OPTIMAL IN HOME CARE INC.
PATIENT NOTICE OF HOME CARE PRIVACY RULES
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review carefully.
Uses and Disclosures of Health Information:
The Agency may use your health information, information that constitutes Protected Health Information (PHI) as defined in the Privacy Rule of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 for purposes of providing you treatment, obtaining payment for your care and conducting health care operations. For any other reason the Agency must obtain your consent. The Agency has established policies to guard against unnecessary uses and disclosure of your health information.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED:
- To Provide Treatment: The Agency may use your health information to coordinate care within the Agency and with others involved in your care, such as your attending physician and other health care professionals who have agreed to assist the Agency in coordinating care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications. The Agency also may use or disclose your health information to individuals outside of the Agency involved in your care including family members, pharmacists, suppliers or medical equipment or other care professionals.
- To Obtain Payment: The Agency may include your health information in invoices to collect payment from third parties for the care you receive from the Agency. For example, the Agency may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or the Agency. The Agency also may need to obtain prior approval from your insurer and may need to explain to the insurer your need for home care and the services that will be provided to you.
- To Conduct Health Care Operations: The Agency may use and disclose health information for its own operations in order to facilitate the function of the Agency and as necessary to provide quality care to all of the Agency's patients. Health care operations includes such activities as:
- Quality assessment and improvement activities
- Training programs including those in which students, trainers or practitioners in health care learn under supervision
- Training of non-health care professionals
- Accreditation, certification, licensing or credentialing activities
- Business management and general administrative activities of the Agency
The Agency may use your health information to evaluate its staff performance, combine your health information with other Agency patients in evaluating how to more effectively serve all Agency patients, disclose your health information to Agency staff and contracted personnel for training purposes, use your health information to contact you as a reminder regarding a visit to you (unless you tell us you do not want to be contacted).
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED WITHOUT FIRST RECEIVING YOUR WRITTEN CONSENT:
- When Legally Required
- Public health activities
- Reporting abuse, neglect, exploitation, or domestic violence
- Health oversight activities
- Judicial and administrative proceedings
- Law enforcement purposes
- Coroners and medical examiners
- Serious threat to health or safety
- Specified government functions
- Worker's compensation
Authorization to Use or Disclose Health Information:
You have the following rights regarding your health information that the Agency maintains:
- Right to Request Restrictions: You may request restrictions on certain uses and disclosures of your health information.
- Right to Receive Confidential Communications: You may request communication in a certain way.
- Right to Inspect and Copy: You may inspect and copy your health records.
- Right to Amend: You may request corrections to your records.
- Right to a Paper Copy: You may request a copy of this notice at any time.
State Restrictions:
State law also imposes restrictions on how we use your PHI. The following Texas laws govern the Agency's use of PHI:
- Texas Insurance Code Article 28A.01 - 28A.04
- Texas Insurance Code Article 288.01 - 28B.12
- Title 28 Texas Administrative Code, Chapter 22, Sections 22.51 - 22.67
Complaints:
Complaints may be filed with the Office for Civil Rights (OCR):
US Department of Health and Human Services, Region VI, OCR
1301 Young St., Suite 1169
Dallas, Texas 75202
Phone: (800) 368-1019
Fax: (214) 767-0432
Email:
Contact Information:
2636 S Loop W. Suite 305
Houston, TX 77054
Phone: (713) 669-0299
Fax: (713) 669-0244
Effective April 14, 2003