Notice of Privacy Practices
For privacy concerns, please call either our Compliance Hotline at (877) 376-3930 or Compliance Officer at (858) 675-3105. You may also report a privacy concern online at www.archhealthcompliance.alertline.com
NOTICE OF PRIVACY PRACTICES
For privacy concerns, please call either our
Compliance Hotline at (877) 376-3930 or Compliance Officer at (858) 675-3105. You may also report a privacy concern online at
Effective Date: April 15, 2011
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.
We understand that your health information is personal. We promise to make every attempt to keep your medical information private. We make a record of the medical care we provide to you. Sometimes we receive records about you from other providers. We use these records to:
• Provide you with quality health care,
• Enable other health care providers to give you care,
• Obtain payment for services as allowed by your health plan, and
• Meet our professional and legal obligations.
We are required by law to keep your protected health information private. We are required by law to provide you with a notice, such as this one, describing our legal duties and our privacy practices regarding your protected health information, and we are required to comply with the notice we provide. This notice describes how we may use and disclose your medical information. This notice describes your rights and our legal responsibilities in regards to your medical information. If you have any questions about this Notice, please contact our Compliance Officer. The phone number is listed above.
Section A – How Arch Health Partners May Use or Disclose Your Health Information
Arch Health Partners collects health information about you and stores it in a chart and on a computer. This is your medical record. The medical record is the property of Arch Health Partners, but the information in the medical record belongs to you. The law permits us to use or disclose your health information for the following purposes:
1. Treatment. We use your medical information to give you medical care. We disclose medical information to our employees. We disclose medical information to others who are involved in providing you care. For example, we may share your medical information with other physicians providing services to you. We may share information with a pharmacist who needs it to fill your prescription. We may share information with a laboratory where you are being tested. We may also disclose medical information to members of your family or others who can help you when you are sick or injured.
2. Payment. We use and disclose medical information about you to obtain payment for our services. For example, we give your health plan the information it requires before it will pay us. We may also disclose information to your other health care providers; this will help them obtain payment for services they have provided to you. We may also disclose information to someone who is involved in paying for or arranging for payment for your care. If you fail to pay for the medical services we provide, we may disclose your information to a collection agency to assist us in obtaining payment.
3. Health Care Operations. We may use and disclose medical information about you to operate Arch Health Partners. For example, we may use and disclose this information to:
• Review and improve the quality of the care we provide,
• Review and improve the competence and qualifications of our professional staff,
• Obtain authorization for services or referrals from your health plan,
• Take part in medical reviews,
• Take part in legal services and audits, including fraud and abuse detection, and
• Take part in compliance programs, business planning and management
We may also share your medical information with our “business associates.” An example would be a billing company that performs services for us. We have a written contract with each of these business associates. This contract requires them to protect the privacy of your medical information. We may also share your information with other health care providers, health care clearinghouses, or health plans that have a relationship with you. We will share your information if they request it in order to:
• Help them with their quality assessment and improvement activities,
• Aid their efforts to improve health or reduce health care costs,
• Assist in their review of competence, qualifications and performance of health care professionals,
• Assist in their training programs, accreditation, qualifications or licensing activities,
• Help them with their health care fraud and abuse detection or compliance efforts.
We may also share your personal information with our legal affiliate, Palomar Pomerado Health (PPH). For example, we may share your personal information with PPH for patient care purposes, performance improvement, and marketing initiatives.
4. Appointment Reminders. We may use and disclose medical information to contact and remind you about appointments. If you are not home, we may leave information about your appointment on your answering machine. If you are not at home, we may leave a message with the person answering the phone. We will not disclose information about your specific medical condition or the purpose of your appointment in a voicemail message or with any individual other than you.
5. Sign In Sheet. We may use and disclose medical information about you by having you sign in when you arrive at our office. We will not require that you state the purpose of your visit or your medical condition on the sign-in sheet. We may also announce your name when we are ready to serve you.
6. Coordination of Care. We may contact you to:
• Give you information about services related to your treatment, case management or care coordination,
• Direct or recommend other treatments or health-related benefits and services that may be of interest to you.
7. Required by Law. We will use and disclose your health information as required by law. We will limit our use or disclosure to the relevant requirements of the law. For example, we may use and disclose your information when necessary to:
• Report abuse,
• Report neglect,
• Report domestic violence,
• Respond to judicial or administrative proceedings, or
• Respond to law enforcement officials.
8. Public Health. We may disclose your health information to public authorities. The reason for the disclosure may include the following:
• Preventing or controlling disease, injury or disability,
• Reporting child, elder or dependent adult abuse or neglect,
• Reporting domestic violence, and
• Reporting disease or infection exposure.
9. Health Oversight Activities. We may disclose your health information to health oversight agencies. This disclosure could occur during the course of:
• Licensure, and
• Other proceedings
The disclosure is subject to the limitations imposed by Federal and California law.
