We are required by law to maintain the privacy of Protected Health Information (PHI) and to provide this Notice explaining our privacy practices. You have certain rights, and we have certain legal obligations, regarding the privacy of your PHI. This Notice explains your rights and our obligations. PHI is information that may identify you and that relates to your past, present, or future physical or mental health or condition, the provision of health care products and services to you, or payment for such services.
This Notice describes how we may use and disclose PHI about you, as well as how you obtain access to such PHI. This Notice also describes your rights with respect to your PHI. We are required by HIPAA to provide this Notice to you. Trident Primary & Preventative Care is required to follow the terms of this Notice or any change to it that is in effect. We reserve the right to change our practices and this Notice and to make the new Notice effective for all PHI we maintain. If we do so, the updated Notice will be posted on our website and will be available at our facilities.
How We May Use & Disclose Your PHI.
Except where prohibited by state or federal laws, we may use and disclose your PHI for treatment, payment, and health care operations without your prior authorization. We may communicate your information using various methods, orally, written, facsimile, and electronic communications. The following describes examples of the way we may use and disclose medical information.
We may use and disclose your PHI provide, coordinate, and manage your treatment or services. We may disclose medical information about you to other healthcare professionals, such as physicians, nurses, technicians, clinical laboratories, imaging centers, medical students, or other personnel who are involved in your care. We may also provide other healthcare professionals who contribute to your care with copies of various reports and information to assist and ensure that they have appropriate information regarding your condition, treatment plan, and diagnosis.
We may use and disclose your PHI so that we can bill and collect payment from you, a health plan, or a third party payer. This use and disclosure may include certain activities that your health plan may undertake before it approves or pays for the health care services we recommend for you, such as making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities.
For Health Care Operations.
We may use and disclose your PHI in order to support our business activities. These activities may include, but are not limited to quality assessments, employee review activities, licensing, legal advice, accounting support, information systems support, and conducting or arranging for other business activities, such as lab or radiology interfaces within the EHR. We may contact you to remind you of your scheduled time of arrival for medical care, or to contact you to tell you about possible treatment options or alternatives or health-related benefits and services that may be of interest to you.
We may use and disclose PHI to our Business Associates who perform certain services for us, such as billing services, copy services, or consulting services. These third party service providers may need to access your PHI to perform services for us. They are required by contract and law to protect your PHI and only use and disclose it as necessary to perform their services for us.
Communication with Individuals Involved in Your Care or Payment for Your Care.
We may disclose to a family member, personal representative, relative, or other person you identify, PHI directly relevant to that person’s involvement in your care or payment related to your care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We also may disclose the PHI of minor children to their parents or guardians, unless such disclosure is otherwise prohibited by law.
We may use or disclose your PHI regarding your location and general condition to notify or assist in notifying a family member, personal representative, or another person responsible for your care.
Workers’ Compensation (W/C).
To the extent necessary to comply with law, we may disclose your PHI to W/C or other similar programs established by law.
Food and Drug Administration (FDA).
We may disclose PHI relative to adverse events with respect to drugs, foods, supplements, products and product defects, or post-marketing surveillance information to persons under the jurisdiction of the FDA to enable product recalls, repairs, or replacement.
We may disclose your PHI to public health or legal authorities charged with preventing or controlling disease, injury, or disability, including the FDA. In certain circumstances, we may also report work-related illnesses and injuries to employers for workplace safety purposes.
To Avert a Serious Threat to Health or Safety.
We may use and disclose your PHI when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
Abuse, Neglect, or Domestic Violence.
We may disclose PHI about you to a government authority if we reasonably believe you are a victim of abuse or neglect. We will only disclose this type of information to the extent required by law, if you agree to the disclosure, or if the disclosure is allowed by law and we believe it is necessary to prevent serious harm to you or someone else.
We may disclose your PHI for law enforcement purposes, as required or permitted by law. For example, in response to a subpoena or court order, in response to a request from law enforcement, and to report limited information in certain circumstances.
As Required by Law.
We will disclose your PHI when required to do so by federal, state, or local law.
Health Oversight Activities.
We may disclose your PHI to an oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections, and credentialing, as necessary for licensure and for the government to monitor the health care system, government programs and compliance with civil rights laws.
Judicial & Administrative Proceedings
If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order. We may disclose your PHI in response to a subpoena, discovery request, or other lawful process instituted by someone involved in the dispute. Efforts will be made, either by the requesting party or us, to first tell you about the request or to obtain an order protecting the information requested. We may also use or disclose your PHI to defend ourselves in the event of a lawsuit.
We may use and disclose your PHI to organizations for purposes of disaster relief efforts.
Coroners, Medical Examiners, & Funeral Directors.
We may disclose PHI to coroners, medical examiners, or funeral directors consistent with applicable law to enable them to carry out their duties. For example, this may be necessary to identify a deceased person or determine the cause of death.
If you are or become an inmate of a correctional institution, we may disclose to the institution, or its agents, PHI necessary for your health and the health and safety of other individuals.
