your personal health information. This section of our notice describes your rights and how to exercise them:
Right to Inspect and Copy: You have the right to inspect and copy the personal health information in your medical and billing records. This right does not include the right to inspect and copy psychotherapy notes or records compiled in anticipation of a judicial proceeding or an investigation. To inspect and copy your personal health information, you must submit your request in writing to our privacy contact person. If you request a copy of the information, we may charge a $20.00 fee for the coping costs associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If your request is denied, you may request that the denial be reviewed. We will designate a licensed health care professional to review our decision to deny your request. The person conducting the review will not be the same person who denied your request. We will comply with the outcome of this review.
Right to Amend: If you feel that the health information we maintain about you is incorrect or incomplete, you may ask us to amend the information. To request an amendment, your request must be made in writing and submitted to our privacy contact person. In addition, you must provide a reason that supports your request for an amendment. We may deny your request for an amendment if your request does not include a reason to support the request, if you ask us to amend information that was not created by us, or if the information is accurate and complete. Any amendment we make to your health information will be disclosed to the health care professionals involved in your care and to others who relied upon this information to carry out treatment, payment and health care operations.
Right to Receive an Accounting of Disclosures. You have the right to receive an accounting of certain disclosures of your health information that we have made. An accounting will not include all disclosures that we made. For example, it will not include disclosures made to carry out treatment, payment and health care operations, pursuant to your written authorization, to you, or to law enforcement officials. To request an accounting of disclosures, you must submit your request in writing to our privacy contact person. Your request must state a time period that may not exceed six (6) years and may not include dates before April 14, 2003. 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. We will mail you a list of disclosures in paper form within 30 days of your request, or notify you if we are unable to supply the list within that time period and by what date we can supply the list; this date will not exceed 60 days from the date you made the request.
Right to Request Restrictions. You have the right to request a restriction or limitation on the 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 health information we disclose about you to someone who is involved in your care. For example, you may request that we not disclose information about you to a certain doctor or other health care professional. We are not required to agree to your request for restrictions if it is not feasible for us to comply with your request or if we believe that it will negatively impact our ability to care for you. If we do agree, however, we will comply with your request unless the information is needed to provide emergency treatment. To request a restriction, you must make your request in writing to our privacy contact person. In your request, you must tell us what information you want to limit and to whom you want the limits to apply.
Right to Receive Confidential Communications. You have the right to request that we communicate with you about health matters in a certain way. For example, you can ask that we only contact you at work or by mail at a specified address. To request that we communicate with you in a certain way, you must make your request in writing to our privacy contact person. 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.
Right to a Paper Copy of this Notice. You have the right to receive a paper copy of this notice at any time. To receive a copy, please request it from our privacy contact person or visit our website, at www.trhs.org.
Complaints:
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. You may file a complaint by mailing or faxing a written description of your complaint or by telling us about your complaint in person or over the telephone. Be sure to describe what happened and give us the dates and names of anyone involved. Additionally, let us know how to contact you so that we can respond to your complaint. You will not be penalized for filing a complaint. Direct complaints to the TRHS Privacy Officer, PO Box 9, Nampa, ID, 83653, or call and ask to speak with the Privacy Officer at (208) 467-4431.