NOTICE OF PRIVACY PRACTICES
Harmony At Home, L.L.C.
774-571-3764 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.
If you have any questions about this Privacy Notice, please contact Amy at the number listed above.
General Overview: We will not use or disclose any of the personal information you provide to us (including your phone number, name, email, child's name or any other information) to third parties except for billing purposes as described below and after you have expressly given consent. We will not keep your payment (checking or credit card information), insert cookies or other tracking software onto your computer or in any other way continue to gather, maintain, or disseminate any information you provide to us.
I. Introduction
This Notice of Privacy Practices describes how we may use and disclose your (“you” and “your” means both the client and family members insofar as they are relevant to the services provided) protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. This Notice also describes your rights regarding health information we maintain about you and a brief description of how you may exercise these rights. This Notice further states the obligations we have to protect your health information. “Protected health information” means health information (including identifying information about you) we have collected from you or received from your health care providers, your family and yourself and, if applicable, your health plans. It may include information about your past, present or future physical or mental health or condition, the provision of your health care, and payment for your health care services. We are required by law to maintain the privacy of your health information and to provide you with this notice of our legal duties and privacy practices with respect to your health information. We are also required to comply with the terms of our current Notice of Privacy Practices. II. How We Will Use and Disclose Your Health Information
We will use and disclose your health information as described in each category listed below. For each category, we will explain what we mean in general, but not describe all specific uses or disclosures of health information.
A. Uses and Disclosures That May Be Made For Treatment, Payment and Operations 1. For Treatment. We will not use or disclose your health information without your authorization to provide your health care and any related services. We will use and disclose your health information to coordinate and manage your care and related services. For example, we may need to disclose information to a separate provider who is responsible for coordinating your care. However, when we make disclosures to a third party for coordination or management of your care, we will obtain your written authorization prior to the disclosure. A third party is a person or entity who is not affiliated with our organization.
For example, we may discuss your care at a case conference.
We will disclose your health information to another health care provider (e.g., your family therapist or school guidance counselor) who do not work for Harmony At Home, LLC only with your authorization.
2. For Payment. We may use or disclose your health information without your authorization so that the treatment and services you receive are billed to, and payment is collected from and/or refunded to, your third party payer. We may also use and disclose your health information to contact you to remind you of your appointment.
Finally, we may use and disclose your health information to inform you about possible treatment options or alternatives that may be of interest to you.
4. Health-Related Benefits and Services. Only with your authorization will we use or disclose health information about you to tell you about health-related benefits or services that may be of interest to you.
5. Uses and Disclosures That May be Made Without Your Authorization, But For Which You Will Have an Opportunity to Object 1. 2. Persons Involved in Your Care. We will provide health information about you only to the individual(s) you authorize to receive information. If you are physically present and have the capacity to make care decisions, your information will only be disclosed with your agreement to persons that you designate to be involved in your care.
But, if you are in an emergency situation, we may disclose your health information to a spouse, a family member, or a friend so that such person may assist in your care. In this case we will determine whether the disclosure is in your best interest and, if so, only disclose information that is directly relevant to participation in your care.
· your guardian or medication monitor if one has been appointed by a court, or · if applicable, the state agency responsible for consenting to your care. C. Uses and Disclosures That May be Made Without Your Authorization or Opportunity to Object 1. Emergencies. We may use and disclose your health information without your authorization in an emergency treatment situation. By way of example, we may provide your health information to a paramedic who is transporting you in an ambulance. If a clinician is required by law to treat you and your treating clinician has attempted to obtain your authorization but is unable to do so, the treating clinician may nevertheless use or disclose your health information to treat you.
2. As Required By Law. We will disclose health information about you when required to do so by federal, state or local law.
3. To Avert a Serious Threat to Health or Safety. We may use and disclose health information about you when necessary to prevent a serious and imminent threat to your health or safety or to the health or safety of the public or another person. Under these circumstances, we will only disclose health information to someone who is able to help prevent or lessen the threat.
4. Public Health Activities. We may disclose health information about you as necessary for public health activities including, by way of example, disclosures to: · report to public health authorities for the purpose of preventing or controlling disease, injury or disability; · report vital events such as birth or death; · conduct public health surveillance or investigations; · report child abuse or neglect; · notify a person who may have been exposed to a communicable disease or who is at risk of contracting or spreading a disease; · We will only notify an agency if we obtain your agreement or if we are required or authorized by law to report such abuse, neglect or domestic violence.
5. Disclosures in Legal Proceedings. We may disclose health information about you to a court when a judge orders us to do so. We also may disclose health information about you in legal proceedings without your permission or a judge’s order when: · your health information involves communications made during a court-ordered psychiatric examination; · you introduce your mental or emotional condition in evidence in support of your claim or defense in any proceeding and the judge approves our disclosure of your health information; · you sue any of our clinicians or staff for malpractice or initiate a complaint with a licensing board against any of our clinicians; · the legal proceeding involves child custody, adoption or dispensing with consent to adoption and the judge approves our disclosure of your health information. We will not provide any other information in response to a subpoena without your authorization.
6. Law Enforcement Activities. We may disclose health information to a law enforcement official for law enforcement purposes when: · you agree to the disclosure; or · when the information is provided in response to an order of a court; or · we determine that the law enforcement purpose is to respond to a threat of an imminently dangerous activity by you against yourself or another person; or the disclosure is otherwise required by law. We may also disclose health information about a client who is a victim of a crime, without a court order or without being required to do so by law. However, we will do so only if the disclosure has been requested by a law enforcement official and the victim agrees to the disclosure or, in the case of the victim’s incapacity, the following occurs: · the law enforcement official represents to us that (i) the victim is not the subject of the investigation and (ii) an immediate law enforcement activity to meet a serious danger to the victim or others depends upon the disclosure; and · we determine that the disclosure is in the victim’s best interest. 7. National Security and Protective Services for the President and Others. We may disclose medical information about you to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law. We may also disclose health information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or so they may conduct special investigations.