Military and Veterans.
If you are a member of the armed forces, we may release PHI about you as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority.
National Security, Intelligence Activities, & Protective Services for the President & Others.
We may release PHI about you to federal officials for intelligence, counterintelligence, protection of the President, and other national security activities authorized by law.
As permitted by applicable law, we may contact you to provide you with information about fundraising programs. You have the right to “opt out” of receiving these communications and such fundraising materials will explain how you may request to opt out of future communications if you do not want us to contact you further for fundraising efforts.
We may use your PHI to conduct research and disclose your PHI to researchers, as authorized by law. For example, we may use or disclose your PHI as part of a research study when the research has been approved by an institutional review board that has reviewed the proposal and established protocols to ensure the privacy of your information.
Organ or Tissue Procurement Organizations
Consistent with applicable law, we may disclose your PHI to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
Uses & Disclosures of PHI that Require Your Prior Authorization
Specific Uses or Disclosures Requiring Authorization.
We will obtain your written authorization for the use or disclosure of psychotherapy notes, use or disclosure of PHI for marketing purposes, and for the sale of PHI, except in limited circumstances where applicable law allows such uses or disclosure without your authorization.
Other Uses & Disclosures of PHI Not Covered by This Notice.
We will obtain your written authorization before using or disclosing your PHI for purposes other than those described in this notice or as otherwise permitted by law. You may revoke an authorization in writing at any time. Upon receipt of the written revocation, we will no longer use or disclose PHI under the authorization, except to the extent that we have already taken action in reliance on the authorization.
Your Health Information Rights
Obtain a Paper Copy of This Notice.
You may request a copy of our current Notice at any time. Even if you have agreed to receive the Notice electronically, you are still entitled to a paper copy. You may obtain a copy at our facilities and on our website.
Notification of a Breach.
You have the right to be notified following a breach of your unsecured PHI, and we will notify you in accordance with applicable law.
Inspect & Obtain a Copy of PHI.
You have the right to access and obtain a copy of your PHI that we maintain. If we maintain your PHI in an electronic health record, you have the right to request to obtain the PHI in an electronic format. To inspect or obtain a copy of your PHI, submit a written request. You may ask us to send a copy of your PHI to other individuals or entities. We may charge you a reasonable fee for the costs of copying, mailing, or other supplies associated with the request. We may deny your request to inspect and copy in certain circumstances. If you are denied access to your PHI, you may request that the denial be reviewed.
Request a Restriction on Uses & Disclosures of PHI.
You have the right to request additional restrictions on our use or disclosure of your PHI by submitting a written request to the Privacy Officer. We are not required to agree to the restrictions, except in the case where the disclosure is a health plan for purposes of carrying out payment or health care operations, is not otherwise required by law, and the PHI pertains solely to a health care item or service for which you, or a person on your behalf, has paid in full.
Request an Amendment of PHI.
If you feel that PHI we maintain about you is incomplete or incorrect, you may request that we amend it. To request an amendment, you must send a written request to the Privacy Officer and include a reason that supports your request. If we deny your request for an amendment, we will provide you with a written explanation. You have the right to file a statement of disagreement with us, and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.
Receive an Accounting of Disclosures of PHI.
With the exception of certain disclosures, restrictions, and limitations, you have a right to receive a list of the disclosures we have made of your PHI, in the six years prior to the date of your request, to entities or individuals other than you, to individuals involved in your care, or for notification purposes. Limitations may differ for electronic health records. To request an accounting, you must submit a request in writing to the Privacy Officer, and specify a time period. The first accounting you request within any 12-month period will be provided free of charge. For additional requests within the same period, we may charge you for reasonable costs. We will inform you of the costs, and you may choose to withdraw your request before the costs are incurred.
Request Confidential Communications of PHI by Alternative Means or At Alternative Locations.
You have the right to request that we communicate with you about health matters in a certain way or location to preserve your privacy. For instance, you may request that we contact you at a different address, via email, or other means. Please note if you choose to receive communications from us via email or other electronic means, those may not be secure. This means there is risk that your PHI in the emails may be intercepted and read by or disclosed to unauthorized parties. To request confidential communication of your PHI, you must submit a written request to the Privacy Officer. Your request must specify how you would like to be contacted. We will accommodate reasonable requests. However, if we are unable to contact you using the ways or locations you have requested, we may contact you using the information we have.
If you believe your privacy rights have been violated, you can file a grievance in person, or by mail or email with:
Trident Primary & Preventative Care
You can also file a grievance electronically through the Office for Civil Rights Complaint Portal, available at www.hhs.gov/ocr/hipaa, or by mail or email with:
U.S. Department of Health & Human Services
200 Independence Avenue SW, Room 509F HHH Bldg.
Washington, D.C. 20201
Grievances must be made in writing and submitted within 180 days of when you knew of, or should have known of, the suspected violation. There will be no retaliation against you for filing a grievance.