Privacy Policy
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.
This privacy policy is adopted to ensure that Medisolare ("MEDISOLARE") fully complies
with all federal and state privacy protection laws and regulations, in particular,
the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Protection
of patient privacy is of utmost importance to MEDISOLARE. Violations of any of these
provisions will result in disciplinary action which may include termination of employment
and possible referral for criminal prosecution.
This policy shall become effective as of May 30, 2005 , and shall remain in effect
until it is either amended or cancelled.
If you have any questions or comments concerning this policy, you should contact:
Chief Privacy Officer
Medisolare
9770 Baymeadows, Suite 117
Jacksonville,
Florida 32256
Telephone No. 904.224.5000
DEFINITIONS
For the purposes of this policy, the following defined terms shall have the following
definitions.
a. "HHS" shall mean the United States Department of Health and Human Services.
b. " Health Information" or "Protected Health Information" shall mean, certain Individually
Identifiable Health Information, as defined in 45 C.F.R. § 164.501 of the Privacy
Standards.
I. Information Collected
In the ordinary course of business MEDISOLARE may receive personal information such
as:
- Patient's name, address, and telephone number;
- Information relating to treatment, diagnostic or other medical information concerning
a patient;
- Patient's insurance information and coverage.
In addition, other information will be gathered about a patient and we will create
a record of the care and/or services provided to the patient by MEDISOLARE.
Some of the information also may be provided to us by other individuals or organizations
that are part of the patient's "circle of care"- such as referring physician, other
physicians, their health plan and family members, hospitals or other health care
providers.
II. How MEDISOLARE Will Use or Disclose Your Protected Health Information
MEDISOLARE collects Protected Health Information from you and stores it on a computer.
This is your medical record. The medical record is the property of MEDISOLARE, but
the information in the medical record belongs to you. MEDISOLARE protects the privacy
of your Protected Health Information. It is the policy of MEDISOLARE that all Protected
Health Information may not be used or disclosed unless it meets one of the following
conditions:
1. The patient who is the subject of the information has consented to the use or
disclosure and the use or disclosure is for the treatment, payment or health care
operations.
a. Treatment . MEDISOLARE collects information from you regarding your past medical
history, present medical problems and/ or complaints, as well as any diagnose and/or
treatment at MEDISOLARE. This information may be transmitted to various departments
within our organization, your referring physician and any other entities associated
or involved in your treatment. This information may also be disclosed to your physicians
or your primary care physician in association with your treatment.
b. Payment . MEDISOLARE will collect billing information from you such as your present
address, social security number, date of birth, health insurance carrier, policy
number and other related billing information. MEDISOLARE may disclose to your health
insurance provider, Medicare and Medicaid, or any other payor of health care claims
the minimum amount necessary of your patient health care information in order to
process your health insurance claim.
c. Regular Health Care Operations . MEDISOLARE will disclose your healthcare information
to our physicians, medical assistants, nurses, x-ray technologists, billing clerks,
administrative staff and other employees involved in your healthcare treatment.
2. The patient who is the subject of the information has authorized the use or disclosure
of the information; or
3. The patient who is the subject of the information does not object to the disclosure
and the disclosure is to persons involved in the health care of the individual or
for facility directory purposes.
a. Notification and communication with family . We may disclose your Protected Health
Information to notify or assist in notifying a family member, your personal representative
or another person responsible for your care about your location, your general condition
or in the event of your death. If you are able and available to agree or object,
we will give you the opportunity to object prior to making this notification. If
you are unable or unavailable to agree or object, our health professionals will
use their best judgment in communication with your family and others.
4. Voice Mail Message. It is the policy of MEDISOLARE that a voice mail or answering
machine message may be left at a patient's home or other number the patient provides
to MEDISOLARE regarding appointments, billing or payment issues, or other PHI, related
to treatment, payment or health care operations.
5. As Required by Law . It is the policy of MEDISOLARE that we may use and disclose
your Protected Health Information as required by law.
a. Public health . As required by law, we may disclose your Protected Health Information
to public health authorities for purposes related to: preventing or controlling
disease, injury or disability; reporting child abuse or neglect; reporting domestic
violence; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure.
b. Health oversight activities . We may disclose your Protected Health Information
to health agencies during the course of audits, investigations, inspections, licensure
and other proceedings.
c. Judicial and administrative proceedings . We may disclose your Protected Health
Information in the course of any administrative or judicial proceeding.
d. Law enforcement . We may disclose your Protected Health Information to a law
enforcement official for purposes such as identifying or locating a suspect, fugitive,
material witness or missing person, complying with a court order or subpoena, and/or
for other law enforcement purposes.
e. Deceased person information . We may disclose your Protected Health Information
to coroners, medical examiners and funeral directors.
f. Organ donation . We may disclose your Protected Health Information to organizations
involved in procuring, banking or transplanting organs and tissues.
g. Research . We may disclose your Protected Health Information to researchers conducting
research that has been approved by an Institutional Review Board or MEDISOLARE's
Board of Directors.
h. Public safety . We may disclose your Protected Health Information to appropriate
persons in order to prevent or lessen a serious and imminent threat to the health
or safety of a particular person or the general public.
i. Specialized government functions . We may disclose your Protected Health Information
for military, national security, prisoner purposes.
j. Worker's compensation . We may disclose your Protected Health Information as
necessary to comply with worker's compensation laws.
k. Marketing . We may contact you to provide appointment reminders or to give you
information about other treatments or health-related benefits and services that
may be of interest to you.
l. Change of Ownership . In the event that MEDISOLARE is sold or merges with another
organization, your Protected Health Information/record will become the property
of the new owner.
