| NOTICE OF
PRIVACY PRACTICES This notice describes how
medical information about you may be used and disclosed.It
also describes how you can get access to this information.
Please review it carefully.
In order to provide your care, we must collect, create and
maintain health information about you. We are required by
law to maintain the privacy of this information. This Notice
of Privacy Practices describes how we use and disclose your
health information, and explains certain rights you have regarding
this information. We are required by law to provide you with
this Notice and we will comply with the terms as stated.
How We Use and Disclose Your Health Information
We protect your health information from inappropriate use
and disclosure. We will use and disclose your health information
for only the purposes listed below:
Uses and Disclosures for Treatment, Payment and Health
Care Operations.
We may use and disclose your protected health information
in order to provide your care or treatment, obtain payment
for services provided to you and in order to conduct our health
care operations as detailed below.
1. Treatment and Care Management.
We may use and disclose health information about you to facilitate
treatment provided to you by us and other health care providers.
For example, your House Calls clinician may discuss your health
condition with your doctor to plan the clinical services you
receive at home. We may also leave protected health information
in your home for the purpose of keeping other caregivers informed
of needed information.
2. Payment. We may use and disclose health
information about you for our own payment purposes and to
assist in the payment activities of other health care providers.
Our payment activities include: determining your eligibility
for benefits and obtaining payment from insurers that may
be responsible for providing coverage to you, including Federal
and State entities.
3. Health Care Operations. We may use and
disclose health information about you to carry out health
care operations, which include care management, quality improvement
activities, evaluating our own performance and resolving any
complaints or grievances you may have. We may also use and
disclose your health information to assist other health care
providers in performing health care operations.
4. Visit Reminders, Information or Services.
We may contact you to provide visit reminders or information
about treatment alternatives or other health-related services
that may be of interest to you.
Uses and Disclosures Without Your Consent or Authorization.
We may use and disclose your health information without your
specific written authorization for the following purposes:
1. As required by law.
We may use and disclose your health information as required
by state, federal or local law.
2. Public health activities. We may disclose
your health information to public health authorities or other
agencies and organizations conducting public health activities,
such as preventing or controlling disease, injury or disability,
reporting births, deaths, child abuse or neglect, domestic
violence, potential problems with products regulated by the
Food and Drug Administration or communicable diseases.
3. Victims of abuse, neglect or domestic violence.
We may disclose your health information to an appropriate
government agency if we believe you are a victim of abuse,
neglect or domestic violence and you agree to the disclosure
or the disclosure is required or permitted by law. We will
let you know if we disclose your health information for this
purpose unless we believe that advising you or your caregiver
would place you or another person at risk of serious harm.
4. Health oversight activities. We may disclose
your health information to health oversight agencies for activities
authorized by law such as audits, investigations, inspections
and licensing surveys.
5. Judicial and administrative proceedings. We
may disclose your health information in the course of any
judicial or administrative proceeding in response to an appropriate
order of a court or administrative body.
6. Law enforcement purposes. We may disclose
your health information to the police or law enforcement officials
as required or permitted by law in compliance with a court
order or a grand jury or administrative subpoena.
7. Deceased individuals. We may disclose
your health information to a coroner, medical examiner or
a funeral director as necessary and as authorized by law.
8. Organ, eye or tissue donations. We may
disclose your health information to organ procurement organizations
and similar entities for the purpose of assisting them in
organ, eye or tissue procurement, banking or transplantation.
9. For research. We may use or disclose your
health information for research purposes, such as studies
comparing the benefits of alternative treatments received
by our patients or investigations into how to improve our
care delivery. We will use or disclose your health information
for research purposes only with the approval of our Institutional
Review Board, which must follow a special approval process.
Before permitting any use or disclosure of your health information
for research purposes, our Institutional Review Board will
balance the needs of the researchers and the potential value
of their research against the protection of your privacy.
10. Health or safety. We may use or disclose
your health information to prevent or lessen a threat to the
health or safety of you or the general public. We may also
disclose your health information to disaster relief organizations
such as the Red Cross or other organizations participating
in bio-terrorism countermeasures.
11. Specialized government functions. We
may use or disclose your health information to provide assistance
for certain types of government activities. If you are a member
of the armed forces of the United States or a foreign country,
we may disclose your health information to appropriate military
authority as is deemed necessary. We may also disclose your
health information to federal officials for lawful intelligence
or national security activities.
