Privacy Practices
Privacy Practices
This notice of Privacy Practices (this “Notice”) describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Notice of Privacy Practices
the term “health information”, as used in this notice, refers to any individually identifiable information which is created, received, maintained, or transmitted by Rise Wellness, and which concerns your health care and treatment, and payment for such care and treatment. Special federal and state privacy protections, not specifically outlined within this notice, may apply to HIV related health information, substance abuse disorder information, mental health information, reproductive health, and genetic or genetic testing information. Some parts of this notice may not apply to these types of information. If you have questions about these special protections, please contact Rise Wellness at the listed contact numbers.
Rise Wellness is required by law to maintain the privacy of your health information; To provide you this detailed notice of our legal duties and privacy practices relating to your health information; To notify affected individuals following a breach of unsecured health information; And to abide by the terms of the notice that are currently in effect. With respect to medical staffs of Rise Wellness. This notice applies to uses and disclosures of your health information by the medical staff in relation to services you receive while a patient of Rise Wellness. Your health information will be shared among only entities covered by this notice on an ongoing basis for treatment, payment and healthcare operations and other purposes associated with the joint management of your medical record.
Your Rights Regarding Your Health Information
Listed below are your rights regarding your health information. You have the right to:
Right to Inspect and/or Obtain Record Copies: you have the right to inspect and obtain either electronic or paper form of any of your health information that may be used to make decisions about your care, subject to some exceptions. We will produce the records in the specific format that you request if it is feasible to do so. Your request must be made in writing. In most cases we may charge a reasonable fee for our costs in copying and mailing your requested information. If you are denied access to health information, in some cases you have the right to request for review of the denial.
We ordinarily will respond to requests for copies within 30 days. If we need additional time to respond to a request for copies, we will notify you in writing within the time frame above to explain the reason for the delay and when you can expect to have a final answer to your request.
Request Restrictions: you have the right to request restrictions on our use or disclosure of your health information for treatment, payment, or healthcare operations. We require that any request for use for disclosure of medical information would be made in writing. Your request should include what information you want to limit; Whether you want to limit how we use the information, how we share it with others, or both; And to whom you want the limits to apply.
In some cases, we are not required to agree to your requested restriction period if we do agree to accept your requested restriction, we will comply with your request unless the information is needed to provide you with emergency treatment or comply with the law.
Request Confidential Communications: you have the right to request that we communicate with you concerning your health matters in a certain manner such as calling you at work rather than at home. We will accommodate your reasonable requests. Your request must specify how or where you wish to be contacted.
Request Amendment: You have the right to request amendment of your health information maintained by us for as long as the information is kept by or for us. Your request must be made in writing and must state the reason for the requested amendment. We ordinarily will respond to your request within 60 days. If we need additional time to respond, we will notify you in writing within the 60 days to explain the reason for the delay and tell you when you can expect to have your final answer to your request.
We may deny your request for amendment if the information requested for the amendment was not created by Rise Wellness and the originator of the information is available to amend the records; Or the information requested for amendment is not part of the designated record set as defined by the law; Or the information would not be available for inspection under 45 CFR §164.5265; or the information requested to be mended is accurate and complete prior to the amendment. If we deny your request for amendment, we will give you a written denial including the reasons for the denial and the right to submit a written statement disagreeing with the denial.
Request an Accounting of Disclosures: you have the right to request an accounting of disclosures, which is a list of what information about how your health information has been disclosed outside of Rise Wellness or other than through a health information exchange that you have not opted out of. And accounting will not include:
Disclosures we made to you or your personal representative;
Disclosures we made pursuant to your written authorization;
Disclosures we've made for treatment, payment, or business operations;
Disclosures we made from the patient directory;
Disclosures made to your friends and family involved in your care or payment for your care;
Disclosures that were incidental to permissible uses and disclosures of your health information;
Disclosures for purposes of research, public health, or our business operations of limited portions of your health information that do not directly identify you;
Disclosures made to federal officials for national security and intelligence activities;
Disclosures about inmates to correctional institutions or law enforcement officers;
·Disclosures made before September 1st, 2007
your request must state a time period within the past six years for the disclosures you want us to include. Or list of certain disclosures of your health information within the last six years. The first accounting provided within a 12 month period will be free; For further requests, we may charge you our costs. We will notify you of any costs involved so that you may choose to withdraw or modify your request before any costs are incurred.
We ordinarily will respond to your request for an accounting within 60 days. If we need additional time to prepare the accounting list you have requested, we will notify you in writing about the reason for the delay and the date when you can expect to receive the accounting list.
Request a Paper Copy of This Notice: you have the right to obtain a paper copy of this notice, even if you have agreed to receive this notice electronically. You may request a copy of this notice at any time.
