Your Information. Your Rights. Our Responsibilities.
Patient Privacy Notice:
This notice describes how medical information about you may be used and disclosed as well as how you can get access to this information.
PLEASE REVIEW IT CAREFULLY.
Your Rights: This notice applies to Intracare Health Services, Inc. (“IHS”) and related companies under IHS’ common ownership or control that provide health-related services. These companies are operating as a single “affiliated covered entity” for purposes of the Health Insurance Portability and Accountability Act (“HIPAA”).
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
- You can request to review or obtain an electronic or paper copy of your medical record and other health information we have. Ask us how to do this in the Contact Form.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based processing fee. In some limited circumstances, we may say deny your request, and you can appeal our decision for further review.
Ask us to correct your medical record
- You can ask us to correct incomplete, inaccurate, or incorrect health information about you. This request must be made in writing within 60 days.
Request confidential communications
- Confidential communications with us will only be through mail. You may request confirmation of your mailing address via phone or email.
Ask us to limit what we use or share
- You can request that IHS shall not use or share certain health information for treatment, payment, or our operations.
- We are not required to grant your request, and we may deny if limiting shared health information may affect your care.
- If you pay for a service or health care item out-of-pocket in full, you can ask us not to provide that information to your health insurer for the purpose of payment or our operations. We will comply with state or federal law if we are required to share that information.
Get a list of those with whom we’ve shared information
- You can request records regarding instances where your health information was shared for up to six years prior the date of your request, who we shared it with and why.
- Except as otherwise required by applicable rules and regulations, we will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make) in compliance with HIPAA. We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
- You may request a physical copy of this notice at any time, even if you have agreed to receive the notice electronically.
Choose someone to act for you
- If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
- We will take reasonable measures if needed to confirm that the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
- You can complain if you feel we have violated your privacy rights by contacting our Privacy Officer via a letter sent to 160 SW 12 Avenue, Suite 101D, Deerfield Beach, FL 33442 or by email: firstname.lastname@example.org, or calling 1-888-327-2233
- You can file a complaint with the US. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting hhs.gov/ocr/privacy/hipaa/complaints/.
- We will not retaliate against you for filing a complaint.
Your choices: For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions if feasible or required by law.
In these cases, unless allowed by applicable law, we never share your information unless you give us written permission:
- Share information with your family, friends, or other people that you indicate are involved in your health care
- Share information in a disaster relief situation
- Include your information in a hospital directory
- If you are unable to state your preference, for example if you are unconscious or unavailable, we may elect to share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
- Marketing purposes (except face-to-face communication or other permissible activities)
- Sale of your information
Our Uses and Disclosures: How do we typically use or share your health information? We typically use or share your health information to treat you, for our operations and for payment purposes. We have provided you with some specific examples, but not every way we use or share your information is listed below.
- We can use your health information and share it, electronically or otherwise, with other professionals who are treating you. If you are younger than 18, we may release your health information to your parents Example: Our pharmacists or nurses may discuss your care or overall health condition with your doctor or other healthcare professionals. These communications may occur verbally, in writing or electronically by e-mail.
Run our organization
- We can use and share your health information to run our business, improve your care, and contact you when necessary. We can also share for other health care operations purposes permitted by law or regulations.
Bill for your services
- We can use and share your health information to bill and get payment from health plans or other entities.
Example: We use health information to manage your treatment and services.
Example: We give information about you to your health insurance plan so it will pay for your services. We may give information to entities that that help us collect payments
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
We can share health information about you for certain situations such as:
- Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic violence
- Preventing or reducing a serious threat to anyone’s health or safety
- We can use or share your information for health research as permitted by law.
Comply with the law
- We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests
Work with a medical examiner or funeral director
Address workers’ compensation, law enforcement, and other government requests
Respond and participate in lawsuits and legal actions
Other uses and disclosures
- We can share health information about you with organ procurement organizations and tissue banks if authorized by you.
- We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
- We can use or share health information about you:
- For workers’ compensation claims
- For law enforcement purposes or with a law enforcement official or to a correctional institution
- With health oversight agencies for activities authorized by law
- For special government functions such as military, national security, and presidential protective services
- We can share health information about you in response to a court or administrative order, or in response to a subpoena.
- Business Associates – There are some health-related services provided through contracts with third parties, called “business associates,” that may need the information to perform certain services on our behalf. Examples include software or technology vendors IHS may utilize to provide technical support, attorneys providing legal services to IHS, accountants, consultants, billing and collection companies, and others. When such a service is contracted, IHS may share your protected health information with such business associates and may allow our business associates to create, receive, maintain or transmit your information on behalf of IHS in order for the business associate to provide services to us, or for the proper management and administration of the business associate. Business associates must protect any health information they receive from, or create and maintain on our behalf in compliance with applicable rules and regulations. In addition, business associates may re-disclose your health information for their own proper management and administration, to fulfill their legal responsibilities, and to business associates that are subcontractors in order for the subcontractors to provide services to the business associate. The subcontractors will be subject to the same restrictions and conditions that apply to the business associate. Whenever such an arrangement involves the use or disclosure of your information to our business associate, we will have a written contract with our business associate that contains terms designed to protect the privacy of your information.
- De-identified information – We may use or disclose your health information to create de-identified information or limited data sets, and may use and disclose such information as permitted by law.
- Inmates -If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release information about you to the correctional institution or law enforcement official as permitted by applicable laws and rules.
- We are required by law to maintain the privacy and security of your protected health records.
- While we take privacy and security very seriously, sometimes things go wrong. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless otherwise instructed in writing.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the terms of this notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.
Florida State Law
Disclosure. IHS will not disclose your records without your written authorization, except to you and/or your legal representative or the Department of Health pursuant to existing law; in the event that you are incapacitated or unable to request your records, your spouse; and in any civil or criminal proceeding, upon the issuance of a subpoena from a court of competent jurisdiction and proper notice to you or your legal representative, by the party seeking the records.