Notice of Privacy Practices
Effective date of this Notice: November 8, 2023
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.
HEALOGICS’ affiliated covered entities are committed to protecting the privacy and safeguarding the security of your protected health information. When you receive services from HEALOGICS we record information that identifies you and that relates to your medical condition,services that are provided to you, and information required for payment purposes. This information is called Protected Health Information (“PHI”). This Notice does not apply to information that could not reasonably be used to identify you. We are required to abide by this Notice, maintain the privacy and security of your PHI, and advise you of our legal duties and privacy practices regarding PHI. We will also comply with applicable state laws that may provide more protection to your PHI. For example, sometimes state laws require us to obtain written authorization for certain disclosures otherwise permitted by HIPAA, such as disclosure of mental health records, HIV results, or other particularly sensitive information.
How We May Use or Disclose Your PHI
We may use or disclose your PHI verbally, on paper, or electronically as allowed by state and federal law. Examples of how we may use and disclose your PHI include:
- Treatment. We may use and disclose your PHI to provide you medical care and services. For example, we may disclose your PHI to your other treating physicians to coordinate your health care and related services.
- Payment. We may use and disclose your PHI as necessary for activities relating to payment for health care services rendered to you. Forexample, we may disclose your PHI to your health insurance company to obtain payment. We may also disclose your PHI for verification of benefits.
- Health Care Operations. We may use and disclose your PHI for our health care operations. These uses and disclosures allow us to continually improve the quality of your care. For example, we may use and disclose your PHI to review our treatment and services and evaluate the performance of our staff. We may use your PHI to create limited data sets or de-identified information that may be used and disclosed for any lawful purpose. We may also transfer information we collect, including PHI, to a third party in connection with a sale or merger. We may also transmit PHI to other covered entities for certain health care operations of those entities, as permitted by law.
- As Required by Law. We will disclose your information when we are required to do so by federal, state, or local law.
- Public Health Activities. We may disclose your PHI for public health activities such as preventing Or controlling disease, reporting adverse events, product defects, or Food and Drug Administration reporting.
- To Report Abuse. We may disclose your PHI if we reasonably believe you are a victim of abuse, neglect, or domestic violence. We will make this report only in accordance with laws that require or allow such reporting or with your permission.
- Health Oversight Activities. We may disclose your PHI to health oversight agencies. This includes uses or disclosures in civil, administrative, or criminal investigations; licensure or disciplinary actions; inspections; and other activities necessary for appropriate oversight of government programs.
- Judicial and Administrative Proceedings. If you or your information are involved in a lawsuit or dispute, we may disclose your PHI in response to a court or administrative order, a subpoena, or other lawful process. We can also chare information when a protective order is in place or the use or disclosure otherwise complies with law, such as a lawsuit brought for payment purposes.
- Law Enforcement. We may disclose your PHI for law enforcement purposes. This includes providing information for identification and location purposes or in connection with suspected criminal activity.
- Coroners, Medical Examiners, and Cadaveric Donations. We may disclose your PHI in an effort to determine cause of death, to funeral directors to assist them in carrying out their duties, and to organ procurement organizations (for organ, eye, or tissue donation).
- Research Purposes. We may use or disclose your PHI in connection with medical research projects if allowed under federal and state laws and regulations. We may disclose PHI for use in a limited data set for purposes of research, public health, or health care operations, but only if a data use agreement has been signed or the disclosure otherwise complies with law.
- Specialized Government Functions. We may disclose your PHI for a number of specialized purposes including national security and intelligence purposes; for military and veteran activities; for protective services for the President and others; and to a correctional institution or law enforcement officials to provide the inmate with health care, to protect the health and safety of the inmate and others, and for the safety, administration, and maintenance of the correctional institution.
- Workers’ Compensation. We may disclose your PHI to your employer for purposes of workers’ compensation and work site safety laws.
- Disaster Relief. We may disclose your PHI to organizations engaged in emergency and disaster relief efforts.
- Fundraising. We may contact you as part of a fundraising effort. You will have the opportunity to opt out of receiving future fundraising communications if you receive written fundraising communications from us.
- To Avert a Serious Threat. We may disclose your PHI if we believe that the disclosure is necessary to prevent serious harm to the public or to an individual. The disclosure will only be made to someone who is able to prevent or reduce the threat.
- Family and Friends. We may disclose your PHI to a member of your family or to someone else who is involved in your medical care or payment for care. We may notify family or friends if you are in the hospital and tell them of your general condition. This may include telling a family member about the status of a claim or what benefits you are eligible to receive. In the event of a disaster, we may provide information about you to a disaster relief organization so they can notify your family of your condition and location. We will not disclose your information to family or friends if you object. We may also disclose PHI to your personal representatives who have authority to act on your behalf (for example, to parents of minors or to someone with a power of attorney).
