PIEDMONT ACCESS TO HEALTH SERVICES, INC.
Policy Number: 01-01-038
SUBJECT: Notice of Privacy Practices
EFFECTIVE DATE: 9/16/2011
REVIEWED/REVISED: 02/11/2013, 05/14/2014, 03/11/2016
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POLICY: This notice describes how PATHS’ health information about you may be used and disclosed and how you can get access to this information. If you have any questions about this notice, please contact PATHS by dialing (434) 791-4122 for Danville, (434) 432-4443 for Chatham,
(434) 738-6420 for Boydton, and (276) 632-2966 for Martinsville. Each time you visit PATHS a record of your visit is made. Typically, this record contains your symptoms, examination, and test results, diagnosis, treatment, a plan for future care or treatment and billing-related information.
· Means by which you or a third-party payer can verify that you actually received the services billed for.
· Tool in medical education.
· Source of information for public health officials charged with improving the health of the regions they serve.
This notice applies to all of the records generated by PATHS to your health care whether made by PATHS’ personnel, agents of the facility or your personal doctor.
Our Responsibilities
We are required by law to maintain the privacy of your health information and provide you a description of our privacy practices. We will abide by the terms of this notice.
Uses and Disclosures:
How we may use and disclose your health information about you. The following categories describe examples of the ways we may use and disclose PATHS’ information, given your consent:
For Treatment
We may use health information about you to provide treatment or services. We may disclose health information about you to doctors, nurses, technicians, and health students who are involved in taking care of you at PATHS. For example: a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. Different departments of PATHS may share information about you in order to coordinate the different things you may need, such as prescriptions, lab work, x-rays, and patient education.
For Payment
We may use and disclose health information about your treatment and services to bill and collect payments from you, your insurance company or a third party payer. For example, we may need to give information about a procedure so that your insurance will pay us or reimburse you for the treatment. We may also tell your insurance company about treatments you are going to receive to determine whether your plan will cover it.
For Health Care Operations
Members of the medical staff and/or quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. The results will then be used to continually improve the quality of care for all patients we serve. For example, we may also combine health information about many patients to evaluate the need for new services or treatment. We may disclose information to doctors, nurses, and students for educational purposes. We may combine information we have along with other health centers to see where we can make improvements. We will remove information that identifies you from this set of health information to protect your privacy. We may also use and disclose PATHS’ health information:
· To business associates we have contracted with to perform the agreed-upon service and billing
· To remind you that you have an appointment for medical care
· To assess your satisfaction with our services
· To tell you about possible treatment alternatives
· To tell you about health-related benefits or services
· To contact you as part of fund-raising efforts
· To inform funeral directors consistent with applicable law
· For population-based activities relating to improving health or reducing health care costs
· For conducting training programs or reviewing competence of health care professionals
Business Associates
There are some services provided by PATHS through contracts with business associates. Examples include mammography technicians, ultrasound technicians and out-source contracts for transcription services. When these services are contracted, we may disclose your information to our business associates so they can perform the job we have asked them to do and bill you or your third party payer for services rendered. To protect your information with PAHTS, however, we require the business associate to appropriately safeguard your information.
Individuals Involved In Your Care or Payment for Your Care
We may release PATHS’ health information about you to a friend or family member who is involved in your medical care or who helps pay for your care. In addition, information about you may be given/released to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status, and location.
Research
We may disclose information to researchers when an institutional review board that has reviewed the research protocol and established protocols to ensure the privacy of your health information has approved their research.
Future Communications
We may communicate to you via newsletters, mail outs, Patient Portal, or other means regarding treatment options, health related information, disease management programs, wellness programs, or other community based initiatives or activities our facility is participating in.
Organized Health Care Arrangements
PATHS and its medical staff members have organized health care arrangements. Information will be shared as necessary to carry out treatment, payment, and health care operations. PATHS’ physicians and care givers may have access to protected health information in any PATHS’ practice locations to assist in reviewing past treatment as it may affect treatment at this time.
As required by law, we may also use and disclose PATHS’ health information for the following types of entities, including but not limited to:
· Food and Drug Administration
· Public health or legal authorities charged with preventing or controlling disease, injury or disability
· Correctional institutions
· Workers Compensation agents
· Organ and tissue donation organizations
· Military command authorities
· Health oversight agencies
· Funeral directors, coroners and medical directors
· National security and intelligence agencies
· Protective services for the President and others
Law Enforcement/Legal Proceedings
We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.
State Specific Requirements
Many states have requirements for reporting population-based activities relating to improving health or reducing health care costs. Some states have separate privacy laws that may apply additional legal requirements. If the state privacy laws are more stringent than federal privacy laws, the state law will be followed instead of the federal law.
