Notice of Privacy Practices
THIS NOTICE OF PRIVACY PRACTICES (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.
At ModeraCare, we believe your health information is personal. We keep records of the care and services that you receive via the Service. We are committed to keeping your health information private, and we are required by law to respect your confidentiality.
This Notice describes the privacy practices of ModeraCare and its affiliated facilities. This Notice applies to all of the health information that identifies you. This information may consist of paper, digital or electronic records but could also include photographs, videos and other electronic transmissions or recordings that are created during your care and treatment. We are legally required to keep your health information private, to notify you of our legal responsibilities and privacy practices that relate to your health information, and to notify you if there is a breach of your unsecured health information. We are also legally required to give you this Notice and to follow the terms of the Notice currently in effect.
HOW MODERACARE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
When you obtain health care services via the MeMD™ Service, we will use your health information within ModeraCare and disclose your health information outside ModeraCare for the reasons described in this Notice. The following categories describe some of the ways that we will use and disclose your health information.
Treatment. We use your health information to facilitate the provision of health care services. We may disclose your health information to doctors, nurses, technicians, medical or nursing students, or other persons who need the information to take care of you, and those health care providers may disclose such information to other health care providers. For example, a doctor treating you for a broken leg may need to ask another doctor if you have diabetes because diabetes may slow the leg’s healing process. We also may disclose your health information to other people outside ModeraCare who may be involved in your health care, such as home care providers, pharmacies, drug or medical device experts, and family members.
Payment. We may use and disclose your health information so that the health care you receive can be billed and paid for by you, your insurance company, or another third party. For example, we may give information about health care services you obtained via the Service to your health plan so it will pay us or reimburse you for such services.
Health Care Operations. We may use your health information and disclose it outside ModeraCare for our health care operations. These uses and disclosures help us operate ModeraCare to maintain and improve patient care. For example, we may combine health information about many patients to identify new services to offer and what services are not needed. We may also disclose information to doctors, nurses, technicians, medical students, and other persons providing health care services via the Service for learning and quality improvement purposes.
Contacting You. We may use and disclose health information to reach you about appointments and other matters. We may contact you by mail, telephone or email. For example, we may leave voice messages at the telephone number you provide us with, and we may respond to your email address.
Health Information Exchanges. We may participate in certain health information exchanges 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.
Organized Health Care Arrangements. We may participate in joint arrangements with other health care providers or health care entities whereby we may use or disclose your health information, as permitted by law, to participate in joint activities involving treatment, review of health care decisions, quality assessment or improvement activities, or payment activities.
Health-Related Services. We may use and disclose health information about you to send you mailings about health-related products and services available at ModeraCare.
Philanthropic Support. We may use or disclose certain health information about you to contact you in an effort to raise funds to support ModeraCare and its operations. You have a right to choose not to receive these communications and we will tell you how to cancel them.
Legal Matters. We will disclose health information about you outside ModeraCare when required to do so by federal, state, or local law, or by the court process. We may disclose health information about you for public health reasons, like reporting births, deaths, child abuse or neglect, reactions to medications or problems with medical products. We may release health information to help control the spread of disease or to notify a person whose health or safety may be threatened. We may disclose health information to a health oversight agency for activities authorized by law, such as for audits, investigations, inspections, and licensure.
AUTHORIZATIONS FOR OTHER USES AND DISCLOSURES
As described above, we will use your health information and disclose it outside ModeraCare for treatment, payment, health care operations, and when required or permitted by law. We will not use or disclose your health information for other reasons without your written authorization. For example, most uses and disclosures of psychotherapy notes, uses and disclosures of health information for certain marketing purposes, and disclosures that constitute a sale of health information require your written authorization. These kinds of uses and disclosures of your health information will be made only with your written authorization. You may revoke the authorization in writing at any time, but we cannot take back any uses or disclosures of your health information already made with your authorization.
ModeraCare understands that it may be subject to state laws governing the privacy and security of health information in addition to or instead of the requirements under HIPAA.
YOUR RIGHTS REGARDING HEALTH INFORMATION
Right to Accounting. You may request an accounting, which is a listing of the entities or persons (other than yourself) to whom ModeraCare has disclosed your health information without your written authorization. The accounting would not include disclosures for treatment, payment, health care operations, and certain other disclosures exempted by law. Your request for an accounting of disclosures must be in writing, signed, and dated. It must identify the time period of the disclosures. We will not list disclosures made earlier than six (6) years before your request. Your request should indicate the form in which you want the list (for example, on paper or electronically). You must submit your written request to ModeraCare. We will respond to you within 60 days. We will give you the first listing within any 12-month period free of charge, but we will charge you for all other accountings requested within the same 12 months.
Right to Amend. If you feel that health information we have about you is incorrect or incomplete, you have the right to ask us to amend your medical records. Your request for an amendment must be in writing, signed, and dated, and it must specify the records you wish to amend and give the reason for your request. You must address your request to the medical records department of ModeraCare. ModeraCare will respond to you within 60 days. We may deny your request; if we do, we will tell you why and explain your options.
Right to Inspect and Obtain Copy. You have the right to inspect and obtain a copy of your completed health records unless a health care provider believes that disclosure of that information to you could harm you. You may not see or get a copy of information gathered for a legal proceeding or certain research records while the research is ongoing. Your request to inspect or obtain a copy of the records must be submitted in writing, signed and dated, to the medical records department of ModeraCare. (Requests for billing records should be sent to the billing departments.) We may charge a fee for processing your request. If ModeraCare denies your request to inspect or obtain a copy of the records, you may appeal the denial in writing to ModeraCare at the following address: ModeraCare, Inc., PO Box 4354, Tequesta, FL 33469-1020.
Right to Request Confidential Communications. You have the right to request that we communicate with you about your health in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. Your request for confidential communications must be in writing, signed, and dated. You need not tell us the reason for your request, and we will not ask.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy. You may obtain a paper copy of this Notice by calling ModeraCare.
Right to Request Restrictions on Use/Disclosure of Your Health Information. You can request in writing that we not use or disclose your information for any reason as provided in this Notice or to persons involved in your care except when specifically authorized by you or when required by law, or in emergency circumstances. We are not legally required to accept such request but we will try to honor any reasonable requests; provided, however, we must agree to such a request when it involves a request to restrict disclosure of protected health information about you to a health plan if: (i) the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law; and (ii) the protected health information pertains solely to a health care item or service for which you, or a person other than the health plan on your behalf, has paid the covered entity in full.
If you believe your privacy rights have been violated, you may file a complaint with ModeraCare or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with ModeraCare, you must submit your complaint in writing to the following address: ModeraCare, Inc., PO Box 4354, Tequesta, FL 33469-1020.
CHANGES TO THIS NOTICE
ModeraCare may change this Notice at any time. Any change in the Notice could apply to medical information we already have about you, as well as any information we receive in the future. We will post a copy of the current Notice on our website. The effective date of the Notice is May 20, 2016.
If you have questions about this Notice, you may contact ModeraCare at email@example.com.