HIPAA NOTICE OF PRIVACY RIGHTS
Telemedicine HIPAA Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This Telemedicine HIPAA Notice of Privacy Practices (the “Notice”) is being provided to You by the Site and the Doctor (as each is defined in the Terms and Conditions) (collectively referred to herein as “We” or “Our”). It contains important information regarding Your (as defined in the Terms and Conditions) medical information. You (as defined in the Terms and Conditions) also have the right to receive a paper copy of this Notice and may ask us to give You a copy of this Notice at any time. If You received this Notice electronically, You are still entitled to a paper copy of this Notice upon Your request. You can request a paper copy of our current Notice from the Privacy Officer at firstname.lastname@example.org, or you can access it on our Site. The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) imposes numerous requirements on health care practices such as ours, defined as Covered Entities, regarding how certain individually identifiable health information – known as protected health information (“PHI”) may be used and disclosed. We understand that medical information about Your health is personal. We are committed to protecting medical information about You and will use it to the minimum necessary to accomplish the intended purpose of the use, disclosure or request of it. As required by law, this notice provides You with information about Your rights and our legal duties and privacy practices with respect to the privacy of PHI. This notice also discusses the uses and disclosures we will make of Your PHI. We must comply with the provisions of this notice as currently in effect, although we reserve the right to change the terms of this notice from time to time and to make the revised notice effective for all PHI we maintain.
PERMITTED USES AND DISCLOSURES:We can use or disclose PHI for purposes of treatment, payment, and health care operations. For each of these categories of uses and disclosures, we have provided a description and examples below. However, not every particular use or disclosure in every category will necessarily be listed.
- “Treatment” means the provision, coordination, or management of health care, including consultations between health care providers relating care and referrals for health care from one health care provider to another.
- “Payment” means the activities we undertake to obtain reimbursement for the health care provided to You, including billing, claims management, determinations of eligibility and coverage, collections, case management, and other utilization review activities. For example, we may need to provide PHI to Your insurance carrier or a party financially responsible for care in order to determine whether the proposed course of treatment will be covered, to determine appropriate reimbursement, or to obtain payment.
- “Health Care Operations” means the support functions for our practice, related to referral, facilitating the telemedicine connection and visit, care coordination, compliance reviews, compliance programs, treatment and payment, quality assurance activities, receiving and responding to patient comments and complaints, training, audits, business planning, development, management, legal, and administrative activities. For example, we may combine PHI about many patients to make clinical qualitative review decisions or decide what additional services we should offer, what services are not needed, and whether certain treatments are effective. We may also disclose PHI for review and educational purposes. In addition, we may remove, or de-identify, information that identifies patients so that others can use the de-identified information to study health care, conduct research, collect population health data, and determine methods for improved health care delivery without learning identification.
OTHER USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION:We may also use your PHI in the following ways:
- To provide appointment reminders.
- To tell You about or recommend possible treatment alternatives or other health-related benefits and services that may be of interest to You.
- To Your family, personal representative, power of attorney, guardian, or any other individual identified by You to the extent directly related to such person’s involvement in Your care or the payment for care. We may use or disclose PHI to notify, or assist in the notification of, a family member, a personal representative, or another person responsible for Your care or general condition. If you are available, we will give You an opportunity to object to these disclosures, and we will not make these disclosures if You object. If You are not available, incapacitated or unable to make informed consent decisions about Your health care we will determine whether a disclosure to Your family or personal representative is permitted or required by law, in Your best interests, taking into account the circumstances, and act based upon our professional judgment.
- When permitted by law, we may coordinate our uses and disclosures of PHI with public or private entities authorized by law or by charter to assist in disaster relief efforts.
- We will allow Your family and friends to act on Your behalf to pick-up filled prescriptions and similar forms of PHI, when we determine, in our professional judgment, that it is in Your best interest to make such disclosures.
- We may use or disclose PHI for research purposes, subject to the requirements of applicable law. For example, a research project may involve comparisons of the health and recovery of all patients who received a particular medication. All research projects are subject to a special approval process which balances research needs with a patient’s need for privacy. When required, we will obtain a written authorization from you prior to using Your PHI for research.