Your Health Information Rights
Although your health record is the physical property of the PATHS’ facility that compiled it; you have the Right to:
Inspect and Copy
Inspect and copy your health information upon request. Again, this right is not absolute. In certain situations, such as if access would cause harm, we can deny access. You do not have a right of access to the following:
· Psychotherapy notes. Such notes consist of those notes that are recorded in any medium by a health care provider who is a mental health professional documenting or analyzing a conversation during a private, group, joint, or family counseling session and that are separated from the rest of your medical record.
· Information compiled in reasonable anticipation of or for use in civil, criminal, or administrative actions or proceedings.
· Protected health information (“PHI”) that is subject to the Clinical Laboratory Improvement Amendments of 1988 (“CLIA”), 42 U.S.C. §263, to the extent that giving you access would be prohibited by law.
· Information that was obtained from someone other than a health care provider under a promise of confidentiality and the requested access would be reasonably likely to reveal the source of the information.
In other situations, we may deny you access, but if we do, we must provide you a review of our decision denying access. These “reviewable” grounds for denial include the following:
· A licensed health care professional, such as your attending physician, has determined, in the exercise of professional judgment, that the access is reasonable likely to endanger the life or physical safety of yourself or another person.
· PHI makes reference to another person (other than a health care provider) and a licensed health care provider has determined, in the exercise of professional judgment, that the access is reasonably likely to cause substantial harm to such other person.
· The request is made by your personal representative and a licensed health care professional has determined, in the exercise of professional judgment, that giving access to such personal representative is reasonably likely to cause substantial harm to you or another person.
For these reviewable grounds, another licensed professional must review the decision of the provider denying access within 60 days. If we deny you access, we will explain why and what your rights are, including how to seek review. If we grant access, we will tell you what, if anything, you have to do to get access. We reserve the right to charge a reasonable, cost-based fee for making copies.
Amend
If you feel that PATHS information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for PATHS. We may deny your request for an amendment and if this occurs, you will be notified of the reason for the denial. We do not have to grant the request if the following conditions exist:
· We did not create the record. If, as in the case of a consultation report from another provider, we did not create the record, we cannot know whether it is accurate or not. Thus, in such cases, you must seek amendment/correction from the party creating the record. If the party amends or corrects the record, we will put the corrected record into our records.
· The records are not available to you as discussed immediately above.
· The record is accurate and complete.
If we deny your request for amendment/correction, we will notify you why, how you can attach a statement of disagreement to your records (which we may rebut), and how you can complain. If we grant the request, we will make the correction and distribute the correction to those who need it and those whom you identify to us that you want to receive the corrected information.
An Accounting of Disclosures
You have the right to request an accounting of disclosures. This is a list of certain disclosures we make of your health information for purposes other than treatment, payment, or health care operations. We must provide the accounting within 60 days. The accounting must include the following information:
· Date of each disclosure
· Name and address of the organization or person who received the protected health information
· Brief description of the information disclosed
· Brief statement of the purpose of the disclosure that reasonably informs you of the basis for the disclosure or, in lieu of such statement, a copy of your written authorization or a copy of the written request for disclosure.
The first accounting in any 12-month period is free. Therefore, we reserve the right to charge a reasonable, cost-based fee.
Request Restrictions
You have the right to request a restriction or limitation on PAHTS’ information we use or disclose about you for treatment, payment or the 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 or the payment of your care, such as a family member or friend. For example, you could ask that we not use or disclose information about a procedure you had. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide your emergency treatment.
· Request restriction on uses and disclosures of your health information for treatment, payment, and health care operations. “Health care operations” consist of activities that are necessary to carry out the operations of the provider, such as quality assurance and peer review. The right to request restriction does not extend to uses or disclosures permitted or required under the following sections of the federal privacy regulations: §164.502(a)(2)(i) (disclosures to you), §164.510(a)(for facility directories, but note that you have the right to object to such uses), or §164.5122(uses and disclosures not requiring a consent or an authorization). The latter uses and disclosures include, for example, those required by law, such as mandatory communicable disease reporting. In those cases, you do not have a right to request restriction. The consent to use and disclose your individually identifiable health information provides the ability to request restriction. We do not, however, have to agree to the restriction, except in the situation explained below. If we do, we will adhere to it unless you request otherwise or we give you advance notice. You may also ask us to communicate with you by alternate means, and if the method of communication is reasonable, we must grant the alternate communication request. You may request restriction or alternate communications on the consent form for treatment, payment, and health care operations. If, however, you request restriction on a disclosure to a health plan for purposes of payment or health care operations (not for treatment), we must grant the request if the health information pertains solely to an item or a service for which we have been paid in full.
Request Confidential Communications
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you ask that we contact you at work or by U.S. mail. PATHS will grant requests for confidential communications at alternative locations and/or via alternative means only if the request is submitted in writing and the written request includes a mailing address where the individual will receive bills for services rendered by PATHS and related correspondence regarding payment for services. Please realize, we reserve the right to contact you by other means and at other locations if you fail to respond to any communication from us that requires a response. We will notify you in accordance with your original request prior to attempting to contact you by other means or at another location.