OUR DUTIES REGARDING YOUR HEALTH INFORMATION
We respect the confidentiality of your health information and recognize that information about your health is personal. We are committed to protecting your health information and to informing you of your rights regarding such information. We are also required by law to protect the privacy of your protected health information and to provide you with notice of these legal duties. This notice explains how, when and why we typically use and disclose health information and your privacy rights regarding your health information. In our Notice, we refer to our uses and disclosures of health information as our Privacy Practices. Protected health information is any information, whether oral or recorded, and in any form or medium, that generally includes information that we create or receive that identifies you and your past, present or future health status or care or the provision of or payment for that health care. We are obligated to abide by these Privacy Practices.
Generally, our Privacy Practices strive:
To make sure that health information that identifies you is kept private; To give you this Notice of our Privacy Practices and legal duties with respect to protected health information; To follow the terms of the Notice that is currently in effect; and To make a good faith effort to obtain from you a written acknowledgement that you have received or been given an opportunity to receive this Notice.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
We use and disclose your PHI in a variety of circumstances and for different reasons. Many of these uses and disclosures require your prior authorization. There are situations, however, in which we may use and disclose your health information without your authorization. Many of these uses and disclosures will occur in connection with your treatment, for payment of health services or for our health-care operations. There are additional situations, however, where the law permits or requires us to use and disclose your health information without your authorization. These situations will also be described in this section of the Notice. Specifically, we may use and disclose your protected health information as follows:
For Treatment, Payment and Health Care Operations
1. For Your Treatment.
Alternative Behavioral Care 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 an Alternative Behavioral Care 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. For Payment of Health Services That You Receive.
Alternative Behavioral Care may use and or disclose your protected health information to bill and receive payment for the health services that you receive from us. For example, Alternative Behavioral Care may be required by your health insurer to release information regarding your health care status so that the insurer will reimburse you or Alternative Behavioral Care. Alternative Behavioral Care may be required to obtain prior approval from your insurer and may need to explain to the insurer your need for home care and the services that will be provided to you. In addition, your billing statement is sent to the responsible party indicated on your account.
3. For Our Health-Care Operations.
Alternative Behavioral Care may use and disclose your protected health information for its own operations and as necessary to provide quality care to all of Alternative Behavioral Care’s patients. Health care operations include activities such as: Quality assessment and improvement activities. Activities designed to improve health or reduce health care costs. Protocol development, case management and care coordination. Professional review and performance evaluation. Training programs including those in which students, trainees or practitioners. Training of non-health care professionals. Accreditation, certification, licensing or credentialing activities. Review and auditing, including compliance reviews, legal services and compliance programs. Business planning and development including cost management and planning related analyses and formulary development. Business management and general administrative activities of Alternative Behavioral Care.
4. For Another Provider’s Treatment, Payment or Health-Care Operations.
The law also permits us to disclose your protected health information to another health-care provider involved with your treatment to enable that provider to treat you and get paid for those services as well as for that provider’s health-care operation activities involving quality reviews, assessments or compliance audits.
5. Special Circumstances When We May Disclose Your Health Information Related to Treatment, Payment or Health-Care Operations.
After removing direct identifying information (such as your name, address, and social security number) from the health information, we may disclose your PHI to outside organizations or providers in order for them to provide services to you on our behalf. We will also seek written assurances from these providers to safeguard the health information that they receive.
6. Business Associates
We may disclose PHI to our business associates that perform functions on Alternative Behavioral Care’s behalf or provide Alternative Behavioral Care with services if the information is necessary for such functions or services. For example, we may use another company to perform billing services on our behalf. All of our business associates are obligated, under contract with us, to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract.
For Permitted or Required by Law Activities
There are situations where we may use and or disclose your health information without first obtaining your written authorization for purposes other than for treatment, payment or health-care operations. Except for the specific situations where the law requires us to use and disclose information (such as reports of births to the health department or reports of abuse or neglect to social services), we have listed all these permitted uses and disclosures in this section.
