Privacy Notice
"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."
Disclosure Parties
Disclosure Circumstances without a Notice
Disclosure Circumstances with a Notice
Your Rights
Complaints
Contact Person
Effective Date
Americare Home Health Services is required by law to maintain the privacy of protected health information and to provide you with notice of its legal duties and privacy practices. Americare Home Health Services must abide by the terms of the notice currently in effect, but Americare Home Health Services reserves the right to change the terms. If there is a change, Americare Home Health Services will provide you with a written revised notice as soon as practicable by mail or hand delivery.
Americare Home Health Services may use or disclose your health information to other parties for purposes of treatment, payment, and health care operations. These uses and disclosure require your consent, and include, but are not limited to, a release of information contained in financial records and/or medical records, including information concerning communicable diseases/drugs/alcohol abuse, psychiatric diagnosis and treatment records and/or laboratory test results, medical history, treatment progress and/or any other related information, to:
-
Your insurance company, self-funded or third-party health plan, Medicare, Medicaid, or any other person or entity that may be responsible for paying or processing for payment any portion of your bill for services;
-
Any person or entity affiliated with or representing for purposes of administration, billing, and quality and risk management;
-
Any hospital, nursing home, or other health care facility to which you may be admitted;
-
Any assisted living or personal care facility of which you are a resident;
-
Any physician providing you care;
-
Family members and other caregivers who are part of your home care plan service;
-
Licensing and accrediting bodies, including the information contained in the OASIS Data Set to the state agency acting as a representative of the Medicare/Medicaid program;
-
Contact you to provide appointment reminders or information about other health related services we provide.
Disclosure Circumstances without a Notice
Americare Home Health Services is permitted to use or disclose information about you without written authorization in the following circumstances:
-
In emergency treatment situations. If Americare Home Health Services attempts to obtain consent as soon as practicable after treatment.
-
Where substantial barriers to communicating with you exist and Americare Home Health Services determines that the consent is clearly inferred from the circumstances;
-
Where Americare Home Health Services is required by law to provide treatment and we are unable to obtain consent;
-
Where the use or disclosure is required by law to assist in disaster relief efforts;
-
For certain public health activities and purposes such as:
-
preventing, controlling disease, injury or disability
-
reports of child abuse or neglect
-
a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition,
-
An employer about an individual who is a member of the workforce of the employer, in certain circumstances;
-
-
Where Americare Home Health Services reasonably believes you are a victim of abuse, neglect, or domestic violence to a government authority authorized to receive reports of abuse, neglect or domestic violence;
-
Health care oversight activities;
-
Certain judicial administrative proceedings;
-
Certain law enforcement purposes;
-
To coroners, medical examiners and funeral directors, in certain circumstances;
-
For cadaveric organ, eye or tissue donation purposes;
-
For certain research purposes;
-
To avert a serious threat to health and safety;
-
For specialized government functions;
-
For Worker?s Compensation purposes.
Disclosure Circumstances with a Notice
Americare Home Health Services is permitted to use or disclose information about you without consent or authorization provided that you are informed in advance and given the opportunity to agree to or prohibit or restrict the disclosure in the following circumstances:
-
The use of a directory of individuals served by Americare Home Health Services;
-
To a family member, relative, friend, or other identified person, the information relevant to such person?s involvement in your care or payment for care.
Other uses and disclosures will be made only with your written authorization. That authorization may be revoked, in writing, at any time., except in limited situations.
You have the right, subject to certain conditions, to:
-
Request restrictions on certain uses and disclosures of information about you. However, Americare Home Health Services is not required to agree to the requested restriction;
-
Receive confidential communication of protected health information;
-
Inspect and copy protected health information;
-
Amend protected health information;
-
Receive an accounting of disclosures;
-
Obtain a paper copy of this notice, if you had agreed to receive this notice electronically.
You may complain to Americare Home Health Services and the Secretary of the U.S. Department of Health and Human Services if you believe that your privacy rights have been violated. There will be no retaliation against you for filing a complaint. The complaint should be filed verbally or in writing with Americare Home Health Services and should state the specific incident(s) in terms of the subject, date, and other relevant matters. A complaint to the Secretary must comply with the standards set out in 45 CFR ?160.306.
Americare Home Health Services has designated the Administrator as its contact person for all issues regarding patient privacy and your rights under the Federal privacy standards. You may contact this person at (317) 736-6005
This notice is effective April 14, 2003
