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Privacy Policy |
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THIS NOTICE DESCRIBES HOW MEDICAL AND HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. USE AND DISCLOSURE OF HEALTH INFORMATIONTLC Medical Staffing, Inc. has a limited right to use and/or disclose your Protected Health Information (PHI) for the purposes of providing you treatment, obtaining payment for your care and conducting health care operations. The Agency has established policies to guard against unnecessary disclosure of your health information THE FOLLOWING IS A SUMMARY OF WHEN AND WHY YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED:
To
Provide Treatment.
The Agency may use your health information to
coordinate or manage your care within the Agency and with other
individuals outside of the Agency involved in your care, such as your
attending physician and other health care professionals.
For example, certain service providers involved in your care need
information about your medical condition in order to deliver appropriate
services.
To
Obtain Payment.
The Agency may include your health information in
invoices to collect payment from third parties for the care you receive
through the Agency. For
example, some health information is transmitted to the Ohio Department
of Aging and the Ohio Department of Job and Family Services when billing
transactions are conducted.
To
Conduct Health Care Operations.
The
Agency may use and disclose health information for its own operations
and as necessary to provide quality care to all of the Agency’s
service recipients. Health
care operations includes such activities as:
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Quality
assessment and improvement activities.
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Activities
designed to improve health or reduce health care costs.
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Protocol
development, case management and care coordination.
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Contacting
health care providers and consumers with information about treatment
alternatives and other related functions that do not include treatment.
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Professional
review and performance evaluation.
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Review
and auditing, including compliance reviews, medical reviews, legal
services and compliance programs.
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Business
planning and development including cost management and planning related
analyses and formulary development.
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Business
management and general administrative activities of the Agency.
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Fundraising
for the benefit of the Agency.
As
an example, the Agency may use your health information to evaluate its
staff performance, or combine your health information with other Agency
consumers in evaluating how to more effectively serve all Agency
consumers. Your health
information may be disclosed to Agency staff and contracted personnel
for training purposes, or used
For
Appointment Reminders.
The
Agency may use and disclose your health information to contact you as a
reminder that you have an appointment for a home visit.
For
Treatment Alternatives.
The
Agency may use and disclose your health information to tell you about or
recommend possible service options or alternatives that may be of
interest to you. THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES WHEN YOUR HEALTH INFORMATION MAY ALSO BE USED AND DISCLOSED
When
Legally Required.
The Agency will disclose your health information when
it is required to do so by any Federal, State or local law.
When
There Are Risks to Public Health.
The
Agency may disclose your health information for public activities and
purposes in order to:
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Prevent
or control disease, injury or disability, report disease, injury, vital
events such as birth or death and the conduct of public health
surveillance, investigations and interventions.
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Notify
a person who has been exposed to a communicable disease or who may be at
risk of contracting or spreading a disease.
To
Report Abuse, Neglect Or Domestic Violence.
The
Agency is allowed to notify government authorities if the Agency
believes a client is the victim of abuse, neglect or domestic violence.
The Agency will make this disclosure only when specifically
required or authorized by law or when the client agrees to the
disclosure.
To
Conduct Health Oversight Activities.
The
Agency may disclose your health information to a health oversight agency
for activities including audits, civil administrative or criminal
investigations, inspections, licensure or disciplinary action.
The Agency, however, may not disclose your health information if
you are the subject of an investigation and your health information is
not directly related to your receipt of health care or public benefits. In Connection With Judicial And Administrative Proceedings. The Agency may disclose your health information in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful process, but only when the Agency makes reasonable efforts to either notify you about the request or to obtain an order protecting your health information.
For
Law Enforcement Purposes.
As
permitted or required by State law, the Agency may disclose your health
information to a law enforcement official for certain law enforcement
purposes as follows:
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As
required by law for reporting of certain types of wounds or other
physical injuries pursuant to the court order, warrant, subpoena or
summons or similar process.
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For
the purpose of identifying or locating a suspect, fugitive, material
witness or missing person.
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Under
certain limited circumstances, when you are the victim of a crime.
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To
a law enforcement official if the Agency has a suspicion that your death
was the result of criminal conduct including criminal conduct at the
Agency.
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In
an emergency in order to report a crime.
For
Research Purposes.
The Agency may, under very select circumstances, use
your health information for research.
Before the Agency discloses any of your health information for
such research purposes, the project will be subject to an extensive
approval process.