1. For Public Health Activities.
We may use or disclose health information to a public health authority that is authorized by law to collect or receive information in order to report, among other things, communicable diseases and child abuse, or to the FDA to report medical device or product related events. In certain limited situations, we may also disclose health information to notify a person exposed to a communicable disease.
2. For Health Oversight Activities.
We may disclose health information to a health oversight agency that includes, among others, an agency of the federal or state government that is authorized by law to monitor the health-care system.
3. For Law Enforcement Activities.
We may disclose limited health information in response to a law enforcement official’s request for information to identify or locate a victim, a suspect, a fugitive, a material witness or a missing person (including individuals who have died) or for reporting a crime that has occurred on our premises or that may have caused a need for emergency services.
4. For Judicial and Administrative Proceedings.
We may disclose health information in response to a subpoena, or order of a court or administrative tribunal.
5. To Coroners, Medical Examiners and Funeral Directors.
We may release health information to a coroner or medical examiner to identify a deceased person or to determine the cause of death.
6. To Avoid Harm to a Person or for Public Safety.
We may use and disclose health information if we believe that the disclosure is necessary to prevent or lessen a serious threat or harm to the public, or the health or safety of another person.
7. For Specialized Government Functions.
We may use and disclose health information of certain military individuals, for specific governmental security needs, or as needed by correctional institutions.
8. For Workers’s Compensation Purposes.
We may disclose your health information to comply with the workers’s compensation laws or other similar programs.
9. For Appointment Reminders and to Inform You of Health Related Products or Services.
We may use or disclose your health information to contact you for medical appointments or other scheduled services, or to provide you with information about treatment alternatives or other health-related products and services.
All Other Uses and Disclosures Require Your Prior Written Authorization
For situations not generally described in our Notice, we will ask for your written authorization before we use or disclose your health information. You may revoke that authorization, in writing, at any time to stop future disclosures of your information. Information previously disclosed, however, will not be requested to be returned, nor will your revocation affect any action that we have already taken. In addition, if we collected the information in connection with a research study, we are permitted to use and disclose that information to the extent it is necessary to protect the integrity of the research study.
Your Rights Regarding Health Information About You
You have the following rights, subject to certain limitations, regarding PHI we maintain about you:
Right to Inspect and Copy
You have the right to inspect and copy the PHI that may be used to make decisions about your care or payment for your care. We may charge you a fee for the costs of copying, mailing or other supplies associated with your request.
Right to Request Amendments
If you feel that the PHI we have is incorrect or incomplete, you may ask us to amend then information and you must tell us the reason for your request. You have the right to request an amendment for as long as the information is kept by or for Alternative Behavioral Care. A request for amendments must be submitted, in writing, to Administrator, 255 Spencer Road, Suite 101, St. Peters, MO 63376.
Right to Request Restrictions
You have the right to request a restriction or limitation on the PHI we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on the PHI we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. We are not required to agree to your request. If we agree, we will comply with your request unless we terminate our agreement or the information is needed to provide you with emergency treatment.
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, you can ask that we only contact you by mail or at work. Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests.
Right to a Paper Copy of This Notice
You, or your representative, have the right to a separate paper copy of this Notice at any time even if you, or your representative, have received this Notice previously. To obtain a separate paper copy, please contact: Administrator, 255 Spencer Road, Suite 101, St. Peters, MO 63376.
How to Exercise Your Rights
To exercise your rights described in this Notice, send your request, in writing, to: Administrator,255 Spencer Road, Suite 101, St. Peters, MO 63376.
Changes to This Notice
We may, however, change our Privacy Practices in the future and specifically reserve our right to change the terms of this Notice and our Privacy Practices. We will communicate any change in our Notice and Privacy Practices as described at the end of this Notice. Any changes that we make in our Privacy Practices will affect any PHI that we maintain.
If you believe your privacy rights have been violated, you may file a complaint with Alternative Behavioral Care or with the Secretary of the Department of Health and Human Services. Any complaints to Alternative Behavioral Care should be made in writing to: Administrator, 255 Spencer Road, Suite 101, St. Peters, MO 63376. Alternative Behavioral Care encourages you to express any concerns that you may have regarding the privacy of your information. You will not be penalized or retaliated against in any way for filing a complaint.