- In certain cases, we will provide information to contractors, agents and other parties who need the information in order to perform a service for us (“Business Associates”), including, without limitation, obtaining payment for health care services, technology services providers, or carrying out other business operations. In those situations, PHI will be provided to those contractors, agents and other parties as is needed to perform their contracted tasks. Business Associates are required to enter into an agreement maintaining the privacy of the protected health information released to them under certain terms and conditions required of them by state and federal law.
- We may share information with an insurance company, law firm or risk management organization in order to maintain professional advice about how to manage risk and legal liability, including insurance or legal claims. However, in these situations, we require third parties to provide us with assurances that they will safeguard PHI under terms and conditions required by applicable state and federal law.
- We will use or disclose PHI about when required to do so by applicable law, only to the extent necessary to meet such a requirement.
- Incidental uses and disclosures of PHI sometimes occur and are not considered to be a violation of rights. Incidental uses and disclosures are by-products of otherwise permitted uses or disclosures which are limited in nature and cannot be reasonably prevented.
SPECIAL SITUATIONS:Subject to the requirements of applicable law, we will make the following uses and disclosures of PHI:
- Emergencies: In life threatening emergencies, we will disclose information necessary to avoid serious harm or death.
- Public Health Activities. We may disclose PHI for public health activities, including disclosures: to prevent or control disease, injury or disability; to report births and deaths; to report child abuse or neglect; to persons subject to the jurisdiction of the Food and Drug Administration (FDA) for activities related to the quality, safety, or effectiveness of FDA-regulated products or services and to report reactions to medications or problems with products; to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; to notify the appropriate government authority if we believe that an adult patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if the patient agrees or when required or authorized by law.
- Health Oversight Activities: We may disclose PHI to federal or state agencies that oversee our activities (e.g., providing health care, seeking payment, integrity agreements, audits, and civil rights).
- Lawsuits and Disputes: If You are involved in a lawsuit or a dispute, or a guardianship proceeding, we may disclose PHI subject to certain limitations and only to the extent permissible by law.
- Law Enforcement: We may release PHI if asked to do so by a law enforcement official:
- In response to a court order, warrant, summons or similar process
- To identify or locate a suspect, fugitive, material witness, or missing person; About the victim of a crime under certain limited circumstances
- About a death we believe may be the result of criminal conduct
- About criminal conduct on our premises
- In emergency circumstances, to report a crime, the location of the crime or the victims, or the identity, description or location of the person who committed the crime.
- Coroners, Medical Examiners and Funeral Directors: We may release PHI to a coroner or medical examiner. We may also release PHI about patients to funeral directors as necessary to carry out their duties.
- Serious Threats. As permitted by applicable law and standards of ethical conduct, we may use and disclose PHI if we, in good faith, believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or another person or is necessary for law enforcement authorities to identify or apprehend an individual. CONFIDENTIALITY OF MENTAL HEALTH, HIV, ALCOHOL, AND DRUG ABUSE PATIENT RECORDS PHI related to mental health, psychotherapy notes, HIV, genetic information, alcohol and/or substance abuse records, and other specially protected health information may enjoy certain heightened confidentiality protections under HIPAA and applicable state and federal law. Any disclosure of these types of records will be subject to these special provisions. Disclosure may be made concerning any threat made by a patient to commit imminent physical violence to one-self or against another person to the potential victim who has been threatened and to law enforcement. Federal law and regulations do not protect any information about suspected child or elder abuse or neglect from being reported under applicable state law to appropriate state or local authorities.
OTHER USES OF YOUR HEALTH INFORMATION:Certain uses and disclosures of PHI will be made only with Your written authorization, including uses and/or disclosures:
- for marketing purposes; and
- that constitute a sale of PHI under the Privacy Rule. Other uses and disclosures of PHI not covered by this notice or the laws that apply to us will be made only with your written authorization. You have the right to revoke that authorization at any time, provided that the revocation is in writing, except to the extent that we already have taken action in reliance on Your authorization.