- Information to Patient.We may use your PHI to provide you with additional information. This may include sending appointment reminders to the phone, address, or e-mail that you have furnished to us or the hospital where you are being treated. This may also include giving you information about treatment options, alternative settings for care, or other health-related services.
- To Business Associates and Subcontractors. We may hire third parties that may need your PHI to perform certain services on our behalf. Under HIPAA and the HITECH Act, these third parties must protect any PHI they receive from us, or create and/or maintain on our behalf, in the same way that we must guard your PHI.
- Authorization. We will ask for your written authorization if we plan to use or disclose your PHI for reasons not covered in this Notice. For example, we may ask for your authorization to engage in marketing activities not already permitted by HIPAA or to disclose psychotherapy notes. If you authorize us to use or disclose your PHI, you have the right to revoke a HIPAA authorization at any time. If you want to revoke an authorization, you must send a written notice to the Privacy Officer listed at the end of this notice. If you revoke an authorization, the revocation will not cover the information already used or disclosed in reliance to the authorization.
- Request Restrictions. You have the right to ask us to restrict how we use or disclose your PHI. You must provide a request, in writing, to the Privacy officer listed in this Notice. We are required to comply with a request for restriction where the disclosure is to a health plan for purposes of carrying out payment when you have paid out of pocket in full. We will consider all other requests, but we are notrequired to agree. If we do agree, we will comply with the request unless the information is needed to provide you with emergency treatment. A restriction cannot prevent uses and disclosures that are required by the Secretary of DHHS to determine or investigate HEALOGICS’ compliance with the Privacy Rules, or that are otherwise required by law.
- Confidential Communications. You have the right to ask us to communicate with you at a special address or by a special means. For example, you may ask us to send letters that contain your PHI to a different address rather than to your home or you may ask us to speak to you personally on the telephone rather than sending your PHI by mail. These requests must be made in writing and we will agree to reasonable requests.
- Inspect and Receive a Copy of PHI. You have a right to inspect the PHI about you that we have in a designated record set and to receive a copy of it. This right is limited to information about you that is kept in records that are used to make decisions about you. For instance, this includesmedication lists, lab results, and encounter information. Where your PHI is contained in an Electronic Health Record, you have the right to obtain a copy of such information in an electronic format and you may request that HEALOGICS transmit such copy directly to an entity or person designated by you, provided that any such choice is clear, conspicuous, and specific. If you want to review or receive a copy of these records, you must make the request in writing. We may charge a fee for the cost of copying and mailing the records. To ask to inspect your records, or to receive a copy, contact the Privacy Officer listed in this Notice. We will respond to your request within the time required by HIPAA and state law. We may deny you access to certain information. If we do we will give you the reason in writing. We will also explain how you may appeal the decision.
- Amend PHI. You have the right to ask us to amend PHI about you in a designated record set which you believe is incorrect or incomplete. You must make this request in writing and give us the reason you believe the information is not correct or complete. We will respond to your request in writing within 60 days. We may deny your request under certain circumstances.
- Accounting of Disclosures. You have a right to receive an accounting of certain disclosures of your information outside of HEALOGICS made within the previous 6 years from the date of your request. We will not include disclosures about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make), except if required by regulation. The first request will be provided to you at no cost, however, we may charge you for any additional requests made within the same 12-month period.
- Paper Copy of this Notice. You have a right to receive a paper copy of this Notice. If you have agreed to receive this Notice electronically, you may receive a paper copy by contacting the Privacy Officer listed at the end of this Notice.
- Complaints. You have a right to complain about our privacy practices if you think your privacy rights has been violated. You may file yourcomplaint with the Privacy Officer listed at the end of this Notice. You may also file a complaint with the Secretary of the U. S.Department of Health and Human Services, at the Office for Civil Rights. All complaints must be in writing. We will not take any retaliation against you if you file a complaint.
- Breach Notes. While we take privacy and security very seriously, sometimes things go wrong. We will let you know promptly if a breach occurs that compromised the privacy or security of your information.
Our Right to Change This Notice
We reserve the right to change our privacy practices as described in this Notice at any time. We reserve the right to apply these changes to any PHI which we already have, as well as to PHI we receive in the future. We will update this Notice before we make any changes to our privacy practices as described. We will make the new Notice available upon request.
If you have any questions about this Notice, our privacy policies, or if you have questions about how to exercise your rights, please contact:
Attn: Privacy Officer
5220 Belfort Rd. Suite 130
Jacksonville, Florida 32256
904-446-3400 (Main Line)
Anonymous Ethics & Compliance Helpline