THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.
This Notice of Privacy Practices is provided to you as a requirement of the Health Insurance Portability and Accountability Act (HIPAA). Prevnos, Inc. (“Prevnos”) is committed to protecting the confidentiality of your medical and health information (“Protected Health Information” or PHI), as described in this Notice. Prevnos is required by law to maintain the privacy of your PHI, and to provide you notice of our legal duties and privacy practices with respect to PHI, and to notify you following a breach of unsecured PHI. This Notice fulfills these obligations by describing our privacy practices relating to PHI, including how we may use your PHI within Prevnos and how under certain circumstances we may disclose it to others outside Prevnos. This Notice also describes the rights you have over your own PHI. Prevnos is required to abide by its terms, unless superseded by a revised Notice, as described below.
If you have questions about any part of this Privacy Notice, please contact the Prevnos Privacy Officer using the information listed at the end of this Notice.
Uses and Disclosures of Your PHI
For Treatment: We may use and disclose your PHI to provide, coordinate or manage your health care and any related services. For example, if you request that we do so and your physician agrees, or if your physician ordered a lab test in connection with your care, we may provide your physician with access to your laboratory test results to assist in your treatment and for follow-up care.
For Payment: We may use and disclose your PHI, as needed, to obtain payment for the health care services and supplies we provide to you. For example, we may share certain information with your health plan or health insurance company regarding the care or services we provided before they will pay us for such care or services.
For Health Care Operations: We may use and disclose your PHI to support our business activities related to your healthcare, which include internal education, administration, planning, and other various activities that improve the quality of care we provide to guests. For example, we may use PHI to analyze the quality of different lab services we provide.
For Treatment Alternatives and Health-Related Benefits and Services: We may use and disclose your PHI, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that might interest you subject to limits imposed by law. For example, your name and address may be used to send you a newsletter about a new service we offer.
We may also use or disclose your PHI for the following purposes in certain circumstances:
Required by Law: We may use or disclose your PHI if required to do so by applicable laws or regulations.
To Business Associates: We may share your PHI with third-party "business associates" who perform various activities (for example, billing, data analysis, accounting, or legal) for us if the information is necessary for such functions or services. The business associates will also be required to protect your PHI.
To Family Members and Others Involved in Your Health Care: Unless you object or unless prohibited by applicable federal or state law, we may disclose your PHI to a member of your family, a relative, a close personal friend, or any other person you identify who is involved in your medical care. We may also give your PHI to someone who helps pay for your care. Additionally, we may use or disclose PHI including to an authorized public or private entity assisting in disaster relief efforts to notify or assist in notifying a family member, personal representative, or any other person who is responsible for your care, of your location, general condition, or death. If you do not want us to disclose your PHI to family members or others involved in your care, please contact the Prevnos Privacy Officer using the information listed at the end of this Notice.
For Public Health or Safety: We may use or disclose your PHI for public health activities as permitted by law. The disclosure may be necessary to prevent or control disease, injury or disability or notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition. For example, a positive communicable disease test result may be reported to the State Health Department. In addition, we may disclose your PHI in connection with a product or activity regulated by the Food and Drug Administration for purposes of ensuring the quality, safety or effectiveness of such product or activity, including to (1) report adverse events, such as reactions to medications or product defects; (2) track products; (3) enable product recalls; (4) make repairs or replacement; and (5) conduct post-marketing surveillance as required.
In Cases of Abuse, Neglect or Domestic Violence: In certain circumstances where required or authorized by law, we may disclose PHI to notify an authorized government authority if we believe a guest has been the victim of abuse, neglect or domestic abuse.
Health Oversight Agencies: We may disclose Protected Health Information to a government agency that oversees the healthcare system and government benefit programs, such as the federal agency that oversees Medicaid and Medicare (CMS), and the Food and Drug Administration (FDA) for activities authorized by law, such as audits, investigations, licensure, and inspections.
For Legal Proceedings: We may disclose PHI for a judicial or administrative proceeding, in response to an order by a court or administrative tribunal, and in certain circumstances in response to a subpoena, discovery request, or other lawful process.
To Law Enforcement: We may disclose PHI for law enforcement purposes, including (1) responses to legal proceedings; (2) information requests for identification and location of a person; (3) circumstances pertaining to victims of a crime; (4) deaths suspected from criminal conduct; (5) crimes occurring at our site; and (6) medical emergencies (not on our premises) believed to result from criminal conduct.
To Avert a Serious Threat: We may use or disclose PHI if we believe, in good faith, 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 and is to a person reasonably able to prevent or lessen the threat or is necessary for law enforcement authorities to identify or apprehend an individual.
To Coroners, Funeral Directors and Organ Donations: We may disclose PHI to coroners or medical examiners for identification purposes, to determine the cause of death or for the performance of other duties authorized by law. We may also disclose PHI to funeral directors as authorized by law. PHI may be used and disclosed for purposes of facilitating cadaveric organ, eye, or tissue donations or transplantation.
For Research: We may use or disclose your PHI without your consent or authorization for research projects when authorized by law, such as if an Institutional Review Board approves a waiver of authorization for disclosure. Such research projects must go through a special process that protects the confidentiality of your PHI.
For Military Activity and National Security: When the appropriate conditions apply, we may use or disclose PHI of individuals who are Armed Forces personnel including (1) for activities believed necessary by appropriate military command authorities to ensure the proper execution of the military mission including determination of fitness for duty; (2) for determination by the Department of Veteran Affairs (VA) of eligibility for benefits; or (3) to a foreign military authority if you are a member of that foreign military service. We may also disclose your PHI to authorized Federal officials for conducting national security, and intelligence and counter-intelligence activities including protective services to the President or others or for the conduct of certain investigations.