Request that Another Person May Act on Your Behalf: if you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. Rise Wellness will require validation of this authority prior to taking any action.
File a Complaint if you Feel Any of Your Rights Have Been Violated: you have the right to file a complaint if you feel Rise Wellness has violated any of your privacy rights. Complaints can be filed with the federal government at the contact info listed below. To obtain further information about the federal privacy rules or to submit a complaint to the Department of Health and Human Services, you may contact the Department of Health and Human Services via electronic mail at ocrmail@hhs.gov or at the following:
Region II: New York
Regional Manager Office for Civil Rights
U.S. Department of Health and Human Services
Jacob Javitz Federal Building
26 Federal Plaza, Suite 3312 New York, NY 10278
Phone: (800) 368-1019
Fax: (202) 619-3818
TDD: (800) 537-7697
How We May Use and Disclose Health Information About You
The following categories describe various ways that we use and disclose your health information. For each category of use or disclosure, we will explain what we mean and try to give some examples. Not every disclosure in a category will be listed. However, all the ways we are permitted to use and disclose health information will fall within one of the categories.
Treatment: we may use your health information to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, healthcare students, or other personnel who were involved in taking care of you. Your doctor may also share your health information with another doctor to whom you have been referred for further health care. For example, a doctor treating you for tick borne illness may need to know if you have diabetes because diabetes may slow or impact your disease state and healing process. In addition, the doctor may need to tell the dietitian if you have diabetes so that you can arrange for appropriate meals. Rise Wellness may also share your health information in order to coordinate the different services you need, such as prescriptions, lab work, X-rays, and other medical purposes. We may also disclose medical information about you to people outside of Rise Wellness involved in your medical care, such as family members or other health care professionals as necessary and appropriate.
Payment: we may use and disclose your health information so that the treatment and services you received at Rise Wellness may be billed to and payment may be collected from you, or a third party. you may direct us not to share a specific health information with your insurance company relating to a service you plan to pay for and do pay for personally. It is your responsibility, however, to inform other providers who may receive copies of your Rise Wellness record that they may not share this information with your insurer.
Health Care Operations: we may use and disclose your health information about you for Rise Wellness operations, as necessary to make sure that all of our patients receive quality care. For example, we may use medical information to review our treatments and services and to evaluate the performance of our staff in caring for you. We also might combine medical information about many of our patients to decide what additional services we should offer, what services are not needed, and whether certain new treatments are effective. We also might disclose information to doctors, nurses, technicians, healthcare students, and other risk Wellness personnel for review and learning purposes. Additionally, the medical information we have may be combined with medical information from other providers to compare how we are doing and see where we can make improvements in our care and service. We might remove information that identifies you from this set of medical information so others can use it to study healthcare and healthcare delivery without learning a patient's identity.
Business Associates: we may disclose the minimum amount of your health information to a contractor, agent, or third party business associates who need the information in order to assist us with obtaining payment or carrying out business operations. For example, we may use another company to perform medical billing services. All of our business associates are required to maintain the privacy and confidentiality of your health information. If we do disclose your health information to a business associate, we will have a written contract with them that requires them in any of its subcontractors to protect the privacy of your health information. They and their subcontractors are independently required by federal law to protect your information.
In addition, at the request of your other healthcare providers or health plan, we may disclose your medical information to their authorized business associates for purposes of performing certain business functions or healthcare services on their behalf. For example, we may disclose medical information to a business associate of Medicare for purposes of medical necessity review and audit.
Individuals Involved in Your Care or Payment for Your Care: if you do not object, we may release your health information to individuals involved in your medical care or involved in the payment for that care period in addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
Health Information Exchange: we may share information that we obtained or created about you with other healthcare providers or other healthcare entities, such as your health plan more health insurer, as permitted by law, through health information exchanges (HIE’s) in which we participate. For example, information about your past medical care and current medical conditions and medications can be available to us or to your primary care physician or hospital outside of Rise Wellness, if they participate in the HIE as well. You may choose to opt out of certain HIE by following the instructions for opting out on the consent form provided.
Appointment Reminders: we may use or disclose health information to remind you about your appointments.
Email Use: E-mail will only be used for communications in accordance with Rise Wellness policies and practices and with your permission. We will only use secured methods of communication.
Treatment Alternatives and Health-Related Benefits and Services: we may use and disclose your health information to inform you about treatment alternatives and health related benefits and services that may be of interest to you.
