NOTICE OF PRIVACY AND SECURITY PRACTICES
As required by the Privacy and Security Regulations promulgated pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its subsequent addendums, modifications, revisions, and clarifications as published
January 25, 2013.
This notice is intended to describe how Health Information may be used
and/or disclosed and how You can access your Identifiable Health
Information. Please review this notice carefully. If you have any questions
regarding this notice, please contact us at the location above.
Our Commitment to your Privacy and the Security of your Identifiable
Health Information
We are dedicated to providing you with the Highest quality services. In conducting
our business, we will create records regarding you and the treatment and services
we provide to you. We are required, by Law, to maintain the confidentiality of
Health Information that Identifies you. In addition, we are obligated to maintain
the security of information that may be electronically stored or retrievable through
safeguards and agreements with Business Associates and their Sub Contractors. It
is our legal responsibility to provide you with a copy of this notice and to follow its
terms faithfully when dealing with your health information.
The terms of this notice will apply to all records containing Identifiable Health
Information or PHI that are either created or retained by our Agency. We reserve
the right to revise or amend this notice to comply with HIPAA regulations. Your
information will be governed by the Privacy and Security Practices in effect at the
time of disclosure. A copy of the most current notice will be posted in the
Agency’s office, and you may request a copy at any time.
We may use and disclose your Identifiable Health Information in the following
ways:
Treatment Our Agency will use your Identifiable Health Information to
plan, implement, or evaluate your treatment or services. An example of this
would be obtaining Lab Results, Physical Therapy notes, or Discharge
Recommendations. In addition, we may find it necessary to share some of
this information with other providers, such as Physicians, Therapists, or
Counselors.
Payment Our Agency will use your Identifiable Health Information to Bill
for services and to collect payment. The information may be disclosed to
your Insurer, Third Party Payee, or to You.
Operations Our Agency may use your Identifiable Health Information to
evaluate, plan, and improve services, assess Quality Indicators, and manage
costs.
Additionally
Service Reminders: Our Agency may use your Identifiable Health
Information to provide reminders regarding service visits, doctor’s
appointments, lab draws, or other health related tasks.
Health Related Benefits Our Agency may use your Identifiable Health
Information to identify services and benefits that might be helpful or
interesting to you, or specific to one of your diagnosis.
Release of Information to Family/Significant Others/Third Parties With
Permission from you, Our Agency will disclose your Identifiable Health
Information to those individuals that you have identified on a HIPAA
Compliant Release of Information Form.
Disclosures required by Law Our Agency will disclose your Identifiable
health Information as required by Federal, State, and Local Laws.
Public Health Risks Our Agency may disclose your Identifiable Health
Information to Public Health Authorities that are authorized to collect
information, maintain vital records, report, prevent, or control abuse,
neglect, disease, injury or disability; Is responsible for notifying persons
regarding exposure to Communicable Disease or of the potential for
contracting or spreading disease; Reporting problems with drugs, devices or
products, and contacting individuals regarding Recalls. Disclosures related
to the potential abuse or neglect of an adult will only be made with the
permission of that patient. This includes Domestic Violence issues.
Health Oversight Activities Our Agency may be required to disclose
Identifiable Health Information for activities authorized by law, such as
Investigations, Inspections, Audits, Surveys, Licensure, Disciplinary
Actions, or Criminal proceedings.
Lawsuits or Similar proceedings Our Agency may disclose your
Identifiable Health Information in response to a Court Order or
Administrative Order. We may also disclose in response to another lawful
process, such as a Subpoena, but only after we have made an attempt to
notify you or to obtain an Order protecting the requested information.
Law Enforcement Our Agency may release Identifiable Health
Information if required to do so by a Law Enforcement Official regarding a
crime, a crime victim, death from criminal conduct, in response to a
Warrant/Subpoena, to locate or identify you, and in an emergency to report a
potential crime.
Serious Threats to Health or Safety Our Agency may disclose Identifiable
Health Information to reduce or prevent serious threats and these disclosures
will only be made to those entities that are able to prevent the threat.
Military and National Security Our Agency may disclose your
Identifiable Health Information if you are a member(or Veteran) of the US or
Foreign Armed Services and are required to do so by Military Command
Authorities. In addition, Our Agency may disclose Identifiable Health
Information to Intelligence or National Security Officials as authorized by
law and to protect the President and other Elected officials or foreign Heads
of State.
Inmates Our Agency may disclose your Identifiable Health Information to
Correctional Facilities and Law Enforcement officials if you are an inmate
or in the custody of Law Enforcement. This disclosure would facilitate
health care services for you, safety and security for the Law Enforcement
entity, and to protect your health and safety, as well as the health and safety
of others.
Workman’s Compensation Our Agency will disclose your Identifiable
Health Information for purposes of Workman’s Compensation and similar
programs.
