Aviso de prácticas de privacidad

Effective Date: March 14, 2024

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

OUR PLEDGE REGARDING HEALTH INFORMATION:

We understand that health information about you and your health care is personal. We are committed to protecting health information about you. We create a record of the care and services you receive from us. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this health care practice, whether made by your personal doctor or others working in this office. This notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights to the health information we keep about you and describe certain obligations we have regarding the use and disclosure of your health information.

We are required by law to:

• Make sure that health information that identifies you is kept private.
• Give you this notice of our legal duties and privacy practices with respect to health information about you.
• Follow the terms of the notice that is currently in effect.

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

Las siguientes categorías describen las distintas formas en que utilizamos y divulgamos la información sanitaria. Para cada categoría de usos o divulgaciones explicaremos lo que queremos decir e intentaremos dar algunos ejemplos. No se enumerarán todos los usos o divulgaciones de una categoría. Sin embargo, todas las formas en que se nos permite utilizar y revelar información estarán dentro de una de las categorías.

For Treatment: We may use health information about you to provide you with health care treatment or services. We may disclose health information about you to doctors, nurses, technicians, health students, or other personnel who are involved in taking care of you. They may work at our offices, at the hospital if you are hospitalized, or at another doctor’s office, lab or pharmacy.  They may also work at another health care provider to whom we may refer you for consultation, to take x-rays, to perform lab tests, to have prescriptions filled or for other treatment purposes. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. In addition, the doctor may need to tell the dietitian at the hospital if you have diabetes so that we can arrange appropriate meals. We may also disclose health 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.

For Payment:   We may use and disclose health information about you so that the treatment and services you receive from us may be billed to and payment collected from you, an insurance company, or a third party. For example, we may contact your health insurer to verify your eligibility for benefits or we may give your health plan information about your office visit so your health plan will pay us or reimburse you for the visit. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

For Health Care Operations: We may use and disclose health information about you for operations of our health care practice. These uses and disclosures are necessary to run our practice and make sure that all of our patients receive quality care. For example, we may use health information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine health information about many patients to decide what additional services we should offer, what services are not needed, whether certain new treatments are effective and to see where we can make improvements. We may remove information that identifies you from this set of health information so others may use it to study health care delivery without learning who our specific patients are.

Appointment Reminders: We may use and disclose health information to contact you as a reminder that you have an appointment.  We will usually call you at home and/or on the cell phone number provided the day before your appointment and leave a message for you, on your answering machine or with an individual who responds to our telephone call.  Please let us know if you do not wish to have us contact you concerning your appointment, or if you wish to have us use a different telephone number or address to contact you for this purpose.

Students: Students, interns and residents in healthcare programs work in our clinics from time to time to meet their educational requirements or to get healthcare experience.  These individuals may observe or participate in your treatment or use health information about you to assist in their training.  You have the right to refuse to be examined, observed or treated by any student, intern or resident.  If you do not want a student, intern or resident to participate in your care please notify your provider.

Business Associates:  We sometime contract with other companies or individuals for services.  Examples would be medical record storage companies, billing services, answering services and consultants.  We may disclose your health information to them so that they can perform the job we have asked them to do.  To protect your health information, we have contracts with each of these companies and/or individuals and they are held to the same standards of privacy as we are.

Release of Information to Family/Friends:  Our providers and staff, using their professional judgment, may disclose to a family member of yours, a close personal friend or any other person you identify, your health information to the extent it is relevant to that person’s involvement in you care or payment related to your care.  We will provide you with an opportunity to object to such a disclosure whenever practical.  We may disclose the health information of minor children to their parents or guardians unless such disclosure is prohibited by law.

Research: Under certain circumstances, we may use and disclose health information about you for research purposes. For example, a research project may 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 a special approval process.  This process evaluates a proposed research project and its use of health information, trying to balance the research needs with patients’ need for privacy of their health information. Before we use or disclose health information for research, the project will have been approved through a research approval process; but we may disclose health information about you to people preparing to conduct a research project. For example, we may help potential researchers look for patients with specific health needs, so long as the health information they review does not leave our facility. We will always ask for your specific permission if the researcher will have access to your name, address, or other information that reveals who you are.

As Required by Law: We will disclose health information about you when required to do so by federal, state, or local law.

To Avert a Serious Threat to Health or Safety: We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public. Any disclosure, however, would only be to someone able to help prevent the threat.

Military and Veterans:  If you are a member of the armed forces or separated/discharged from military services, we may release health information about you as required by military command authorities or the Department of Veterans Affairs as may be applicable. We may also release health information about foreign military personnel to the appropriate foreign military authorities.

