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.
The HIPAA Privacy rule DOES NOT CHANGE the way you receive services from The Resource Center, or the privacy rights you have always had under NYS Privacy laws or NYS Mental Hygiene law. The Privacy Rule adds details about how you can exercise your rights.
If you have any questions about this notice, please contact TRC’s Compliance Officer at (716) 661-1011.
Your Health Information
This notice applies to the information and records we have about your health, health status, and the health care and services you receive from this agency. We are required by law to give you this notice. It will tell you about the ways in which we may use and disclose health information about you and describes your rights and our obligations regarding the use and disclosure of that information.
How We May Use and Disclose Health Information About You
We may use or disclose health information about you without your permission for the following purposes, subject to applicable legal requirements and limitations:
For Treatment We may use health information about you to provide you with medical treatment or services.
- Consulting another health care professional about your condition so they can help determine the most appropriate care for you
- You may be receiving treatment or services and we may need to know if you have other health problems that could complicate your treatment.
- Referral to another doctor or scheduling outside medical services
For Payment We can use and share your health information to bill and get payment from you, an insurance company or other third party.
- We may need to give your health plan information about a service you received here so your health plan will pay us or reimburse you for the service.
- We may tell your health plan about a treatment you are going to receive to obtain prior approval, or to determine whether your plan will cover treatment.
For Health Care Operations We may use and disclose health information about you in order to run the agency, improve your care, and contact you when necessary.
- We may use your health information to evaluate the performance of our staff in caring for you
- We may use health information about all or many of our patients to help us decide what additional services we should offer, how to become more efficient or whether certain new treatments are effective
Appointment Reminders We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care. If you do not wish to be contacted for appointment reminders please notify the office where you receive services so they can ensure we do not disclose your information for these purposes.
Treatment Alternatives We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you. If you do not wish to receive communications about treatment alternatives please notify the office where you receive services so they can ensure we do not disclose your information for these purposes.
Health‑Related Products and Services We may use and disclose medical information to tell you about health‑related products or services that may be of interest to you. If you do not wish to receive communications about health related products and services please notify the office where you receive services so they can ensure we do not disclose your information for these purposes.
Required By Law We will disclose health information about you when required to do so by federal, state or local law.
Research We may use and disclose health information about you for research projects that are subject to a special approval process.
- We will ask you for your permission if the researcher will have access to your name, address or other information that reveals who you are, or will be involved in your care at the office.
Organ and Tissue Donation If you are an organ donor we can share health information about you with organ procurement organizations.
Military, Veterans, National Security and Intelligence: If you are or were a member of the armed forces we may be required by government authorities to release health information about you.
Workers’ Compensation: We may release health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Health Oversight Activities: We may disclose health information to a health oversight agency for audits, investigations, inspections, or licensing purposes. These disclosures may be necessary for certain state and federal agencies to monitor the health care system, government programs and compliance with civil rights laws.
Public Health and Safety Risks We can share health information about you for certain situations such as the ones listed below:
- preventing disease
- helping with product recalls
- reporting adverse reactions to medications
- reporting suspected abuse, neglect or domestic violence
- preventing or reducing a serious threat to anyone’s health or safety
Lawsuits and Disputes If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. Subject to all applicable legal requirements, we may also disclose health information about you in response to a subpoena.
Coroners, Medical Examiners and Funeral Directors We may release health information to a coroner or medical examiner.
- To identify a deceased person
- To determine the cause of death
Family, Friends and others involved in your care: We may disclose health information about you to your family members, friends or others involved in your care. If we obtain your verbal agreement to do so or if we give you an opportunity to object to such a disclosure and you do not raise an objection.
- We may assume you agree to our disclosure of your personal health information to your spouse when you bring your spouse with you into the exam room during treatment or while treatment is discussed.
- If you are not able to tell us your preference, for example, if you are unconscious, we may share your information if we believe it is in your best interest.
What is NOT covered under this notice?
We will not use or disclose your health information for any purpose other than those identified in the previous sections without your specific, written Authorization. If you give us Authorization to use or disclose health information about you, you may revoke that Authorization, in writing, at any time. If you revoke your Authorization, we will no longer use or disclose information about you for the reasons covered by your written Authorization, but we cannot take back any uses or disclosures already made with your permission.
In the following cases we never share your information unless you give us written permission:
- Alcohol/Drug Treatment
- HIV-Related Information
- Most sharing of psychotherapy notes
- Marketing Purposes
- Sale of your Protected Health Information
What are your Rights regarding your Health Information?
You have the following rights regarding health information we maintain about you:
Right to Inspect and Copy You have the right to inspect get a paper or electronic copy of health information, such as medical and billing records.
- You must submit a Patient Request to Access Medical Records Form to the office which you are requesting records from
- We may charge a fee for the costs of copying, mailing or other associated supplies
- We may deny your request to inspect and/or copy in certain limited circumstances.
Right to correct your medical record: If you believe health information we have about you is incorrect or incomplete, you may ask us to amend the information.
- Submit a Medical Record Amendment/Correction Form, available from the Compliance Officer.
- We may deny your request, but we will tell you why, in writing, within 60 days
Right to an Accounting of Disclosures: You can ask for a list (accounting) of the times we’ve shared your health information for six (6) years prior to the date you ask, who we shared it with, and why.
- You must submit your request in writing to the Corporate Compliance Officer
- We will include all the disclosures except for those about treatment, payment and health care operations, and certain other disclosures (such as any you asked us to make).
- We will provide the first list in any 12 month period without charge. Subsequent accountings within 12 months are subject to fees if we notify you in advance.
Right to Request Restrictions
- You have the right to request a restriction or limitation on the health information we use or share about you for treatment, payment or health care operations.
- We are not required to agree to your request, and we may say “no” if it would affect your care.
- You 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 for it, like a family member or friend.
- Your request must be submitted in writing to the Corporate Compliance Officer
Right to 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, home or office phone). We will accommodate all reasonable requests.
- To request confidential communications, you must submit the request in writing to the office where you receive services. We will not ask you the reasons for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Right to Restrict Release of Information For Certain Services You have the right to restrict the disclosure of information regarding services for which you have paid in full or on an out of pocket basis. This information can then only be released upon your written authorization.
Right to a Paper Copy of This Notice You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
If you have questions about any of your rights and how to exercise them please contact the Compliance Officer for further information at (716) 661-1011 or TRC.firstname.lastname@example.org.
Our Rights and Responsibilities
- We are required by law to maintain the privacy and security of your protected health information
- We will provide individuals with notice of our legal duties and privacy practices with respect to protected health information
- We will notify you of any breach of records containing your health information as required by law
- We reserve the right to change this notice; any change will be effective for all PHI whether created or received before or after the change
- If the notice is changed, the updated version will be posted in a prominent location in our offices and copies will be readily available
Your Right to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint. You will not be penalized for filing a complaint. You may file a complaint with:
- Our office; TRC’s Corporate Compliance Officer at 716-661-1011, email@example.com, or write to 200 Dunham Ave., Jamestown, NY 14701.
- The Secretary of the federal Department of Health and Human Services, 200 Independence Ave. S.W., Washington D.C. 20210 or phone 1-877-696-6675.
- The federal Office for Civil Rights, 200 Independence Ave. S.W., Room 509F, HHH Building, Washington D.C. 20201 or phone 1-866-627-7748 or TTY (886-4989); or by email at www.hhs.gov/ocr