12. Workers' compensation. We may use or
disclose your health information as permitted by the laws
governing the workers' compensation program or similar programs
that provide benefits for work-related injuries or illnesses.
13. Individuals involved in your care. We
may disclose your health information to a family member, other
relative or close personal friend assisting you in receiving
health care services. We will disclose your health information
to these individuals only if you tell us to do this or if
we can reasonably infer that you do not object.
Special Treatment of Alcohol and Drug Abuse Records.
Health information we may receive about you from federally
assisted alcohol or drug treatment programs is subject to
special protection under federal law. We will not disclose
this information without your express written authorization
except: (a) to medical personnel who need this information
for the purpose of providing you with emergency treatment;
(b) to the Food and Drug Administration for the purpose of
identifying potentially dangerous products; (c) for research
purposes if approved by our privacy board; (d) to authorized
persons conducting on-site audits of our records, subject
to the requirement that these persons not remove the information
from our facilities and agree in writing to safeguard the
information; and (e) in response to an appropriate court order.
Obtaining Your Authorization for Other Uses and Disclosures.
We will not use or disclose your health information for any
purpose not specified in this Notice of Privacy Practices
unless we obtain your express written authorization or the
authorization of your legally appointed representative. If
you give us your authorization, you may revoke it at any time,
in which case we will no longer use or disclose our health
information for the purpose you authorized, except to the
extent we have relied on your authorization to provide your
care.
Your Rights Regarding Your Health Information
You have the following rights regarding your health information:
1. Right to Inspect and Copy.
You have the right to inspect or request a copy of health
information about you that we maintain. Your request should
describe the information you want to review and the format
in which you wish to review it. We may refuse to allow you
to inspect or obtain copies of this information in certain
limited cases. We may charge you a fee of up to $.75 per page
for copies or the rate established by the Department of Health.
2. Right to Request Amendments. You have
the right to request changes to any health information we
maintain about you if you state a reason why this information
is incorrect or incomplete. We may not agree to make the changes
you request. If we do not agree with the requested changes
we will notify you in writing and inform you how to have your
objection included in our records.
3. Right to an Accounting of Disclosures.
You have the right to receive a list of the disclosures of
your health information by House Calls Homebased Health Care.
The list will not include disclosures made for certain purposes
including disclosures for treatment, payment or health care
operations or disclosures you authorized in writing. Your
request should specify the time period covered by your request,
which cannot exceed six years and may not include dates prior
to April 14, 2003. The first time you request a list of disclosures
in any 12-month period, it will be provided at no cost. If
you request additional lists within the 12-month period, we
may charge you a nominal fee.
4. Right to Request Restrictions. You have
the right to request restrictions on the ways in which we
use and disclose your health information for treatment, payment
and health care operations, or disclose this information to
disaster relief organizations or individuals who are involved
in your care. We may not agree to the restrictions you request.
5. Right to Request Confidential Communications. You
have the right to ask us to send health information to you
in a different way or at a different location if you believe
that you may be endangered by our ordinary form of communication.
For example, if you are afraid that someone living with you
may open your mail resulting in harm, you may ask us to mail
to an alternate address. You must state in your request that
you believe you may be endangered. Your request for an alternate
form of communication should also specify where and/or how
we should contact you.
6. Right to Paper Copy of Notice. You have
the right to receive a paper copy of this Notice of Privacy
Practices at any time. You may obtain a paper copy of this
Notice, by writing to the House Calls Privacy Official. You
may also print out a copy of this Notice by going to our website
at www.housecallsrgv.com
To make a request as described in any of the above, please
submit a request to:
House Calls Homebased Health Care Privacy
Official
P.O. Box 720009
McAllen Tx 78504
Telephone number: 1 800 313 2392
Complaints
If you believe your privacy rights have been violated you
may file a complaint with House Calls by writing to our Privacy
Official, P.O. Box 720009, McAllen, Texas 78504. You may also
file a complaint with The Secretary of the U.S. Department
of Health and Human Services. You will not be penalized or
retaliated against by House Calls for filing a complaint.
Changes to this Notice
We may change the terms of this Notice of Privacy Practices
at any time. If the terms of the Notice are changed, the new
terms will apply to all of your health information, whether
created or received by us before or after the date on which
the Notice is changed. We will notify you of changes to this
Notice by mailing you a copy of the new Notice within 60 days
of the date on which it becomes effective.
These Privacy Practices are effective April 14, 2003
|