Notice of Privacy Practices
(trading as Check4Cancer US)
Effective Date: March 1, 2013
THIS NOTICE DESCRIBES HOW PROTECTED HEALTH INFORMATION (“PHI”) ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Your PHI is information about you that is created and received by us, including information that may reasonably identify you and that relates to your past, present, or future physical or mental health or condition, or information related to payment for your health care.
We understand the importance of privacy, and are committed to maintaining the confidentiality of your PHI. We make a record of the medical services we provide, and may receive such records from others. We use these records to provide or enable other health care providers to provide quality medical care and to enable us to meet our professional and legal obligations to provide our services properly. We are required by law to maintain the privacy of PHI and to provide individuals with notice of our legal duties and privacy practices with respect to PHI. If the privacy of your unsecured PHI is breached, we are required to notify you following such breach. This notice describes how we may use and disclose your PHI. It also describes your rights and our legal obligations with respect to your PHI. If you have any questions about this Notice, please contact our Privacy Officer, at tel: 877 927 9066.
A. How We May Use or Disclose Your Health Information
The law permits us to use or disclose your health information for the following purposes:
- Treatment. We may use PHI about you to provide your medical services. We disclose PHI to our employees and others who are involved in providing the services you request. For example, we may share your PHI with your physicians or other health care providers who will provide services, which we do not provide. We may also share this information with a laboratory that performs a test.
- Payment. We may use and disclose PHI about you to obtain payment for the services
- Health Care Operations. We may use and disclose PHI about you for the purposes of our medical operations. For example, we may use and disclose this information to review and improve the quality of care we provide, or the competence and qualifications of our professional staff. We may also use and disclose this information as necessary for medical reviews, legal services and audits, including fraud and abuse detection and compliance programs and business planning and management.
- Electronic Health Record System. We maintain your PHI in an electronic health record system.
- Business Associates. We may share your PHI with our “business associates”, such as entities or services that perform administrative services for us. We have a written contract with each of these business associates that contains terms requiring them to protect the confidentiality of your PHI.
- Appointment Reminders, Treatment Alternatives, Benefits and Services. We may use and disclose PHI to contact and remind you about an appointment. We may also use your health information in order to recommend possible treatment alternatives or health-related benefits and services that may be of interest to you.
- Notification and Communication with Family. With your permission we may disclose your health information to a family member or a close friend or other person you identify where relevant to that person’s involvement in your care or payment for your care. We may disclose your health information to notify or assist in notifying a family member, your personal representative or another person responsible for your care about your location and your general condition. If you are able and available to agree or object, we will give you the opportunity to object prior to making these disclosures, although we may disclose this information in a disaster even over your objection if we believe it is necessary to respond to the emergency circumstances. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communicating with your family and others.
- Required by Law. As required by law, we will use and disclose your health information, but we will limit our use or disclosure to the relevant requirements of the law. We may, and are sometimes required by law to disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability; reporting abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure.
- Health Oversight Activities. We may, and are sometimes required by law to disclose your health information to health oversight agencies during the course of audits, investigations, inspections, licensure and other proceedings.
- Judicial and Administrative Proceedings. We may, and are sometimes required by law, to disclose your health information in the course of any administrative or judicial proceeding to the extent expressly authorized by a court or administrative order. We may also disclose information about you in response to a subpoena, discovery request or other lawful process if the law permits such disclosure.
- Workers’ Compensation. We may disclose your health information as necessary to comply with workers compensation laws. For example, to the extent your care is covered by workers’ compensation, we will make periodic reports to your employer about your condition. We are also required by law to report cases of occupational injury or occupational illness to the employer or workers’ compensation insurer.
- Completely De-identified Information. We may use and disclose your health information if we have removed any information that has the potential to identify you so that the health information is "completely de-identified."
B. When We May Not Use or Disclose Your Health Information
Except as described in this Notice of Privacy Practices, and as permitted by applicable state or Federal law, we will not use or disclose your PHI without your written authorization. You may also initiate the transfer of your records to another person by completing a written authorization form. If you provide us with written authorization, you may revoke that written authorization at any time, except to the extent that we have already relied upon it. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provide to you.
We need your specific authorization before we use or disclose your PHI for the activities described below:
- Marketing. A signed authorization is required for the use or disclosure of your PHI for a purpose that encourages you to purchase or use a product or service except for certain limited circumstances such as when the marketing communication is face-to-face or when marketing includes the distribution of a promotional gift of nominal value provided by us.