YOUR RIGHTS:You have the right to request restrictions on our uses and disclosures of PHI for treatment, payment and health care operations. However, we are not required to agree to Your request unless the disclosure is to a health plan in order to receive payment, the PHI pertains solely to your health care items or services for which You have paid the bill in full, and the disclosure is not otherwise required by law. To request a restriction, You may make your request in writing to the Privacy Officer. You have the right to reasonably request to receive confidential communications of PHI by alternative means or at alternative locations, including electronically. To make such a request, You may submit your request in writing to the Privacy Officer. You have the right to inspect and copy the PHI contained in our provider records, except for:
- information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding
- PHI involving laboratory tests when your access is restricted by law;
- if we obtained or created PHI as part of a research study, your access to the PHI may be restricted for as long as the research is in progress, provided that you agreed to the temporary denial of access when consenting to participate in the research;
- PHI contained in records kept by a federal agency or contractor when your access is restricted by law; and
- PHI obtained from someone other than us under a promise of confidentiality when the access requested would be reasonably likely to reveal the source of the information. In order to inspect or obtain a copy of PHI, you may submit your request in writing to the Privacy Officer or Medical Records Custodian. If you request a copy, we may charge You a fee for the costs of copying and mailing your records, as well as other costs associated with your request. We may also deny a request for access to PHI under certain circumstances if there is a potential for harm to yourself or others. If we deny a request for access for this purpose, you have the right to have our denial reviewed in accordance with the requirements of applicable law. You have the right to request an amendment to your PHI but we may deny your request for amendment, if we determine that the PHI or record that is the subject of the request:
- was not created by us, unless you provide a reasonable basis to believe that the originator of PHI is no longer available to act on the requested amendment;
- is not part of your medical or billing records or other records used to make decisions about You;
- is not available for inspection as set forth above; or
- is accurate and complete.
You have the right to receive an accounting of disclosures of PHI made by us to individuals or entities other than to you for the six years prior to your request, except for disclosures:
- to carry out treatment, payment and health care operations as provided above;
- incidental to a use or disclosure otherwise permitted or required by applicable law;
- pursuant to Your written authorization;
- to persons involved in care or for other notification purposes as provided by law;
- for national security or intelligence purposes as provided by law;
- to correctional institutions or law enforcement officials as provided by law;
- as part of a limited data set as provided by law.
NOTICE REGARDING USE OF TECHNOLOGY:We may use electronic software, services, and equipment, including without limitation email, video conferencing technology, cloud storage and servers, internet communication, cellular network, voicemail, facsimile, electronic health record, and related technology (“Technology”) to share PHI with You or third-parties subject to the rights and restrictions contained herein. In any event, certain unencrypted storage, forwarding, communications and transfers may not be confidential. We will take measures to safeguard the data transmitted, as well as ensure its integrity against intentional or unintentional breach or corruption. However, in very rare circumstances security protocols could fail, causing a breach of privacy or PHI.
CHANGES TO THIS NOTICE:We reserve the right to change this Notice at any time, for any reason permissible by law. We reserve the right to make the revised or changed Notice effective for PHI and medical information we already have as well as any information we receive in the future. We will post a copy of the current Notice at the Site and provide copies to the facilities we provide care at. The Notice will contain on the first page, in the top right-hand corner, the effective date.
COMPLAINTSIf You believe that your privacy rights have been violated, You should immediately contact the Privacy Officer at email@example.com. We will not take action against You for filing a complaint. You also may file a complaint with the Secretary of the U.S. Department of Health and Human Services.
CONTACT PERSONIf you have any questions or would like further information about this Notice, please contact the Privacy Officer. This notice is effective as of February 2023.
What personal data (excluding PHI) we collect and why we collect it:
For users that register on our website, we also store the personal information they provide in their user profile (PHI). All users can see, edit, or delete their personal information at any time (except they cannot change their username). Website administrators can also see and edit that information.
What rights You have over Your website data (This includes website data only, for HIPAA privacy notice please read above).
If you have an account on this site, You can request to receive an exported file of the personal data we hold, including any data you have provided to us. You can also request that we erase any personal data we hold. This does not include any data we are obliged to keep for administrative, legal, or security purposes.