In
the Event of A Serious Threat To Health Or Safety.
The
Agency may, consistent with applicable law and ethical standards of
conduct, disclose your health information if the Agency, in good faith,
believes that such disclosure is necessary to prevent or lessen a
serious and imminent threat to your health or safety or to the health
and safety of the public.
For
Specified Government Functions.
In
certain circumstances, the Federal regulations authorize the Agency to
use or disclose your health information to facilitate specified
government functions relating to military and veterans, national
security and intelligence activities, protective services for the
President and others, medical suitability determinations and inmates and
law enforcement custody.
For
Worker’s Compensation.
The
Agency may release your health information for worker’s compensation
or similar programs.
AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATIONOther than is stated above, the Agency will not disclose your health information other than with your written authorization. If you or your representative authorizes the Agency to use or disclose your health information, you may revoke that authorization in writing at any time.
YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATIONYou have the following rights regarding your health information that the Agency maintains:
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Right
to request restrictions.
You
may request restrictions on certain uses and disclosures of your health
information. You have the
right to request a limit on the Agency’s disclosure of your health
information to someone who is involved in your care or the payment of
your care. However, the
Agency is not required to agree to your request.
If you wish to make a request for restrictions, please contact
the Agency’s Privacy Officer.
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Right
to receive confidential communications.
You
have the right to request that the Agency communicate with you in a
certain way. For example,
you may ask that the agency only conduct communications pertaining to
your health information with you privately with no other family members
present. If you wish to receive confidential communications, please
contact the Privacy Officer at 1-888-298-5532.
The Agency will not request that you provide any reasons for your
request and will attempt to honor your reasonable requests for
confidential communications.
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Right
to inspect and copy your health information.
Unless
your access to your records is restricted for clear and documented
treatment reasons, you have the right to see your protected health
information upon your request.
You
have the right to inspect and copy records containing your health
information including billing records.
A request to inspect and copy records containing your health
information may be made to the Privacy Officer at 1-800-298-5532.
If you request a copy of your health information, the Agency may
charge a reasonable fee for copying and assembling costs associated with
your request.
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Right
to amend health care information.
You
or your representative have the right to request that the Agency amend
your records, if you believe that your health information is incorrect
or incomplete. That request
may be made as long as the information is maintained by the Agency.
A request for an amendment of records must be made in writing to
TLC Medical Staffing, Inc. Attention:
Privacy Officer, 203 N. Seltzer St., Crestline, OH
44827. The Agency
may deny the request if it is not in writing or does not include a
reason for the amendment. The
request also may be denied if your health information records were not
created by the Agency, if the records you are requesting are not part of
the Agency’s records, if the health information you wish to amend is
not part of the health information you or your representative are
permitted to inspect and copy, or if, in the opinion of the Agency, the
records containing your health information are accurate and complete. -
Right
to know what disclosures have been made.
You
or your representative have the right to request an accounting of
disclosures of your health information made by the Agency for certain
reasons, including reasons related to public purposes
- Right
to a paper copy of this notice.
You
or your representative have a right to a separate paper copy of this
Notice at any time even if you or your representative have received this
Notice previously. To
obtain a separate paper copy, please contact the Privacy Officer at
1-888-298-5532.
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DUTIES
OF THE AGENCY The Agency is required by law to maintain the privacy of your health information and to provide to you and your representative this Notice of its duties and privacy practices. The Agency is required to abide by the terms of this Notice as may be amended from time to time. The Agency reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all health information that it maintains. If the Agency changes its Notice, the Agency will provide a copy of the revised Notice to you or your appointed representative. WHERE TO FILE A COMPLAINT You or your personal representative have the right to express complaints to the Agency and to the Secretary of DHHS is you or your representative believe that your privacy rights have been violated. Any complaints to the Agency should be made in writing to the contact person listed below. The Agency encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint. You may also file a written complaint with the Secretary of the U.S. Department of Health and Human Services, 200 Independence Ave SW, Washington, D.C., 2201 or call 1-877-696-6775. CONTACT
PERSON The Agency has designated a Privacy Officer as its contact person for all issues regarding client privacy and your rights under the Federal privacy standards. You may contact this person at TLC Medical Staffing, Inc., 203 N. Seltzer St., Crestline, OH 44827. EFFECTIVE
DATE This Notice is effective April 14, 2003. IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT THE PRIVACY OFFICER AT THE AGENCY. |