Notice of Privacy Practices

How OBHAW Client Medical Information May Be Used and Disclosed and How You Can Get Access to This Information

This Notice of Privacy Practices describes how OBHAW may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” (PHI) is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.

OBHAW is required to abide by the terms of this Notice of Privacy Practices. Any change in terms will be posted and effective for all protected health information maintained at that time. The revised Notice of Privacy Practices will be given to you if you request it by mail or ask for a copy at our office.

SECTION 1. Uses and Disclosures of Protected Health Information

Uses of PHI Based Upon Your Consent

You will be asked by our staff to sign a consent form. Once you have consented to use and disclosure of your protected health information for treatment, payment and health care operations (TPO) by signing the consent form, OBHAW may use or disclose your protected health information as described in this section.

Following are examples of the types of uses and disclosures of your protected health care information for TPO that OBHAW is permitted to make. These examples are not meant to be exhaustive but to describe the types of uses and disclosures that may be made by our office after you have provided consent.

Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care among OBHAW staff members or with a third party who has already obtained your permission to have access to your protected health information. For example, we would disclose your protected health information, as necessary, to staff members who provide care to you. In addition, we may disclose your protected health information from time-to-time to another physician or health care provider (e.g., your primary care physician or a laboratory) who, at the request of OBHAW staff, may become involved in your care by making a referral or providing assistance with your health care diagnosis or treatment at OBHAW.

Payment: Your protected health information will be used, as needed, to obtain payment for your health care services. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we recommend for you. Examples of these activities are making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities. For example, obtaining approval for services provided by OBHAW may require that certain relevant protected health information be disclosed to the health plan to determine medical necessity.

Healthcare Operations: We may use or disclose, as-needed, your protected health information in order to support the business activities of OBHAW. These activities include, but are not limited to, quality assessment activities, employee review activities, training of interns or students, licensing, fundraising, and conducting or arranging for other business activities. For example, we may disclose your protected health information as part of quality assessment for accreditation of the organization.

In addition, we may use a sign-in sheet at the registration desk where you will be asked to sign your name. We may also call you by name in the waiting room when your clinician is ready to see you. We may attempt to contact you to remind you of your appointment.

We will share your protected health information with third party “business associates” that perform various activities (e.g., transcription services or accreditation organizations) for OBHAW. Whenever an arrangement between our office and a business associate involves the use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy of your protected health information.

We may use or disclose your protected health information, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you.

 

Uses of PHI Based upon Your Written Authorization

Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke this authorization, at any time, in writing, except to the extent that OBHAW has taken an action in reliance on the use or disclosure indicated in the authorization.

OBHAW may use and disclose your protected health information in the following instances, and you have the opportunity to agree or object to the use or disclosure of all or part of your protected health information. If you are not present or able to agree or object to the use or disclosure of the protected health information, then OBHAW may, using professional judgment, determine whether the disclosure is in your best interest. In this case, only the protected health information that is relevant to your health care will be disclosed.

Others Involved in Your Healthcare: Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your protected health information that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. Finally, we may use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.

Emergencies: We may use or disclose your protected health information in an emergency treatment situation. If this happens, OBHAW will try to obtain your consent as soon as reasonably practicable after the delivery of treatment. If OBHAW is required by law to treat you and has attempted to obtain your consent but is unable to obtain your consent, OBHAW may still use or disclose your protected health information to treat you.

Communication Barriers: OBHAW may use and disclose your protected health information if a staff member attempts to obtain consent from you but is unable to do so due to substantial communication barriers and determines, using professional judgment, that you intend to consent to use or disclosure under the circumstances.

 

Uses and Disclosures that May Be Made Without Your Consent, Authorization or Opportunity to Object

We may use or disclose your protected health information in the following situations without your consent or authorization. These situations include:

Required By Law: We may use or disclose your protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures.

Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

Health Oversight: We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.

Abuse or Neglect: We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.

Food and Drug Administration: We may disclose your protected health information to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls; to make repairs or replacements, or to conduct post marketing surveillance, as required.

Legal Proceedings: We may disclose protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), in certain conditions in response to a subpoena, discovery request or other lawful process.

Law Enforcement: We may also disclose protected health information, so long as applicable legal requirements are met, for law enforcement purposes. These law enforcement purposes include (1) legal processes and otherwise required by law, (2) limited information requests for identification and location purposes, (3) pertaining to victims of a crime, (4) suspicion that death has occurred as a result of criminal conduct, (5) in the event that a crime occurs on the premises of OBHAW, and (6) medical emergency (not on OBHAW premises) and it is likely that a crime has occurred.

Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information, if we 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 the public. We may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.

Military Activity and National Security: When the appropriate conditions apply, we may use or disclose protected health information of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if you are a member of that foreign military services. We may also disclose your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.

Workers’ Compensation: Your protected health information may be disclosed by us as authorized to comply with workers’ compensation laws and other similar legally-established programs.

Inmates: We may use or disclose your protected health information if you are an inmate of a correctional facility and OBHAW created or received your protected health information in the course of providing care to you.

Required Uses and Disclosures: Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500 et. seq.

 

SECTION 2. Your Rights

Following is a statement of your rights with respect to your protected health information and a brief description of how you may exercise these rights.

You have the right to inspect and copy your protected health information. This means you may inspect and obtain a copy of protected health information about you in a designated record set for as long as we maintain the protected health information. A “designated record set” contains medical and billing records and any other records that OBHAW uses for making decisions about you.

Under federal law, however, you may not inspect or copy the information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and protected health information that is subject to law that prohibits access to protected health information. Depending on the circumstances, a decision to deny access may be reviewable. Please contact our Information Coordinator if you have questions about access to your medical record.

You have the right to request a restriction of your protected health information. This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must be in writing to your therapist with a copy to the medical record coordinator and state the specific restriction requested and to whom you want the restriction to apply.

OBHAW is not required to agree to a restriction that you may request. If OBHAW believes it is in your best interest to permit use and disclosure of your protected health information, your protected health information will not be restricted. If OBHAW does agree to the requested restriction, we may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment. With this in mind, please discuss any restriction you wish to request with your therapist. You may request a restriction by completing a “Request for Restriction of Release of Protected Health Information.” Your therapist will determine if information should be restricted and sign the request which will be maintained with your record.

You have the right to request to receive confidential communications from us by alternative means or at an alternative location. We will accommodate reasonable requests. We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. We will not request an explanation from you as to the basis for the request. Please make this request in writing to our Information Coordinator.

You may have the right to request your physician or therapist amend your protected health information. This means you may request an amendment of protected health information about you in a designated record set for as long as we maintain this information. In certain cases, we may deny your request for an amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. Please contact our Information Coordinator to determine if you have questions about amending your medical record.

You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. This right applies to disclosures for purposes other than treatment, payment or healthcare operations as described in this Notice of Privacy Practices. It excludes disclosures we may have made to you, to family members or friends involved in your care, or for notification purposes. You have the right to receive specific information regarding these disclosures that occurred after April 14, 2003. You may request a shorter time frame. The right to receive this information is subject to certain exceptions, restrictions and limitations.  You have the right to notice in the event of a breach of your confidentiality. You have the right to opt out of fundraising communications.

You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice electronically.

 

SECTION 3. Complaints

You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our Grievance Officer. For more information about our Grievance Process click here. You may also contact our Privacy Officer at (501-624-7111 or e-mail grievance@OBHAW.org for further information about the complaint process. We will not retaliate against you for filing a complaint.