For Workers' Compensation: We may disclose your PHI to comply with workers' compensation laws and other similar legally established programs.
For Inmates: We may use or disclose your PHI if you are an inmate of a correctional facility if necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional facility.
For Data Breaches: We may use your contact information to provide you with notice of an unauthorized access, use, disclosure, or acquisition of your PHI.
Uses and Disclosures With Your Authorization
Prevnos cannot use your Protected Health Information for purposes other than the reasons mentioned above, without your signed “Authorization”. For example, Prevnos will not use or disclose your PHI for certain marketing activities without your Authorization. An Authorization is a written document signed by you giving us permission to use or disclose your Protected Health Information for the purposes set forth in the Authorization. You may revoke the Authorization, at any time, by delivering a written statement to the Prevnos Privacy Officer identified below. If you revoke your Authorization, Prevnos will no longer use or disclose your Protected Health Information as permitted by your Authorization. However, your revocation of Authorization will not reverse the use or disclosure of your Protected Health Information made while your Authorization was in effect.
Your Rights Regarding Your Health Information
You may exercise the following rights by submitting a written request to the Prevnos Privacy Officer using the contact information below. Please be aware that in certain circumstances, when permitted by law, we may deny your request; however, you may be able in certain instances to seek a review of any such denial.
Right to Inspect and Copy: You may inspect and obtain a copy of your PHI that is contained in a "designated record set" for as long as we maintain the PHI. A designated record set contains medical and billing records and any other records that we use for making decisions about you. However, other federal or state laws may affect how we may provide you with the results of certain lab tests.
To request a copy of your PHI, write to the Prevnos Privacy Officer as set forth below. We may charge a fee for the costs of copying, mailing or other supplies associated with your request, but we will let you know about the fee in advance.
Right to Request Restrictions: You have the right to request that we restrict our uses and disclosures of PHI for treatment, payment or health care operations. You also have the right to request that we restrict disclosures to family members or others who are involved in your health care or payment for your health care. We will consider your requests carefully, but we are not required to agree to your requested restriction. If you want to request a restriction, submit your request in writing to the Prevnos Privacy Officer and describe your request in detail.
Right to Request Confidential Communications: You may request that we communicate with you using alternative means or at an alternative location. We will not ask you the reason for your request. For example, you can ask us not to call your home, but to communicate with you only by mail. We will accommodate reasonable requests, when possible. To make such a request, write to the Prevnos Privacy Officer.
Right to Restrict Certain Disclosures to Health Plans: You may request that in certain circumstances we not send PHI to health plans if the PHI concerns a health care item or service you have paid for out-of-pocket in full.
Right to Request Amendment: If you believe that the PHI we have about you is incorrect or incomplete, you may request an amendment to your PHI as long as we maintain this information. We will comply with your request unless we are not the originator of the information or we believe that the information you request to be amended is accurate and complete or special circumstances apply. To ask us to amend your PHI, write to the Prevnos Privacy Officer.
Right to Request an Accounting of Disclosures: You have a right to an accounting of certain disclosures of your PHI made by us during the six years prior to your request. This accounting will not include disclosures of information made: (i) for treatment, payment, and health care operations purposes; (ii) to you or your personal representative; (iii) pursuant to your authorization; (iv) to correctional institutions or law enforcement officials; and (v) certain other disclosures for which federal law does not require us to provide an accounting. If you would like to receive such a list, write to the Prevnos Privacy Officer. Your request must state a time period desired for the accounting, which must be within six years prior to the date of your request. We will provide the first list to you free of charge, but we may charge you for any additional lists you request during the same twelve (12) month period. We will tell you in advance what this list will cost, at which time you may withdraw or modify your request.
Right to Obtain a Copy of this Notice: You may obtain a paper copy of this Notice from us upon request at any time by writing to the Prevnos Privacy Officer.
Other Applicable Laws
This Notice of Privacy Practices is provided to you as a requirement of HIPAA. There are other federal and state privacy laws that may apply and further limit our ability to use and disclose your PHI. For example, information about HIV/AIDS and genetic testing may have added protections. When state law is more protective of your privacy than federal law, we are required to follow the more protective state law. For information about your specific state’s laws, please contact the Prevnos Privacy Officer.
Changes to This Notice
From time to time, we may change our practices concerning how we use or disclose PHI, or how we will implement guest rights concerning such information. Prevnos reserves the right to amend this Notice of Privacy Practices, at any time, to reflect changes in our privacy practices, and these changes will apply retroactively, unless otherwise stated. Any such changes will be applicable to and effective for all PHI that we maintain, including PHI we created or received prior to the effective date of the Notice revision. You can get a copy of our current Notice at any time by calling or writing to the Prevnos Privacy Officer.
Questions, Concerns, or Complaints
If you have any questions about this Notice, or have further questions about how Prevnos may use and disclose your PHI, please contact the Privacy Officer as set forth below. In addition, if you believe your privacy rights have been violated, you can file a complaint with Prevnos or the Secretary of the Department of Health and Human Services (“HHS”). To file a complaint with Prevnos, please contact the Privacy Officer at email@example.com
We will not retaliate against you in any way for filing a complaint.
Effective Date: September 13, 2015