This notice describes how medical information about you may be used and disclosed, and how you can access this information. Please review carefully.
Summary
This is a summary of how we may use and disclose your protected health information (PHI), and your rights and choices regarding your information. PHI includes, but is not limited to; patient name, contact information, physical or mental health medical conditions, payment for health care products or services, or prescriptions.
Our Uses and Disclosures
We may use and disclose your information as we:
- Treat you.
- Bill for services.
- Run our organization.
- Help with public health and safety issues
- Do research.
- Comply with the law.
- Respond to organ and tissue donation requests.
- Work with a medical examiner or funeral director.
- Address workers’ compensation, law enforcement (in compliance with applicable state law), or other government requests.
- Respond to lawsuits and legal actions.
Your Choices
You have some choices about how we use and share your information as we:
- Tell family and friends about your condition.
- Provide disaster relief.
- Provide mental health care.
- Market our services and/or sell your information.
Your Rights
You have rights to:
- Get a copy of your paper or electronic protected health information.
- Request to correct your protected health information.
- Ask us to limit the information we share, in some cases.
- Get a list of those with whom we’ve shared your information.
- Request confidential communication.
- Get a copy of this privacy notice.
- Choose someone to act for you.
- File a complaint if you believe your privacy rights have been violated.
Our Responsibilities
ZoomCare is legally required to maintain the privacy of your PHI under the Health Insurance Portability and Accountability Act (HIPAA) and other federal and state laws. We will follow applicable state privacy laws when they are stricter or more protective of your PHI than federal law.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here, unless you tell us we can in writing. If you tell us we can, you may change your mind at any time and let us know in writing.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to this Notice
We can change the terms of this Notice, and the changes will apply to all information we have about you. The new notice will be available on request, in our office, and on our website.
Breach Notification
We will promptly notify you if a breach occurs that may have compromised the privacy or security of your PHI. We will notify you within the legally required time frame. Most of the time, we will notify you in writing, by first class mail. Or, we may email you if you have provided us with your current email address and you have previously agreed to receive notices electronically. In some cases, our business associates may provide the notification. In limited cases, when we have insufficient or out-of-date contact information, we may provide notice in a legally acceptable alternative form.
Our Uses and Disclosures
The law permits or requires us to use or disclose your PHI for various reasons. When using or disclosing PHI, or requesting your PHI from another source, we will make reasonable efforts to limit our use, disclosure, or request about your PHI to the minimum necessary information that is needed to accomplish our intended purpose.
Treatment, Payment, or Health Care Operations (TPO)
We typically use or share your PHI in the following ways:
- Treatment. We may use or disclose your PHI with other professionals who are treating you or personnel involved in your care. For example, we might disclose information about your overall health condition with physicians or nurses who are treating you for a specific injury or condition.
- Payment. We may use and disclose your PHI to bill and get payment from health plans or others. For example, we share your PHI with your health insurance plan so it will pay for the services you receive.
- Health Care Operations. We may use and disclose your PHI to run our practice and improve your care. For example, we may use your PHI to manage the services you receive or to monitor the quality of our health care services.
Other Uses and Disclosures
We may share your information in other ways, usually for public health or research purposes, or to contribute to the public good. For more information on permitted uses and disclosures, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
These other uses and disclosures may involve:
- ZoomCare’s Business Associates. We may use and disclose your PHI to outside persons or entities that perform services on our behalf, such as auditing, legal, or transcription. Our business associates and their subcontractors are lawfully and contractually required to protect your PHI in the same way we do and only as permitted.
- Health Information Exchanges (HIE). We may participate in certain HIE whereby we may disclose your health information, as permitted by law, to other health care providers or entities for treatment, payment, or health care operations purposes.
- Public Health and Safety Activities. For example, we may share your PHI to: report injuries or prevent disease; report adverse reactions to medications or medical device product defects/recalls; report suspected abuse, neglect; or avert a serious threat to public health or safety.
- Responding to Legal Actions. We may share your PHI in response to a court or administrative order, subpoena, discovery request, or another lawful process.
- Research. We may share your PHI for some types of health research, such as if an institutional review board (“IRB”) has waived the written authorization.
- Medical Examiners or Funeral Directors. We may share PHI with coroners, medical examiners, or funeral directors when an individual dies.
- Organ or Tissue Donation. We may share your PHI with organ procurement organizations.
- Workers’ Compensation, Law Enforcement, or Other Government Requests. We may use and disclose your PHI for: Workers’ compensation claims; Health oversight activities by federal or state agencies; Law enforcement purposes with a law enforcement official or specialized government functions, such as military, national security and presidential protective services.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, please contact us and we will make reasonable efforts to follow your instructions. You have both the right and choice to tell us whether to:
- Share information with your family, close friends, or others involved in your care
- Share information in a disaster relief situation.
We may share your information if we believe it is in your best interest, according to our best judgment, and:
- If you are unable to tell us your preference, for example, if you are unconscious.
- When needed to lessen a serious and imminent threat to health or safety.
Uses and Disclosures that Require Authorization
In these cases, we will only share your information if you give us written permission, except as allowed by HIPAA or applicable law:
- Most sharing of a mental health care professional’s notes from a private counseling session or a group, joint, or family counseling session.
- Marketing, except as allowed by HIPAA or applicable law. For example, marketing communications pertaining to care or treatment and/or our products or services.
- Sale of your information.
- Other uses and disclosures not described in this Notice or otherwise protected by federal and state law, as applicable.
You may revoke your authorization at any time, but it will not affect information that we already used and disclosed.
Your Rights
This section explains your health information rights and some of our responsibilities to help you.
You have the right to:
- Obtain a Copy of Your Medical Record. You have the right to see or obtain an electronic or paper copy of the PHI that we maintain about you.
- Make Amendments. You may ask us to correct or amend PHI.
- Request Confidential Communications. You may request that we contact or send PHI to you in a certain way or at a certain location, such as only at work or home, or only by mail. We will not ask you the reason for your request, and we will accommodate all reasonable requests.
- Request to Limit PHI. You have the right to ask us to limit what we use or share about your PHI for treatment, payment, operations, or with certain persons involved in your care. We will agree not to disclose information to a health plan for purposes of payment or health care operations if the requested restriction concerns a health care item or service for which you or another person, other than the health plan, paid in full out-of-pocket, unless it is otherwise required by law. We may require that you submit this request in writing. We are not required to agree and we may say “no” if it would affect your care.
- Request an Accounting of Disclosures. You have the right to request a list of those of whom we have shared PHI. For these requests, ZoomCare will: 1) Include all the disclosures except for those about treatment, payment, health care operations, and certain other disclosures, such as any you asked us to make.; and 2) Provide one accounting a year for free, but will charge a reasonable, cost-based fee if you ask for another one within 12 months. You may choose to withdraw or modify your request at that time.
- Choose Someone to Act for You. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your PHI. We will confirm the person has this authority and can act for you before we take any action.
- Obtain a Copy of This Privacy Notice. You can ask for a copy of this notice at any time. We will provide you with a copy promptly.
- Make Complaints. You have the right to complain if you feel we have violated your rights. We will not retaliate against you for filing a complaint. You may either file a complaint: 1) Directly with us by contacting our Privacy Officer. All complaints must be submitted in writing; or, 2) With the Office for Civil Rights at the US Department of Health and Human Services. Send a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, call 1-877-696-6775, or visit www.hhs.gov/ocr/privacy/hipaa/complaints/.
