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.
SBH Medical Ltd. Privacy & HIPPA Notice
S.B.H. Medical Ltd. is committed to protecting
the confidentiality of your health information. We have policies and safeguard
in place to ensure your privacy. S.B.H. Medical is also required by state
and federal laws to protect the confidentiality of your health information.
The confidential health information that
we collect as we deliver care or services to you is called "protected
health information'. We can use and disclose your protected health information.
To provide treatment
and to help us coordinate services among S.B.H. Medical personnel
and with others involved in your care such as family members, your
information to recommend an alternative treatment to you or to notify
you of a service.
To obtain payment such as
including your health information on invoices to collect payment.
For example, we may be required by your insurer to provide information
regarding your health so that they will pay you or S.B.H. Medical.
We may also need to obtain prior approval from your insurer and explain
your need for home infusion therapy, home care and the care or services
that we will provide to you.
For health care operations
such as using your protected health information to evaluate and improve
that quality of the services or to write new guidelines to provide
more effective pharmacy information and care; to satisfaction with
our services; for general business planning and development; or for
business management and general administration activities.
You also have the following rights regarding
that use and disclosure of your protected health information:
Right to Inspect and Copy. You have
the right to inspection and/or obtain a copy of the health information
about you that we maintain to make decisions about your care. Your
request must be in writing. If you request a copy of your health information,
we may charge you a fee to cover the costs of copying and mailing
the information. In certain very limited circumstances, we may deny
your request to inspect and copy your health information. If you are
denied access to your health information, we will explain our reasons
in writing. You have that right to request that the decision be reviewed
by another person, We will comply with the outcome of the review.
Right to Amend.
If you feel that health information about you that we maintain is
inaccurate or incomplete, you have that right to request that we amend
the information. You have the right to request an amendment as long
as we maintain the information. Your request must be in writing and
include a reason supporting the request. In certain circumstances,
we may deny your request to amend your health information. If your
request for an amendment is denied, we will explain our reasons in
writing. You have the right to submit a statement explaining why you
disagree with our decision to deny your amendment request. We will
share your statement when we disclose health information about you
that we maintain.
Right to Request Alternative Communications.
You have that right to request that we communicate with you about
medical matters in a certain way or at a certain way or at a certain
location. We will agree to the request to the extent that it is reasonable
for us to do so. For example, we can send all of our written communication
to your daughter's address, if you ask us to do so.
Right to Request Restrictions. You
have the right to request a restriction or limitation on the health
information about you that we use or disclosure. Your request must
be in writing. Please be aware that we are not required to agree to
your restrictions. If we agree to your request for a restriction,
we will comply with it unless the information is needed for emergency
treatment.
Right to Accounting of Disclosures.
You also have the right, with limited exceptions under federal regulations
to receive an accounting of the disclosures we have made of your protected
health information other that those used for treatment, payment, operations.
The time period covered by the accounting is limited. Your request
must be in writing. If you request an accounting more often that once
every twelve (12) months, we may charge you a fee to cover the cost
of preparing the accounting.
Right to Revoke Authorization. There
are occasions when you have the right, with limited exceptions when
you may give us written authorization to use or disclose your health
information. You have the right to revoke your authorization to use
or disclose health information, except to the extent that action has
been taken in reliance upon your authorization.
Right to a Copy of our Notice of Privacy
Practices. You have the right to a paper copy of our Notice
of Privacy Practices at any time. To obtain a copy of our current
Notice, please contact S.B.H. Medical at 866.724.6333.
If you believe that your confidentiality
has been violated, you can contact the Privacy Officer at our S.B.H. Medical
office at 866.724.6333 to file a complaint, or you can file a complaint
with the office of the Secretary of Health and Human Services.
We want to hear your concerns, and yo
will not be retaliated against if you file a complaint.
If you wish to see your protected health information, receive a copy of
it or ask to amend it, please contact the Privacy Officer at 866.724.6333.
If any one wishes to use or access your
protected health information for reasons other that to provide care, obtain
payment or run our operations, we can only release it with your written
authorization. And, you may revoke that authorization at any time.
However, there are some important exceptions
to requiring an authorization stated in the federal regulation. We can
provide your protected health information to representatives of the following
organizations without your written authorization or without obtaining
your agreement or objection:
To public health authorities;
To a government representative responsible for responding
to concerns about abuse, neglect or domestic violence as permitted
by law;
For judicial or administrative proceedings or in
response to a subpoena or discovery request;
For a law enforcement purpose;
To local or national health oversight organizations
that conduct audits or investigations;
To funeral directors, coroners and medical examiners;
For purpose of organ or tissue donation;
For research proposes as approved by a Privacy Board;
To avert a serious threat to health or safety;
For special government functions such as national
security;
For purposes of worker's compensation.
We may not disclose your health information
if you are the subject of an investigation unless your health information
is directly related to your receipt of public-benefits.
We at S.B.H. Medical abide by this Notice
effective April 14, 2003. The Notice is available to any individual upon
request. We do reserve the right to change that terms of the Notice, and
to provide the revised Notice to any patient/client who is receiving care
of services. We will also honor the terms of the Notice for any protected
health information that we maintain at the time of the change.
If
you have any concerns about this Notice or wish to have additional information,
you may contact our Privacy Officer at 866-724-6333. We welcome your
questions, as the privacy of your protected health information is one
of our most important promises to you.
If
you have any concerns about this Notice or wish to have additional information,
you may contact our Privacy Officer at 866-724-6333. We welcome your
questions, as the privacy of your protected health information is one
of our most important promises to you.