Workers’ Compensation:  We may release health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Public Health Risks: We may disclose health information about you for public health activities. These activities generally include the following:

• Para prevenir o controlar enfermedades, lesiones o discapacidades.
• Informar de nacimientos y defunciones.
• Para denunciar malos tratos o abandono de menores.
• Para notificar reacciones a medicamentos o problemas con productos.
• Notificar a los ciudadanos la retirada de productos que puedan estar utilizando.
• Notificar a la persona u organización obligada a recibir información sobre productos regulados por la FDA.
• Notificar a una persona que pueda haber estado expuesta a una enfermedad o pueda correr el riesgo de contraer o propagar una enfermedad o afección.
• Para notificar a la autoridad gubernamental apropiada si creemos que un paciente ha sido víctima de abuso, negligencia o violencia doméstica. Sólo haremos esta divulgación si usted está de acuerdo o cuando lo exija o autorice la ley.

Health Oversight Activities: We may disclose health information to a health oversight agency or activity authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. We may also disclose health 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 health information if asked to do so by a law enforcement official:

• En la notificación de determinadas lesiones, como exige la ley, heridas de bala, quemaduras, lesiones a autores de delitos.
• En respuesta a una orden judicial, citación, orden de arresto, emplazamiento o proceso similar.
• Identificar o localizar a un sospechoso, fugitivo, testigo material o persona desaparecida.
• Nombre y dirección
• Fecha o lugar de nacimiento
• Número de la seguridad social
• Grupo sanguíneo o factor rh; Tipo de lesión
• Fecha y hora del tratamiento y/o fallecimiento, si procede
• Una descripción de las características físicas distintivas
• Sobre la víctima de un delito, si la víctima está de acuerdo con la divulgación o, en determinadas circunstancias limitadas, no podemos obtener el acuerdo de la persona.
• Sobre una muerte que creemos que puede ser el resultado de una conducta criminal.
• Sobre la conducta delictiva en nuestras instalaciones.
• En circunstancias de emergencia, para denunciar un delito; la localización del delito o de las víctimas; o la identidad, descripción o localización de la persona que cometió el delito.

Psychotherapy notes:  Psychotherapy notes means notes recorded (in any medium) by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual’s medical record. Psychotherapy notes excludes medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date.

We may use or disclose your psychotherapy notes, as required by law, or:

• Para uso de Neighborhood Healthcare en el curso de la prestación de atención a usted
• En programas supervisados de formación en salud mental para estudiantes, aprendices o profesionales
• Por la entidad cubierta para defender una acción legal u otro procedimiento iniciado por el individuo
• Para prevenir o reducir una amenaza grave e inminente para la salud o la seguridad de una persona o del público.
• Para la supervisión sanitaria de Neighborhood Healthcare
• Para uso o divulgación al forense o al médico forense para informar de la muerte de un paciente
• Para su uso o divulgación al Secretario del Departamento de Salud y Servicios Humanos (DHHS) en el curso de una investigación

Coroners, Health Examiners and Funeral Directors: We may release health information to a coroner or health examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release health information about patients to funeral directors as necessary to carry out their duties.

National Security and Intelligence Activities: We may release health information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Protective Services for the President and Others:  We may disclose health information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.

Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release health information about you to the correctional institution or law enforcement official. This release would be 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 institution.

AUTHORIZATION FOR OTHER USES OF YOUR HEALTH INFORMATION

Uses of your health information not covered by our current Notice of Privacy Practices or laws that apply to us will be made only with your written authorization.  This would include disclosures of psychotherapy notes, disclosures that would constitute a sale of information and disclosures of information used for marketing.  If you provide us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission and that we are required to retain our records of the care that we provided to you.

YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU

Usted tiene los siguientes derechos en relación con la información sanitaria que conservamos sobre usted:

Right to Inspect and Copy: You have the right to inspect and copy health information that may be used to make decisions about your care. Usually, this includes health and billing records.

Para inspeccionar u obtener una copia de la información sanitaria que puede utilizarse para tomar decisiones sobre usted, debe presentar su solicitud por escrito a una recepcionista o a un empleado de registros médicos de su centro de atención primaria. Si solicita una copia de la información, podemos cobrarle una tarifa por los costes de copia, envío u otros suministros y servicios relacionados con su solicitud.

Because we maintain your health information in an electronic health record, you also have the right to request that an electronic copy of your record be sent to you or to another individual or entity.  We may charge you a reasonable cost-based fee limited to labor costs associated with transmitting the electronic health record.