Research: under certain circumstances, we may use and disclose medical information about you for research purposes. For example, a research project could involve comparing the health and recovery of all patients who received one medication, to those who received another, for the same condition. All research projects, however, are subject to special approval process. This process evaluates a proposed research project and its use of medical information, trying to balance the research needs with the patient's need for privacy of their medical information. All research projects are subject to an approval process involving an Institutional Review Board (IRB). The IRB evaluates proposed research projects and their use of health information, balancing research needs and a patient's right to privacy. We may disclose health information about you to people preparing to conduct a research project in order to help identify patients with specific medical needs. Health information disclosed during this process never leaves our control. We might ask for specific permission from you if the researcher will have access to your name, address, or other information that reveals who you are, or will be involved in your care at Rise Wellness.
To Avert a Serious Threat to Health or Safety: when necessary to prevent a serious threat to your health or safety or the health or safety of the public or another person, we may use or disclose health information, limiting disclosures to somewhat able to help lessen or prevent the threatened harm.
As Required By Law: we may use or disclose your health information when required by law to do so by federal, state, or local law.
Special Situations
Emergencies: we may use or disclose your health information as necessary in emergency treatment situations.
Communication Barriers: we may use or disclose your health information if we are unable to obtain your consent because of substantial communication barriers and we believe you would want us to treat you if we could communicate with you.
Coroners, Medical Examiners, Funeral Directors, Organ Procurement Organizations: we may release your health information to a coroner, medical examiner, funeral director, or if you are an organ donor, to an organization involved in the donation of organs and tissue.
Military and Veterans: If you're a member of the armed forces, we may use and disclose your health information as required by military command authorities for activities they deem necessary to carry out their military mission. We may disclose health information about foreign military personnel to the appropriate foreign military authority.
Reporting Victims of Abuse. Neglect, or Domestic Violence: if we believe that you have been a victim of abuse, neglect, or domestic violence, we may use and disclose your health information to notify a government authority, if required by law or if you agree to the report.
Inmates/Law Enforcement Custody: if you were under the custody of a law enforcement official or a correctional institution, we may disclose your health information to the institution or law enforcement official, if necessary, to provide you with healthcare, or to protect the health and safety of other inmates or persons involved in supervising or transporting inmates.
Disaster Relief: unless you object, we may disclose health information about you to a disaster relief organization.
Public Health Activities: We may disclose your health information to public health officials so that they can carry out their public health activities. These activities generally include the following:
To prevent or control disease, injury, or disability
To report births and deaths
To report child abuse or neglect
To report reactions to medications or problems with products
To notify people of recalls of products they may be using
To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition
To notify the appropriate government authority if we believe the patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
Health Oversight Activities: we may disclose your health information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections, and licensure actions or for activities involving government oversight of the healthcare system. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Lawsuits and Disputes: We may disclose your health information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
Law Enforcement: We may release your health information for certain law enforcement purposes, if asked to do so by a law enforcement official:
In response to a court order, subpoena, warrant, summons, or similar process
To identify or locate a suspect, fugitive, material witness, or missing person
About the victim of a crime if, under certain limited circumstances, we are unable to obtain the persons agreement
About a death we believe may be the result of criminal conduct
About criminal conduct that occurred on Rise Wellness property
In emergency circumstances, to report a crime; The location of the crime or victims; Or the identity, description, or location of the person who committed the crime
National Security and Intelligence Activities: we may release your health information to authorize federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Protective Services for the President and Others: we may disclose your health information to authorized federal officials so they may provide protection to the president, other authorized persons, or foreign heads of state or conduct special investigations.
Worker’s Compensation: We may use or disclose your health information to comply with laws relating to workers compensation or similar programs.
Uses and Disclosures That Require Your Authorization
We will not use health information about you for any purposes not specifically allowed by federal or state laws or regulations without your written authorization. Specifically, the following types of uses and disclosures of your health information require an authorization:
Marketing: your written authorization is required for us to use or disclose your health information for marketing purposes. If market activities are to result in payment to us from a third party, we will state this on the authorization.
Sale of Health Information: we are required to obtain your written authorization before using or disclosing your health information for purposes other than those discussed in the preceding sections of this notice or as otherwise permitted or required by law. Any authorization for the sale of health information will state that the disclosure will result in payment to Rise Wellness.
Other uses and disclosures of health information not described in this notice will not be made unless you provide a written authorization, and that authorization may be revoked prospectively at any time by written revocation.
Breach Notifications
Rise Wellness makes every effort to secure your health information, including the use of encryption whenever possible. In the event that any of your health information that has not been encrypted is the subject of a breach, we will provide you with a written or electronic notification about the breach as required by federal law.
For Further Information or to File a Privacy Complaint
to obtain a copy of the most recent current notice, to exercise any of your rights described in this notice, or to receive further information about the privacy of your medical information, you may contact Rise Wellness at any time.
Rise Wellness
860-237-5511
Changes to This Notice
We reserve the right to change this notice and to make the revised or new notice provisions effective for all health information already received and maintained by us as well As for all health and rich and received in the future. We will provide a copy of the revised notice upon request.