10. Judicial and Administrative Proceedings. We may disclose your health information in the course of any administrative or judicial proceeding. We will only disclose your information to the extent authorized by a court or administrative order. We may also disclose health information about you in response to: a subpoena, discovery request, or other lawful process. In this case, we will only disclose your health information if reasonable efforts have been made to notify you of the request, and you have not objected. If you have objected, we will only disclose your information if your objections have been resolved by a court or administrative order.
11. Law Enforcement. We may disclose your health information to law enforcement officials. The purposes for such a disclosure include:
• Identifying or locating a suspect, fugitive, material witness, or missing person,
• Complying with a court order, warrant, grand jury subpoena, and
• Complying with other law enforcement purposes.
12. Coroners. We may disclose your health information to a coroner or health examiner.
13. Public Safety. We may disclose your health information to the appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.
14. Specialized Government Functions. We may disclose your health information for military or national security purposes. We may disclose your health information to correctional institutions or law enforcement officers that have you in their lawful custody.
15. Workers’ Compensation. We may disclose your health information to comply with workers’ compensation laws. For example, to the extent your care is covered by worker’s compensation, we will make periodic reports to your employer about your condition. We are also required by law to report cases of occupational injury or occupational illness to the employer or worker’s compensation insurer.
16. Research. Under certain circumstances, we may disclose your health information for research purposes. We will ask for your permission if the researcher will have access to identifying information, such as your name or address.
17. Change of Ownership. If Arch Health Partners is sold or merged with another organization, your health information and medical record will become the property of the new owner, although you will maintain the right to request that copies of your information and medical record be transferred to another physician or medical group.
Section B – When Arch Health Partners May Not Use or Disclose Your Health Information
Except as described in this Notice of Privacy Practices, Arch Health Partners will not use or disclose health information which identifies you without your written authorization. If you do authorize Arch Health Partners to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.
Section C – Your Health Information Rights
If you would like to have a more detailed explanation of the rights listed below, or if you would like to exercise one or more of these rights, contact our Compliance Officer. The phone number for the Compliance Officer is listed on the front of this Notice of Privacy Practices.
1. Right to Request Special Privacy Protections. You have the right to request restrictions on certain uses and disclosures of your health information. You can do this by a written request. You need to specify what information you want to limit. You need to specify what limitations on our use of the information you wish to have in place. We reserve the right to accept or reject your request, and we will notify you of our decision.
2. Right to Request Confidential Communications. You have the right to request that you receive your health information in a certain way or at a certain location. We will comply with all reasonable requests submitted in writing. You need to specify how or where you wish to receive these communications.
3. Right to Inspect and Copy. You have the right to inspect and copy your health information, with limited exceptions. To access your medical information, you must submit a written request. The request must detail what information you want to access and whether you want to inspect it or get a copy of it. If requesting a copy of your health information, you have the option of obtaining either (1) a paper copy of your health information or (2) an electronic copy of your health information on a CD. As allowed by California law, we may charge a reasonable fee. We may deny your request under limited circumstances. If you are denied access to your health information, you may request that the denial be reviewed.
4. Right to Amend or Supplement. You have a right to request that we amend your health information, which you believe to be incorrect or incomplete. You must make a request to amend in writing. Your statement of amendment may be up to 250 words. The request must include the reasons you believe the information is inaccurate or incomplete. We may deny your request if:
• We do not have the information;
• We did not create the information (unless the person or entity that created the information is no longer available to make the amendment)
• You would not be permitted to inspect or copy the information at issue;
• We determine in our sole discretion that the information is accurate and complete as is.
5. Right to Accounting of Disclosures. You have a right to receive an accounting of disclosures of your health information made by Arch Health Partners. Arch Health Partners does not have to account for disclosures:
• Provided to you,
• Provided to others by your written authorization,
• In facility directories,
• To relatives and close personal friends involved in your care,
• For notification purposes in disaster and other situations,
• To correctional institutions or law enforcement officials as required or allowed by law,
• As described in paragraphs 1 through 6 of Section A of this Notice of Privacy Practices, or
• That occurred prior to April 14, 2003.
6. Paper Copy. You have the right to a paper copy of this Notice of Privacy Practices, even if you have previously requested an e-mail copy.
Section D – Changes to this Notice of Privacy Practices
We reserve the right to amend this Notice of Privacy Practices at any time in the future. Until such amendment is made, we are required by law to comply with this Notice. After an amendment is made, the revised Notice of Privacy Practices will apply to all protected health information that we maintain, regardless of when it was created or received. We will keep a copy of the current Notice posted. A copy will be available at each appointment, if requested. We will also post the current Notice on our website.
Section E – Complaints
Complaints about this Notice of Privacy Practices or about how Arch Health Partners handles your health information should be directed to our Compliance Hotline or our Compliance Officer. The phone number for the Compliance Hotline and Compliance Officer is listed on the front of this Notice of Privacy Practices. You may also submit a formal complaint to the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.