We may deny your request to inspect and copy in certain very limited circumstances, including requests for psychotherapy notes. If you are denied access to health information, you may request that the denial be reviewed. Another licensed health care professional chosen by our practice will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

Right to Amend: If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as we keep the information. To request an amendment, your request must be made in writing, submitted to our Privacy Officer, and must be contained on one page of paper legibly handwritten or typed in at least 10-point font size. In addition, you must provide a reason that supports your request for an amendment.

Podemos denegar su solicitud de modificación si no se presenta por escrito o no incluye una razón que la justifique. Además, podemos denegar su solicitud si nos pide que modifiquemos información que:

• No fue creada por nosotros, a menos que la persona o entidad que creó la información ya no esté disponible para realizar la modificación.
• No forma parte de la información sanitaria conservada por o para nuestra consulta.
• No forma parte de la información que usted puede inspeccionar y copiar o
• Es preciso y completo.

Cualquier modificación que hagamos de su información sanitaria se comunicará a aquellas personas con las que divulguemos información según lo especificado anteriormente.

Right to an Accounting of Disclosures:  You have the right to request a list accounting for any disclosures of your health information we have made, except for uses and disclosures for treatment, payment, and health care operations, as previously described.

To request this list of disclosures, you must submit your request in writing to our Privacy Officer. Your request must state a time period which may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred. We will mail you a list of disclosures in paper form within 30 days of your request, or notify you if we are unable to supply the list within that time period and by what date we can supply the list; but this date will not exceed a total of 60 days from the date you made the request.

Right to Request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care, such as a family member or friend. For example, you could ask that we restrict a specified nurse from use of your information, or that we not disclose information to your spouse about a surgery you had.

No estamos obligados a acceder a su solicitud de restricciones si no nos resulta factible garantizar nuestro cumplimiento o creemos que repercutirá negativamente en la atención que podamos prestarle. Si estamos de acuerdo, accederemos a su solicitud a menos que la información sea necesaria para proporcionarle un tratamiento de emergencia. Para solicitar una restricción, debe dirigirse por escrito a nuestro responsable de privacidad. En su solicitud, debe indicarnos qué información desea limitar y a quién desea que se apliquen los límites; por ejemplo, el uso de cualquier información por parte de una enfermera específica, o la divulgación de una cirugía específica a su cónyuge.

Si pagó de su bolsillo por un artículo o servicio específico, y pagó en su totalidad, tiene derecho a solicitar que la información médica con respecto a ese artículo o servicio no sea divulgada a un plan de salud para fines de pago u operaciones de atención médica.

Right to Request Confidential Communications: You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail to a post office box.

Para solicitar comunicaciones confidenciales, debe dirigir su solicitud por escrito a nuestro Responsable de Privacidad. No le preguntaremos el motivo de su solicitud. Atenderemos todas las solicitudes razonables. Su solicitud debe especificar cómo o dónde desea que nos pongamos en contacto con usted.

Right to Receive Notice of a Breach:  We are required to notify you by first class mail or by e-mail if you have indicated that as your preference, of any breaches of Protected Health Information as soon as possible, but in any event, no later than 60 days following discovery of the breach.  We give you the following information:

• Una breve descripción de la infracción que incluya la fecha de la infracción y la fecha de descubrimiento.
• Una descripción de la información divulgada.
• Las medidas que hemos tomado para investigar, mitigar las pérdidas y prevenir nuevas infracciones.
• Información de contacto que puede utilizar para hacer preguntas u obtener información adicional.

Right to a Paper Copy of This Notice: You have the right to obtain a paper copy of this notice at any time. To obtain a copy, please request it from the receptionist at your clinic.

You may also obtain a copy of this notice either from our website, www.nhcare.org, or by requesting that a copy of this notice be sent through electronic mail to ComplianceDepartment-Private@nhcare.org. If we know that the electronic message has failed to be delivered, a paper copy of the notice will be provided. Even if you have received a notice electronically, you still retain the right to receive a paper copy upon request.

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our facility. The notice will contain on the first page, in the top right-hand corner, the effective date and at the bottom of each sheet, the revision date.  In addition, each time you register for treatment or health care services, we will offer you a copy of the current notice in effect.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with Neighborhood Healthcare or the Secretary of the Department of Health and Human Services, 200 Independence Ave, SW, Washington, DC  20201.  You may also file a complaint with the California Office of Information Integrity (CALOHI) by e-mail to enforce@ohi.ca.gov or calling by calling 888-549-8674.  To file a complaint with us, request a complaint form from the receptionist at your clinic, complete and submit. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

Acuse de recibo de la presente notificación

We will request that you sign a separate form acknowledging that you have received a copy of this notice. If you choose, or are not able to sign, a staff member will sign their name. This acknowledgement will be filed with your records.  If you have any questions about this notice, please contact Neighborhood HealthCare’s Privacy Officer at (833) 867-4642.