Alternative Behavioral Care

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.

We have a legal duty to safeguard your Protected Health Information (PHI)

We are legally required to protect the policy of your health information.  We will call this information “protected health information” or “PHI” for short, it includes information that we’ve collected  or received about your past, present, or future health or future condition, that can be used to identify you, the provision of healthcare to you, or payment of this healthcare.  We must provide you with this notice: about our privacy practices, that explain how, when and why we use and disclose your PHI.  With some exceptions, we may not use or disclose any more of your PHI than is necessary to accomplish the purpose of the use or disclosure. We are legally required to follow the privacy practices that are described in this notice.  We however, reserve the right to change the terms of this notice and our privacy policies at any time.  Any changes will apply to the PHI we already have.  Before we make an important change to our policies, we will promptly change this notice and post a new notice in the waiting room of our office.  You can request a copy of this notice from the Administrator.  For further questions, please call (636)477-6111.

How may we use and disclose your Protected Health Information

We use and disclose health information for many different reasons.  For some of these uses or disclosures, we need your prior consent or specific authorization.  Below, we describe the different categories of our uses and disclosures and give you some examples of each category, but these examples are not meant to be exhaustive.

A.    Uses and disclosures relating to treatment, payment, or Health Care Operations that do not require your prior written consent.

We may use and disclose your PHI for the following reasons:                                         

1.) For treatment.  We may disclose your PHI to physicians, nurses, therapist, and other healthcare personnel who provide you with health care services or are involved in your care.  For example, when Alternative Behavioral Care’s physician, has someone cover for him or her.  PHI will be provided to the physician providing coverage.  Also, if you were in need of emergency treatment, your PHI would be released to the treating entity. 

2.) To obtain payment for treatment.   We may use and disclose your PHI in order to bill and collect payment for the treatment and services provided to you.  For example, we made provide portions of your PHI to our billing department and your health plan to get paid for the healthcare services we provided to you.  We may also provide your PHI to our business associates, claims processing companies and others that process our healthcare claims.  In addition, your billing statement is sent to the responsible party indicated on your account.

3.) For healthcare operations.  We may disclose your PHI in order to operate Alternative Behavioral Care.  For example, we may use your PHI in order to evaluate the quality of healthcare services that you received or to evaluate the performance of the healthcare professional that provided healthcare services to you.  We may also provide your PHI to outside auditors.   

B.    Other uses and disclosures that do not require your consent.   

We may use and disclose your PHI without your consent or authorization for the following reasons.

1.)  When disclosure is required by federal, state or local laws, judicial or administrative proceedings, or law enforcement.  For example, we make disclosures when the law requires that we report information to the government officials and law enforcement Personnel about victims of abuse, neglect, or domestic violence, or when ordered in judicial or administrating proceedings.

2.)  For public health activities.  We provide coroners, medical examiners, and funeral directors necessary information relating to an individuals death.

3.) For health oversight authorities.  For example, we will provide information to assist the government when it conducts an investigation or inspection of a healthcare provider or organization.

4.)  To avoid harm.  In order to avoid a serious threat to the health or safety of a person or the public, we may provide PHI to law enforcement personnel or persons able to prevent or lessen such harm.

5.) For specific Government Functions.  We may disclose PHI of military personnel in certain situations.  We may disclose PHI for national security purposes, such as protecting the President of the United States or conducting intelligence operations.

6.)  For worker’s compensation purposes.  We may provide PHI in order to comply with worker’s compensation laws.

7.)  Appointment reminders and health related benefits or services.  We may use PHI to provide printed appointment reminders, phone reminders and or mailed reminders.

8.)  Research.  We will use and disclose your PHI to researchers provided the research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

9.)  Treatment Alternatives.  We will use and disclose your PHI to tell you about or to recommend possible alternative treatment or options that may be of interest to you.

10.) Other involved in your case.  We will use and disclose your PHI to a family member, a relative, a close friend, or any other person you identify that is involved in your medical care or payment for care.

C.     All other uses and disclosures require your prior written authorization

In any other situation not described in section 3 A and B above, we will ask you for your written authorization before using or disclosing any of your PHI.  If you choose to sign an authorization to disclose your PHI, you can later revoke that authorization in writing to stop any future uses and disclosures (to the extent that we haven’t taken any action relying on the authorization).

What rights you have regarding your PHI

You have the following rights with respect to your PHI:

A. The right to request limits on uses and disclosures of your PHI

You have the right to ask that we limit how we use and disclose your PHI.  We will consider your request but are not legally required to accept it.  If we accept your request, we will put any limits in writing and abide by them except in emergency situations.  You may not limit the uses and disclosures that we are legally required and allowed to make.

B.  The right to choose how we send PHI to you.

You have the right to ask that we send information to you, to an alternate address (for example, sending information to your work address instead of your home address) or by alternate means.  We must agree to your request so long as we can easily provide it in the form you requested.

C.  The right to see and get copies of your PHI.

In most cases, you have the right to look at or get copies of your PHI that we have, but you must make the request in writing.  If we don’t have your PHI but we know who does, we will tell you how to get it.  We will respond to you within 30 days after receiving your written request.  In certain situations, we may deny your request.  If we do, we will tell you, in writing, our reasons for the denial and explain your right to have the denial reviewed.

If you request copies of your PHI, we will charge you according to the current Missouri Medical Records cost.  Instead of providing the PHI you requested, we may provide you with a summary or explanation of the PHI as long as you agree to that and to the cost in advance.

D.     The right to get a list of disclosures we have made.

You have the right to get a list of instances in which we have disclosed your PHI.  The list will not include uses or disclosure of treatment, payment, or healthcare operations directly to you.  The list also won’t include uses and disclosures made for national security purposes, to corrections, or other law enforcement personnel or before April 14, 2003.

We will respond within 60 days of receiving your request.  The list will also not include the request made after the date stated in section D.  We will provide data for the time span you request, not to exceed 6 years.  The list will include the date of disclosure, to whom PHI was disclosed (including their address, if known), a description of the information disclosed, and reason for disclosure.  We will provide the list to you at no charge, but if you make more than one request in the same year, we will charge according to current charges.

E.      The right to correct or update your PHI.

If you believe that there is a mistake in your PHI or that a piece of important information is missing, you have the right to request that we correct the existing information or add the missing information.  You must provide the request and your reason for request in writing.  We will respond within 60 days of receiving your request.  We may deny your request in writing if the PHI is 1) correct and complete, 2) not created by us, 3) not allowed to be disclosed, or 4) not part of our records.  Our written denial will state the reasons for the denial and explain the right to file a written statement of dis agreement with the denial.  If you don’t file one, you have the right to request that your request and our denial be attached to all future disclosures of your PHI.  If we approve your request, we will the change to your PHI, tell you that we have done it, and tell others that need to know about the change in your PHI.

How to complain about our Privacy Practices

If you think we may have violated your privacy rights, or you disagree with a decision we made about access to your PHI, you may file a complaint with the person listen in section 6 below.  We will take to retaliatory action against you if you file a complaint about our privacy practices.

Person to contact for information about this notice or to complain about our Privacy Practices

If you have any questions about this notice or any complaints about our privacy practices, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact the Administrator, 255 Spencer Road Suite 101, St. Peters, MO. 63376 (636) 477-6111

Effective date of this notice

This notice is effective April 7, 2008