THIS NOTICE DESCRIBES HOW MEDICAL & CLIENT INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
The terms of this Notice of Privacy Practices (“Notice”) apply to Alternative Office, Inc., its affiliates and its employees. Alternative Office, Inc. will share protected health information of clients & patients as necessary to carry out communications, and health care operations as permitted by law.
We are required by law to maintain the privacy of our clients and their patients’ protected health information and to provide clients with notice of our legal duties and privacy practices with respect to protected health information. We are required to abide by the terms of this Notice for as long as it remains in effect. We reserve the right to change the terms of this Notice as necessary and to make a new notice of privacy practices effective for all protected health information maintained by Alternative Office, Inc. We are required to notify you in the event of a breach of your unsecured protected health information. We are also required to inform you that there may be a provision of state law that relates to the privacy of your health information that may be more stringent than a standard or requirement under the Federal Health Insurance Portability and Accountability Act (“HIPAA”). A copy of any revised Notice of Privacy Practices or information pertaining to a specific State law may be obtained by mailing a request to the Privacy Officer at the address shown at the bottom of this notice.
USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION:
Authorization and Consent: Except as outlined below, we will not use or disclose your protected health information for any purpose other than relaying communications as directed by you or health care operations unless you have signed a form authorizing such use or disclosure. You have the right to revoke such authorization in writing, with such revocation being effective once we actually receive the writing; however, such revocation shall not be effective to the extent that we have taken any action in reliance on the authorization.
Uses and Disclosures for Treatment: We will make uses and disclosures of your protected health information as necessary for your treatment. Doctors and nurses and other professionals involved in your care will use information in your medical record and information that you provide about your symptoms and reactions to your course of treatment that may include procedures, medications, tests, medical history, etc. Only limited information will be relayed over non secure messaging services. If detailed health information is required via text services those text messages must be transmitted via a secure server network per HIPAA. We offer those services at additional fees.
Business Associates: Certain aspects and
components of our services are performed through contracts with outside persons
or organizations, such as auditing, accreditation, outcomes data collection,
legal services, etc. At times it may be necessary for us to provide your
protected health information to one or
more of these outside persons or organizations who assist us with our health
care operations. In all cases, we require these associates to appropriately
safeguard the privacy of your information.
Other Uses and Disclosures: We are permitted and/or required by law to make certain other uses and disclosures of your protected health information without your consent or authorization for the following:
- Any purpose required by law;
- To a government oversight agency conducting audits, investigations, civil or criminal proceedings;
- Court or administrative ordered subpoena or discovery request;
DISCLOSURES REQUIRING AUTHORIZATION:
Marketing: We must obtain your authorization for any use or disclosure of your protected health information for marketing; however, we do not utilize any protected health information in any type of marketing.
RIGHTS THAT YOU HAVE REGARDING YOUR PROTECTED HEALTH INFORMATION:
Access to Your Protected Health Information: You have the right to copy and/or inspect much of the protected health information that we retain on your behalf. For protected health information that we maintain in any electronic designated record set, you may request a copy of such health information in a reasonable electronic format, if readily producible. Requests for access must be made in writing and signed by you or your legal representative. You may obtain a “Patient Access to Health Information Form” by calling the Privacy Officer at (800)821-9168. You will be charged a reasonable copying fee and actual postage and supply costs for your protected health information. If you request additional copies you will be charged a fee for copying and postage.
Amendments to Your Protected Health Information: You have the right to request in writing that protected health information that we maintain about you be amended or corrected. We are not obligated to make requested amendments, but we will give each request careful consideration. All amendment requests, must be in writing, signed by you or legal representative, and must state the reasons for the amendment/correction request. If an amendment or correction request is made, we may notify others who work with us if we believe that such notification is necessary. You may obtain an “Amendment Request Form” by calling the Privacy Officer at (800) 821-9168.
Restrictions on Use and Disclosure of Your Protected Health Information: You
have the right to request restrictions on uses and disclosures of your
protected health information for treatment, payment, or health care operations.
We are not required to agree to most restriction requests but will attempt to
accommodate reasonable requests when appropriate. If we agree to any
discretionary restrictions, we reserve the right to remove such restrictions as
we deem appropriate. We will notify you if we remove a restriction imposed in
accordance with this paragraph. You also have the right to withdraw, in writing
or orally, any restriction by communicating your desire to do so to the
individual responsible for medical records.
Right to Notice of Breach: We take very
seriously the confidentiality of our patients’ information, and we are required
by law to protect the privacy and security of your protected health information
through appropriate safeguards. We will notify you in the event a breach occurs
involving or potentially involving
your unsecured health information and inform you of what steps you may need to
take to protect yourself.
Paper Copy of this Notice: You have a right, even if you have agreed to receive notices electronically, to obtain a paper copy of this Notice. To do so, please submit a request to the Privacy Officer at the address shown at the bottom of this notice.
Complaints: If you believe your privacy rights have been violated, you can file a complaint in writing with the Privacy Officer. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services at the US Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, Washington, D.C. 20201, calling 1-877-696-6775 or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. There will be no retaliation for filing a complaint.
For Further Information: If you have questions, need further assistance regarding or would like to submit a request pursuant to this Notice, you may contact Alternative Office, Inc. Privacy Officer Wade Neal by phone at (800) 821-9168 or at the following address: Alternative Office, Inc., 4682 Cecile Rd, Plano, TX 75024.