III. OTHER POLICIES, USES AND DISCLOSURES
1. Notice of Privacy Practices . It is the policy of MEDISOLARE that privacy practices
must be published and that all uses and disclosures of Protected Health Information
are done in accordance with MEDISOLARE's privacy policy.
2. Deceased Individuals . It is the policy of MEDISOLARE, that privacy protections
extend to information concerning deceased individuals.
3. Restriction Requests . It is the policy of MEDISOLARE that serious consideration
must be given to all requests for restrictions on uses and disclosures of Protected
Health Information as published in this privacy policy. You have the right to request
restrictions on certain uses and disclosures of your Protected Health Information.
MEDISOLARE is not required to agree to the restriction that you requested. If a
particular restriction is agreed to, MEDISOLARE is bound by that restriction.
4. Minimum Necessary Disclosure . It is the policy of MEDISOLARE that it shall make
reasonable efforts to limit the disclosure to the minimum amount of information
needed to accomplish the purpose of the disclosure. It is also the policy of MEDISOLARE
that all requests for Protected Health Information must be limited to the minimum
amount of information needed to accomplish the purpose of the request.
5. Access to Information . It is the policy of MEDISOLARE that you have the right
to inspect and copy your Protected Health Information. It is MEDISOLARE's policy
that access to Protected Health Information must be granted to a patient when such
access is requested. Such request shall be submitted in writing by completing MEDISOLARE's
request form entitled " Request for Inspection and/or Copy of Protected Health Information".
Costs associated with the copying of any Protected Health Information shall be in
accordance with applicable state and federal law.
6. Designation of Personal Representative . It is the policy of MEDISOLARE that
access to protected health information must be granted to your designated personal
representative as specified by you when such access is requested. This designation
of a personal representative must be made in writing by completing MEDISOLARE's
form entitled "Designation of Personal Representative."
7. Confidential Communications Channels. It is the policy of MEDISOLARE that you
have the right to receive your protected health information through a reasonable
alternative means or at an alternative location. Confidential communication channels
can be used within the reasonable capability of MEDISOLARE, (i.e. do not call me
at work, call me at home) as requested by you. Such request shall be made in writing
by completing MEDISOLARE's form entitled "Confidential Channel Communication Request."
8. Amendment of Incomplete or Incorrect Protected Health Information. It is the
policy of MEDISOLARE that you have a right to request that MEDISOLARE amend your
protected health information that is incorrect or incomplete. MEDISOLARE is not
required to change your protected health information and will provide you with information
about MEDISOLARE's denial and how you can disagree with the denial. A request to
amend your protected health information shall be made in writing by completing MEDISOLARE's
form entitled "Request for Amendment of Health care Information."
9. Accounting of Disclosures . It is the policy of MEDISOLARE that an accounting
of disclosures of Protected Health Information made by MEDISOLARE is given to you
whenever such an accounting is requested in writing. You have a right to receive
an accounting of disclosures of your Protected Health Information made by MEDISOLARE,
except that MEDISOLARE does not have to account for the disclosures described in
Section II (1) (a)(b)(c), of this Notice of Privacy Practices. Such written request
for an accounting shall be made by completing MEDISOLARE's form entitled "Request
for Accounting of Disclosures".
10. Complaints. It is the policy of MEDISOLARE that all complaints by employees,
patients, providers or other entities relating to Protected Health Information be
investigated and resolved in a timely fashion. Complaints about this Notice of Privacy
Practices or how MEDISOLARE handles your Protected Health Information should be
directed to:
Chief Privacy Officer
Medisolare
9770 Baymeadows, Suite 117
Jacksonville,
Florida 32256
Telephone No. 904.224.5000
If you are not satisfied with the manner in which this office handles a complaint,
you may submit a formal complaint to:
Department of Health and Human Services
Office of Civil Rights
Hubert H. Humphrey Bldg.
200 Independence Avenue, S.W.
Room 509F HHH Building
Washington , DC 20201
11. Prohibited Activities . It is the policy of MEDISOLARE that no employee may
engage in any intimidating or retaliatory acts or actions against any person who
files a complaint or otherwise exercises their rights under HIPAA regulations. It
is also the policy of MEDISOLARE that no disclosure of protected health care information
will be withheld as a condition for payment for services from the patient or from
an entity.
12. Responsibility. It is the policy of MEDISOLARE that the responsibility for designing
and implementing procedures related to this policy lies with the Chief Privacy Officer.
13. Mitigation . It is the policy of MEDISOLARE that the effects of any unauthorized
use or disclosure of Protected Health Information be mitigated (to decrease the
damage caused by the action) to the extent possible.
14. Business Associates . It is the policy of MEDISOLARE that business associates
must be contractually bound to protect your Protected Health Information to the
same degree as set forth in this policy.
15. Preemption of State Law . It is the policy of MEDISOLARE that the federal privacy
regulations are the minimum standard to be used regarding the privacy of a patient's
protected health care information. If the laws of the State of California are more
stringent in certain areas, the state laws in these areas shall prevail. In all
other areas, the federal privacy regulations shall prevail.
16. Cooperation with Privacy Oversight Authorities . It is the policy of MEDISOLARE
that oversight agencies such as the Office for Civil Rights of the Department of
Health and Human Services be given full support and cooperation in their efforts
to ensure the protection of Protected Health Information within this organization.
It is also the policy of MEDISOLARE that all personnel cooperate fully with all
privacy compliance review and investigations.
If you would like to have a more detailed explanation of these rights or if you
would like to exercise one or more of these rights, contact the Chief Privacy Office
of MEDISOLARE.
IV. Changes to this Notice of Privacy Practices
MEDISOLARE reserves the right to amend this Notice of Privacy Practices at any time
in the future and will provide a copy of such amendment to you upon request or upon
your next visit. Until such amendment is made, MEDISOLARE is required by law to
comply with this Notice.