8. Workers’ Compensation. We will not disclose health information about you to comply with the Massachusetts Workers’ Compensation Law. III. Uses and Disclosures of Your Health Information with Your Permission.
Uses and disclosures not described in Section II of this Notice of Privacy Practices will generally only be made with your written permission, called an “authorization.” You have the right to revoke an authorization at any time. If you revoke your authorization we will not make any further uses or disclosures of your health information under that authorization, unless we have already taken an action relying upon the uses or disclosures you have previously authorized.
IV. Your Rights Regarding Your Health Information.
A. Right to Inspect and Copy.
You have the right to request an opportunity to inspect or copy information used to make decisions about your care – whether they are decisions about your treatment or payment of your care. Usually, this would include clinical and billing records, but not psychotherapy notes.
You must submit your request in writing. If you request a copy of the information, we may charge a fee for the cost of copying, mailing and supplies associated with your request.
We may deny your request to inspect or copy your health information in certain limited circumstances. In some cases, you will have the right to have the denial reviewed by a licensed health care professional not directly involved in the original decision to deny access. We will inform you in writing if the denial of your request may be reviewed. Once the review is completed, we will honor the decision made by the licensed health care professional reviewer.
B. Right to Amend.
For as long as we keep records about you, you have the right to request us to amend any health information used to make decisions about your care – whether they are decisions about your treatment or payment of your care. Usually, this would include clinical and billing records, but not psychotherapy notes.
To request an amendment, you must submit a written document and tell us why you believe the information is incorrect or inaccurate.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. We may also deny your request if you ask us to amend health information that: · was not created by us, unless the person or entity that created the health information is no longer available to make the amendment; · is not part of the health information we maintain to make decisions about your care; · is not part of the health information that you would be permitted to inspect or copy; or · is accurate and complete. If we deny your request to amend, we will send you a written notice of the denial stating the basis for the denial and offering you the opportunity to provide a written statement disagreeing with the denial. If you do not wish to prepare a written statement of disagreement, you may ask that the requested amendment and our denial be attached to all future disclosures of the health information that is the subject of your request.
If you choose to submit a written statement of disagreement, we have the right to prepare a written rebuttal to your statement of disagreement. In this case, we will attach the written request and the rebuttal (as well as the original request and denial) to all future disclosures of the health information that are the subject of your request.
C. Right to an Accounting of Disclosures.
You have the right to request that we provide you with an accounting of disclosures we have made of your health information. An accounting is a list of disclosures. But this list will not include those we have made for purposes of treatment, payment, and health care operations.
To request an accounting of disclosures, you must submit your request in writing. The request should state the time period for which you wish to receive an accounting. This time period should not be longer than six years.
The first accounting you request within a twelve month period will be free. For additional requests during the same 12 month period, we will charge you for the costs of providing the accounting. We will notify you of the amount we will charge and you may choose to withdraw or modify your request before we incur any costs.
D. Right to Request Restrictions.
You have the right to request a restriction on the health information we use or disclose about you for treatment, payment or health care operations. You may also ask that any part (or all) of your health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in Section II(B)(2) of this Notice of Privacy Practices.
You must request the restriction in writing. We are not required to agree to a restriction that you may request. If we do agree, we will honor your request unless the restricted health information is needed to provide you with emergency treatment.
E. Right to Request Confidential Communications.
You have the right to request that we communicate with you about your health care only in a certain location or through a certain method. For example, you may request that we contact you only at work or by e-mail.
To request such a confidential communication, you must make your request in writing. We will accommodate all reasonable requests. You do not need to give us a reason for the request; but your request must specify how and where you wish to be contacted.
F. Right to a Paper Copy of this Notice.
You have the right to obtain a paper copy of this Notice of Privacy Practices at any time. Even if you have agreed to receive this Notice of Privacy Practices electronically, you may still obtain a paper copy. To obtain a paper copy, contact Amy.
V. Confidentiality of Substance Abuse Records
For individuals who have received treatment, diagnosis or referral for treatment for drug or alcohol abuse programs, the confidentiality of drug or alcohol abuse records is protected by federal law and regulations. As a general rule, we may not tell a person outside the programs that you attend any of these programs, or disclose any information identifying you as an alcohol or drug abuser, unless: · you authorize the disclosure in writing; or · the disclosure is permitted by a court order; or · the disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit or program evaluation purposes; or · you threaten to commit a crime either at the drug abuse or alcohol program or against any person who works for our drug abuse or alcohol programs. A violation by us of the federal law and regulations governing drug or alcohol abuse is a crime. Suspected violations may be reported to the Unites States Attorney in the district where the violation occurs.
Federal law and regulations governing confidentiality of drug or alcohol abuse require us to report suspected child abuse or neglect under state law to appropriate state or local authorities.
Please see 42 U.S.C. § 290dd-2 for federal law and 42 C.F.R., Part 2 for federal regulations governing confidentiality of alcohol and drug abuse patient records.
VI. Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. All complaints must be submitted in writing. We will not retaliate against you for filing a complaint.
VII. Changes to this Notice
We reserve the right to change the terms of our Notice of Privacy Practices. We also reserve the right to make the revised or changed Notice of Privacy Practices effective for all health information we already have about you as well as any health information we receive in the future. We will post a copy of the current Notice of Privacy Practices at our main office and at each site where we provide care. You may also obtain a copy of the current Notice of Privacy Practices by accessing our website at www.HarmonyAtHome.org or by calling us at 774-581-3764 and requesting that a copy be sent to you in the mail or by asking for one any time you are in contact with Amy. |