- Sale of PHI. A signed authorization is required for the use or disclosure of your PHI in the event that we receives remuneration for such use or disclosure, except under certain circumstances as allowed by federal or applicable state law.
C. Your Health Information Rights
- Right to Request Special Privacy Protections. You have the right to request restrictions on certain uses and disclosures of your health information, by submitting a written request specifying what information you want to limit and what limitations on our use or disclosure of that information you wish to have imposed. We are not required to agree to your request for a restriction, unless it involves the disclosure of PHI to a health plan for purposes of carrying out payment or health care operations that pertains solely to a health care item or service for which we has been paid out of pocket in full. We will notify you of our decision.
- Right to Request Confidential Communications. You have the right to request that you receive your health information in a specific way or at a specific location. For example, you may ask that we send information to a particular e-mail account or to your work or home address. We will comply with all reasonable requests submitted in writing which specify how or where you wish to receive these communications.
- Right to Inspect and Copy. You have the right to inspect and copy your health information, with limited exceptions. This includes the right to obtain an electronic copy of your health information maintained in our electronic health record. To access your PHI, you must submit a written request detailing what information you want access to and whether you want to inspect it or get a copy of it. If you request a paper copy of the information, we may charge a fee for the costs of copying, mailing or other supplies we use to fulfill your request. If you request an electronic copy, we may charge a fee for our labor costs in fulfilling your request. We may deny your request under limited circumstances.
- Right to Amend. You have a right to request that we amend your health information that you believe is incorrect or incomplete. You must make a request to amend in writing, and include the reasons you believe the information is inaccurate or incomplete. We are not required to change your health information, and will provide you with information about our denial and how you can disagree with the denial. We may deny your request under certain circumstances.
- Right to an Accounting of Disclosures. You have a right to receive an accounting of disclosures of your health information made by us or by others on our behalf. An accounting of disclosures does not include information about disclosures made: to you or your personal representative; pursuant to your written authorization; for treatment, payment or business operations (unless such disclosures were made from our electronic health record, as noted below); or to family and friends involved in your care or payment for your care. To request an accounting of disclosures, you must submit a request in writing, stating a time period beginning that is within six (6) years of the date of your request. The first accounting provided within a twelve-month period will be free. We may charge you a reasonable, cost-based fee for each future request for an accounting within a single twelve-month period. An accounting of disclosures made from the electronic health record system related to treatment, payment or health care operations will be made only for the three (3) year period preceding the request, beginning on the date that we are required to provide an accounting of such disclosures under applicable law.
- Right to Receive a Notice of Privacy Practices. You have a right to receive a paper copy of this Notice of Privacy Practices. If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, contact our Privacy Officer listed at the top of this Notice of Privacy Practices.
D. Special Rules Regarding Disclosure of Certain Health Information
Additional restrictions may apply to disclosures of health information that relates to care for psychiatric conditions, substance abuse or HIV-related testing and treatment. In most cases, this information may not be disclosed without your specific written permission, except as may be specifically required or permitted by federal or applicable state law.
Mental Health Information. Certain mental health information may be disclosed for treatment, payment, and health care operations as permitted or required by law. Otherwise, we will only disclose such information pursuant to an authorization or court order, or as otherwise required by law.
Substance Abuse Treatment Information. If we have information regarding treatment you have received in a substance abuse program, Federal law protects the confidentiality of patient records containing information about alcohol and drug abuse. These records may be disclosed only upon limited circumstances.
HIV-Related Information. We may disclose HIV-related information only as permitted or required by state law. For example, state law may allow HIV-related information to be disclosed without your authorization for treatment purposes, certain health oversight activities, when pursuant to a court order, or in the event of certain exposures to HIV by our personnel, another person, or a known partner.
E. Changes to this Notice of Privacy Practices
We reserve the right to amend this Notice of Privacy Practices at any time in the future. Until such amendment is made, we are required by law to comply with this Notice. After an amendment is made, the revised Notice of Privacy Protections will be posted on our website and will apply to all PHI that we maintain, regardless of when it was created or received.
Complaints about this Notice of Privacy Practices or how we handle your health information should be directed to our Privacy Officer listed at the top of this Notice of Privacy Practices.
You may also submit a complaint to:
Department of Health and Human Services
Office of Civil Rights
Hubert H. Humphrey Bldg.
200 Independence Avenue, S.W.
Room 509F HHH Building
Washington, DC 20201
You will not be penalized for filing a complaint.
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