| Clear-Care Corporation
HIPAA Notice of Privacy Practices
Effective date of this notice: April 14, 2003
This Notice Describes How Medical Information About You May Be Used And Described And How You Can Get Access To This Information.
Please Review It Carefully.
If you have any questions about this notice, please contact:
Deborah Ryan, HIPAA Privacy Officer
1229 South Second Street
Clearfield, Pa. 16830
Clear-Care will ask you to sign an Acknowledgment that you have received this Notice of Privacy Practices.
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment of health care operations and for purposes that are permitted or required by law. It also describes our rights to access and control your protected health information.
Your Protected Health Information
This notice applies to the information we have about you, including your demographics, your health, health status, and the health care and service you receive from Clear-Care.
Use and Disclosure of Protected Health Information
Clear-Care Corporation is required to maintain the privacy of your health information and abide by the terms of this notice. Clear-Care may use and disclose your protected health information to carry out treatment, payment or health care operations and for other specific purposes that are permitted or required by law.
For Treatment: We may use your health information to provide you with medical services. We may disclose your health information to your doctors, therapists, technicians, office staff or others who are involved in your health care.
For example, information obtained by a respiratory therapist or other member of your healthcare team will be recorded and used to determine your course of treatment. We may disclose that information to other healthcare professionals as needed to assist in your health care.
Clear-Care may disclose your information in order to coordinate your care. Family members and others may require information from our records.
For Payment: We may use and disclose your health information so that the services may be billed and payment collected from you, an insurance company or another third party. For example, we may disclose information about a service you received so that your health plan will pay us or reimburse you for such service. We may also tell your health plan about a treatment you are going to receive to obtain prior approval, or to determine whether your plan will cover the treatment.
For Health Care Operations: Clear-Care may use and disclose your health information in order to manage internal operations. For example, we may use your health information to evaluate the performance of our staff; to help determine additional services; to ensure efficiency and product/service effectiveness.
- We may contact you as a reminder that you have an appointment for services, treatment or medical care at one of our facilities.
- We may contact you about or recommend possible treatment options or alternatives that may be of interest to you.
You may notify us if you do not wish to be contacted for appointment reminders, or if you do not wish to receive communications about treatment alternatives or health-related products and services.
Other Permitted and Required Uses and Disclosures: We may use or disclose your protected health information without your authorization for the following purposes, subject to all-applicable legal requirements and limitations:
- To avert a serious threat to health and safety
- As required by law
- To the Food and Drug Administration
- For research
- For organ and tissue donations
- To military authorities
- For national security and intelligence
- For workers compensation
- To prevent public health risks
- For health oversight activities
- For legal proceedings
- For law enforcement
- To coroners, medical examiners and funeral directors
- Family and friends: We may disclose health information about you to your family members or friends or any person you have identified as being involved in your health care.
- In situations where you have not identified others as being involved in your healthcare, we may, using our professional judgment, determine that a disclosure to such individuals is in your best interest. In that situation, we will disclose only health information relevant to that person’s involvement in your care.
- Business Associates: There are some services provided in our organization through contracts with business associates. Example includes but is not limited to billing service. When these services are contracted, we may disclose your health information so they can bill you or your third-party payor for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.
Authorized Uses and Disclosures
We will obtain your written Authorization before using or disclosing protected health information about you for purposes other than those listed above or otherwise permitted or required by law. You may revoke that Authorization, in writing, at any time. If you revoke your Authorization, we will no longer use or disclose information about you for the reasons covered by your written Authorization, but we cannot take back any uses or disclosures already made with your permission.
- You have the following rights regarding your protected health information
- You have the right to inspect and copy your health information, such as medical and billing records. You must submit a written request to Clear-Care Corporation’s HIPAA Privacy Officer in order to inspect and or copy your health information. We may charge a fee for the costs of copying, mailing or other associated supplies. We may deny your request to inspect and or copy in certain limited circumstance. If you are denied access to your health information, you may ask that the denial be reviewed.
- You have the right to request an amendment to your information if you feel the information is not correct, or not complete. The request must be in writing and must be submitted to Clear-Care Corporation’s HIPAA Privacy Officer. We will respond in writing to your request within 30 days. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request to amend information that:
- We did not create.
- Is not part of the health information that we keep.
- You would not be permitted to inspect and copy.
- Is accurate and complete.
- You have the right to receive an accounting of disclosures we have made during the six-year period preceding the date of your request. However, disclosures listed in the “Other Permitted and Required Uses and Disclosures” section of this document and (i) disclosures that occurred prior to April 14, 2003, (ii) disclosures made pursuant to an authorization signed by you, (iii) disclosures that are part of a limited data set, (iv) disclosures that are incidental to another permissible use or discolor, (v) will not be accounted for. The accounting will include the date of each disclosure, the name of the entity or person who received the disclosure, that person’s address (if known), and a brief description of the information disclosed and the purpose of the disclosure. To obtain an accounting of disclosures, you must submit your request in writing to Clear-Care Corporation’s HIPAA Privacy Officer. A reasonable charge may be assessed for more than one accounting in any 12-month period. We will notify you of the cost involved and you may choose to withdraw your request prior to any costs being incurred.
- 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. Such requests must be made in writing to Clear-Care Corporation’s HIPAA Privacy Officer. We are not required to agree to your request. If we do agree, we will comply with your request.
- You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. A written request must be sent to Clear-Care Corporation’s HIPAA Privacy Officer. We will comply with all reasonable requests.
- 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 it electronically, you are still entitled to a paper copy. To obtain such a copy, contact Clear-Care Corporation’s HIPAA Privacy Officer.
Changes To This Notice
We reserve the right to change this notice, and to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a summary of the current notice in the office with its effective date in the top right hand corner. You are entitled to a copy of the notice currently in effect.
If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. To file a complaint with our office, contact Deborah Ryan, HIPAA Privacy Officer, at 814-765-0221 or submit in writing to same at Clear-Care Corporation, 1229 South Second Street, Clearfield, Pa. 16830. Clear-Care Corporation and its employees and contractors cannot and will not retaliate against you for filing a complaint.
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