In the Event of Your Death Our Agency may disclose your Identifiable
Health Information to your family or other persons involved with your care
or payment for care prior to your death unless doing so is inconsistent with
your wishes. Unless your wishes are made known to Our Agency, relevant
health information will be disclosed.
Your Rights Regarding Your Identifiable Health Information
Confidential Communication You have the Right to request that our
Agency communicate with you about health and related issues in a particular
manner or at a certain time or location. You may request that we contact you
at home rather than at work. To request a Confidential Communication a
written request should be forwarded to Our Agency at the address given.
Our Agency will accommodate all Reasonable requests.
Requesting Restrictions You have the Right to request a restriction in our
use or disclosure of your Identifiable Health Information. In some cases, we
are not obligated to agree to your request for restriction. If Our Agency
agrees to the restriction, we are bound by that agreement except when
otherwise required by Law or Emergency. If your request for Restriction
involves limiting a disclosure to a Health Plan regarding payment and it is
solely pertaining to items or services paid for In Full by you or by another on
your behalf, Our Agency Must agree to that restriction. All restrictions must
be requested in writing and sent to Our Agency address. Your request must
describe concisely (a) what information is to be restricted; (b) whether you
are requesting to limit Our Agency’s use; (c) to whom the restrictions apply.
Inspection and Paper Copies You have the right to inspect and obtain
copies of your Identifiable Health Information that may be used to make
decisions about you or your care which includes medical records and billing
records, but excludes psychotherapy notes. You must submit a request in
writing to Our Agency address. Our Agency may charge a fee for the costs
of copying, mailing and preparing, in addition to supplies and labor required
to fulfill your request. Our Agency may deny your request in certain limited
circumstances, however you may request a review of the denial. Reviews
are conducted by a Licensed Health Care Professional chosen by Our
Agency.
Electronic Copies In the event that Identifiable Health Information is
maintained Electronically, you have the Right to request an Electronic copy.
Furthermore, you may request the form and format. If unable to provide the
information in the format you requested, Our Agency will provide you with
readable electronic formatting which is mutually acceptable.
Amendments You may ask to amend your Identifiable Health Information
if you feel it is incorrect or incomplete. Request must be made in writing
and sent to Our Agency address. Our Agency will deny any requests not
submitted in writing, or if there is not a supporting reason for your request.
Denials will also be issued if you request amendments to accurate or
complete information, if the information to be amended is not part of the
Identifiable Health Information on file with Our Agency, if you request
amendment to information that was not part of your review, if the
information was not created by Our Agency unless the person who created
the information is no longer available to amend it.
Accounting of Disclosures You have the Right to request an “Accounting
of Disclosures” which is a list of certain disclosure Our Agency has made of
your Identifiable Health Information. All requests must be made in writing
and sent to Our Agency address. You must state a Time Period which is no
longer than 6 years and does not include dates prior to April 14, 2003. The
first list you request in any 12 month period may be free of charge, however
subsequent request in the same 12 month period will incur a fee. Our
Agency will inform you of any charges prior to processing your request and
allow you to withdraw your request at that time.
Right to Paper Copy of this Notice Contact us at anytime to receive a
Paper Copy of this notice
Right to File a Complaint If you believe that your Privacy has been
violated you may file a complaint with our Agency or with the Secretary of
the Department of Health and Human Services. All complaints must be
submitted in writing. You will not be penalized for filing a complaint.
To submit a complaint with N and J Home Care you can by the following means:
By mail:
Attn. Compliance Officer
9851 Queens Blvd, Ste 1C and 1D,
Rego Park, NY 11374
By Phone: (929) 305-9293
By email: [email protected]
With the Department of Health and Human Services (HHS) Office of Civil Rights:
By mail: 200 Independence Avenue, S.W. Washington, D.C. 20201
By Phone: 1-877-696-6775
Or online at www.hhs.gov/ocr/privacy/hipaa/complaints/.
Right to Provide Authorization for Other Use or Disclosure Our Agency
will accept written authorization for uses and disclosures not identified
within this notice or permitted by Law You may revoke these authorizations
at any time, in writing. Once revoked, your PHI will no longer be disclosed
for that purpose.
Right to be notified of Breach in Confidentiality You have the Right to be
notified if Our Agency feels that the confidentiality of your Identifiable
Health Information has been compromised.
Security of Electronically Stored or Managed Identifiable Health Information
ePHI is any Identifiable Health Information covered under HIPAA (1996) and is
produced, saved, transferred, or received in electronic form. This information may
be stored in computers, Lap Tops, I Pads, Smart Phones, etc. This does not apply
to equipment such as FAX machines or copiers. Passwords, Pin Numbers, and
limited access to electronic office equipment are utilized in an effort to maintain
the confidentiality of all health related information.