Effective date of this notice: April 14, 2003
NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION
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.
You have the right to a paper copy of this notice and may ask for a copy of this notice at any time.
GENESYS HOME & HOSPICE CARE (GH&HC) PLEDGE REGARDING MEDICAL INFORMATION: We understand that medical information about you is personal. We are committed to protecting medical information about you. We create a record of the care and services that you receive from GH&HC. This is used to provide you with quality care and to comply with certain legal rules. This notice applies to all of the records of your care at the agency and will tell you about the ways in which we may use and disclose information about you. We also explain your rights and certain duties we have regarding the use of your medical information.
By law we need to
- Make sure that medical information that identifies you is kept confidential;
- Give you this notice of our legal duties and privacy practices with medical information about you; and
- Follow the terms of the notice that is currently in effect
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU:
There are many different ways that we may use medical information. For each type of use or disclosure we will explain what we mean and try to give an example. Not every use will be listed. However, all of the ways we are permitted to use and disclose information fall within one of the categories.
For Treatment. Your medical information may be used to coordinate or manage your health care, related services and consultation between health care providers. For instance your doctor will need information about your symptoms in order to prescribe appropriate medications. We may share this information with people helping in disaster relief, or with people that may help with your medical care while you are in our care such as family members, clergy or others we use to provide services that are part of your care.
For Payment. We may share information about the care you received with GH&HC so that it may be billed. For example, we may need to give your health plan information about the care you received from us so that your health plan will pay for the care. We may also tell your health plan about treatment you are going to receive to obtain prior approval or to find out if your plan will cover the treatment.
For Health Care Operations. We may use information about you for general agency administrative and business functions, quality assurance/improvement activities; medical review; auditing functions, developing clinical guidelines; determining the competence or qualifications of health care professionals; evaluating agency performance; conducting training programs with students or new employees; licensing, survey, certification, accreditation and credentialing activities; internal auditing and certain fundraising and marketing activities. For example, GH&HC may disclose your health information to agency staff and contracted personnel for training purposes, use your health information to contact you as a reminder of a visit to you, or contact you as part of general fundraising and community information mailings (unless you tell us you do not want to be contacted).
SPECIAL SITUATIONS:
We may disclose health information, including individually identifiable health information about you as required by State or Federal Laws and regulations relating to any or all of the following, as such may apply to you.
- Community / Public Health activities and reports such as disease control, abuse or neglect, and health and vital statistics.
- To avert a serious treat to your health or safety and to protect the health and safety of the public. Any disclosure would only be to someone able to help prevent or lessen the threat.
- Administrative oversight for such things as audits, investigations, licensure, or determining cause of death.
- Court order or other legal process related to law enforcement activities including custody of inmates, legal actions or national security activities.
- Military and Veteran reporting on members of the armed forces of U.S. or foreign military as required by military command authorities.
- Organ Tissue Donation and Transplant reports as required by regulatory organizations as necessary to facilitate organ or tissue donation and transplant.
- Workers’ Compensation or other rehabilitative activities reporting as required by law or insurers in order to provide benefits for work related or victim injuries or illness.
- Funeral Directors consistent with applicable law, if necessary to carry out their duties for your funeral. Agency may disclose your health information prior to and in reasonable anticipation of your death.
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU:
You have the following rights to medical information we maintain about you. To use these rights contact the GH&HC Quality Department, 3933 Beecher Rd., Flint Mi. 48532.
Right to Inspect and Copy. You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes. We may charge a fee for the costs of copying mailing or other supplies related to your request.
We may deny your request to inspect and copy in certain very limited circumstance. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by the agency will review your request and the denial. The person conducting the review will not be the person who denied the request. We will comply with the outcome of the review.
Right to Amend. If you feel that medical 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 the agency.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition we may deny your request if you ask us to amend information that:
- Was not created by us, unless the person or entity that created the information is no longer available to make the amendment
- Is not part of the medical information kept by or for the agency
- Is not part of the information which you would be permitted to inspect and copy; or
- Is accurate and complete
Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of medical information about you. Your request must state a time period, which may not be longer than six years
and may not include dates before April 14, 2003. The first list you request within a 12-month period will be free. For additional lists, we may charge you for the cost of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Restrictions. You have the right to request limits on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example you could ask that we not use or disclose information about a type of treatment you received.
We are not required by Federal regulation to agree to your request for restrictions. If we do agree, we will comply with your request unless the information is needed to provide you emergency care or bill for the care that you receive. For example we could not comply with your request if it prohibits us from billing for services provided.
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 at work or by mail. We will not ask you the reason for your request. Your request must specify how or where you wish to be contacted. We will accommodate all reasonable requests.
CHANGES TO THIS NOTICE
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. A copy will always be given to you upon request.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with the Quality Department of GH&HC or with the Secretary of the Department of Health and Human Services. To file a complaint with Genesys Home & Hospice Care you must submit your complaint to: Quality Department of GH&HC at 3933 Beecher Rd., Flint, Mi. 48532. If you wish to discuss your complaint you may call the Quality Department at 810-762-4600. You will not be penalized for filing a complaint.
OTHER USES OF MEDICAL INFORMATION:
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you give us permission to use or disclose medical information, you may cancel that permission, in writing, at any time. If you cancel your permission, we will no longer use or disclose medical information about you for the reason covered by your written authorization. We are unable to take back any disclosures we have already made with your permission, and that we are required to retain in our records of the care that we provided to you.
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