THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY
The agency is required by law to maintain the privacy of your protected health
information (PHI). The agency must abide by the terms of this notice and any update to this notice.
Uses and Disclosures: We will use and disclose elements of your protected health information in the following ways:
1. For the provision of health care treatment:
Examples include:
a. Written and oral communications with your physician for the
oversight and supervision of the care provided by the agency.
Including review, approval and changes to your plan of care,
summary reports of care provided and your response to care
provided.
b. Written and oral communications with facilities which provided
you with in-patient and or outpatient care.
c. Written and oral communications with other home health or
personal assistance agencies which are currently providing care
to you.
d. Written and oral communication with laboratory or x-ray
facilities required to provide or have provided care for the
purpose of providing monitoring and diagnosis of your
condition.
e. Written and oral communication with contacted health care
providers involved in the care provided to you by the agency.
f. In emergency situations or to avert serious health/safety
issues.
2. Payment:
Examples include:
a. Written and oral communications with Medicare, Medicaid or
your private insurance carrier.
b. Electronically submitted health claims.
3. Health Care Operations:
Examples include:
a. Referral to Durable Medical Equipment Companies and
Pharmacies for the purpose of obtaining medical equipment,
supplies or medications necessary to provide treatment.
b. Conducting quality assessment and improvement activities,
including outcomes evaluation and development of clinical
guidelines.
c. Conducting training programs in which students, trainees, or
practitioners in areas of health care learn under supervision
to practice or improve their skills as health care providers.
4. When release is required by law, including in judicial settings and to
health oversight regulatory agencies and law enforcement.
5. To medical examiners, coroners or funeral directors to aid in identifying
you or to help in performing their duties.
6. All other uses and disclosure by us will require us to obtain from you a
written authorization.
You Have the Following Rights Concerning Your PHI:
Restrictions: To request restricted access to all or part of your PHI. To do this you must inform the agency verbally and sign an authorization that identifies what PHI you are requesting restricted access is requested. The agency staff member will provide you will a form for this request. We are not required to grant your request.
Confidential Communications: To receive correspondence for confidential
information by alternate means or location. To do this, you must inform the agency verbally and in writing of the alternate means or location, you wish to use to receive correspondence of confidential information. The agency staff member will provide you will a form for this request.
Access: To inspect or receive copies of your protected information. To do this, you must inform the agency verbally and in writing of the information, you are requesting access to. The agency staff member will provide you will a form for this request.
Amendments: To request changes be made to your PHI. To do this, you must inform the agency verbally and in writing of the information, you are requesting be changed. The agency staff member will provide you will a form for this request. We are not required to grant your
request.
Accounting: To receive an accounting of the disclosure by us of your PHI in the six years prior to your request. To do this, you must inform the agency verbally and in writing of the accounting of information, you are requesting. The agency staff member will provide you will a form for this request.
This Notice: To get updates or reissue of this notice, at your request. The agency staff will provide you with reissue of this notice at your verbal request. If you are an active patient at the time a change is made to the agency’s privacy practices, you will be provided written notification of the changes at least 5 days prior to the implementation of the change. If you are no longer a patient of the agency you may request any writing the agency provide you with the changes to the privacy practices at any time.
Complaints: To complain to the U.S. Department of Health and Human Services or us if you feel your privacy rights have been violated. To register a complaint with the agency, you may call the agency administrator at
1-877-711-0900 or submit a complaint in writing to:
119 E. Canton Rd., Edinburg, TX. 78539.
Privacy Contact: For more information about our privacy practices, please contact:
The Agency Administrator
119 E. Canton Rd., Edinburg, TX. 78539.
Telephone # 1-877-711-0900
This notice is effective 04/14/2003.
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