NOTICE of PRIVACY PRACTICES
This notice describes how medical information about you may be used and disclosed and how you can obtain access to this information.
Please review it carefully.If you have any questions about this Notice please contact our Privacy contact,
Cole Noble, LCSW at 512-328-1144.
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
Understanding your Health Record/Information
Each time you visit a healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, diagnoses, treatment goals, prognosis, and a plan for referrals, treatment, or future care. This information, often referred to as your health or medical record, serves as a
- basis for planning your care, and treatment referrals
- means of communication for the health professionals who contribute to your care
- legal document describing the care you received
- means by which you or a third-party payer can verify that services billed were actually provided for purposes of payment
- source (in an aggregate format of data so that no person’s identity is revealed) of data for our customer service reports
- source of data for facility planning and marketing
- a tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.
Understanding what is in your record and how your health information is used helps you to: ensure its accuracy; better understand who, what, when, where, and why others may access your health information; and make more informed decisions when authorizing disclosure to others.
Your Health Information Rights
Although your health record is the physical property of the Alliance Work Partners, the information belongs to you. You have the right to
- request a restriction on certain uses and disclosures of your information
- obtain a paper copy of the notice of information practices upon request
- inspect and obtain a copy of your health record
- amend your health record
- obtain an accounting of disclosures of your health information
- request communications of your health information by alternative means (e.g., requests in writing).
- revoke your authorization to use or disclose health information except to the extent that action has already been taken.
This organization is required to
- maintain the privacy of your health information
- provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
- abide by the terms of this notice
- notify you if we are unable to agree to a requested restriction
- accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.
AWP will not use or disclose your health information without your consent/authorization, except as described in this notice.
If you believe your privacy rights have been violated, you can file a complaint with our Privacy Contact or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint. You may contact our Privacy contact, Cole Noble, LCSW at 328-1144 or at email@example.com for further information about the complaint process.
Examples of Disclosures for Treatment, Payment, and Health Operation
- We will use your health information for sessions and for future treatment. For example, we may use clinical information regarding your concerns to make the most appropriate match for you in your future treatment and care. We may use this information to assist you in finding the most appropriate level of care and practitioner for your concerns.
- We will use your health information for payment. A bill may be sent to a third-party payer. The information on or accompanying the bill may include demographic information that identifies you as well as your diagnosis.
- We will use your health information for regular health operations. We may use information in your health record to assess the care and outcomes in your case and others like it. For example we ask all participants to complete a quality assurance questionnaire to give us feedback about our services. This information will then be used in an effort to continually improve the quality and the effectiveness of the healthcare and services we provide.
- Business associates: There are some services provided in our organization through contacts with business associates. Examples include our answering service, and our shredding service. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we’ve asked them to do and bill you or your third-party payer for services rendered. To protect your health information, however, we require the business to appropriately safeguard your information.
- Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition in an emergency situation.
- Coroners/medical examiners: We may disclose health information to coroners/medical examiners consistent with applicable law to carry out their duties.
- Marketing: We may contact you to provide appointment reminders.
- Workers compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.
- Law enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena/court order. Federal law makes provision for your health information to be released to appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.
Except as described in this Notice of Privacy Practices, AWP will not use or disclose your health information without your written authorization. If you do authorize to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.
This notice becomes effective on April 14, 2003. AWP reserves the right to amend this Notice of Privacy Practices at any time in the future. Until such amendment is made, AWP is required by law to comply with this notice. AWP will make arrangements to distribute any amendments to this Notice of Privacy Practices to all current clients.