Effective Date: April 1, 2003; REV (1) July 27, 2016
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.
We understand the importance of privacy and are committed to maintaining the confidentiality of your medical information. We make a record of the medical care we provide and may receive such records from others. We use these records to provide or enable other health care providers to provide quality medical care, to obtain payment for services provided to you as allowed by your health plan and to enable us to meet our professional and legal obligations to operate this medical practice properly. We are required by law to maintain the privacy of protected health information, to provide individuals with notice of our legal duties and privacy practices with respect to protected health information, and to notify affected individuals following a breach of unsecured protected health information. This notice describes how we may use and disclose your medical information. It also describes your rights and our legal obligations with respect to your medical information. If you have any questions about this Notice, please contact our Privacy Officer.
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Centric Health is required by law to maintain the privacy of health information that identifies you, which is called protected health information (PHI), and to provide you with notice of our legal duties and privacy practices regarding PHI. Centric Health is committee to the protection of your PHI and will make reasonable efforts to ensure the confidentiality of your PHI as required by statute and regulation. We take this commitment seriously and will work with you to comply with your right to receive certain information under HIPAA.
The following categories explain the types of uses and disclosures of PHI that Centric Health is permitted to make under HIPAA. Some of the uses and disclosures may be limited or restricted by state laws or other legal requirements. Please contact our Privacy Officer, using the information provided at the end of this notice, for specific information regarding applicable state laws.
Treatment. Centric Health may use PHI to provide your medical care and treatment. We may disclose PHI to our employees and other health care professionals who are involved in coordinating or providing the care you need. For example, we may share your PHI with other physicians or other health care providers who will provide services that we do not provide. Or we may share this information with a pharmacist who needs it to dispense a prescription to you, or a laboratory that performs a test. We may also disclose PHI to members of your family or other authorized persons who can help you when you are sick or injured, or after you die.
Payment. Centric Health may use and disclose your PHI to bill and obtain payment for the services we provide. For example, we may provide your health plan the information it requires before it will pay us. We may also disclose information to other health care providers to assist them in obtaining payment for services they have provided to you or to coordinate health care or health benefits.
Health Care Operations. Centric Health may use and disclose your PHI for the operation of this medical practice. For example, we may use and disclose this information to review and improve the quality of care we provide, or the competence and qualifications of our professional staff. Or we may use and disclose this information to get your health plan to authorize services or referrals. We may also use and disclose this information as necessary for medical reviews, legal services and audits, including fraud and abuse detection and compliance programs and business planning and management. We may also share your medical information with our "business associates," such as our billing service, that perform administrative services for us. We have a written contract with each of these business associates that contains terms requiring them and their subcontractors to protect the confidentiality and security of your protected health information. We may also share your information with other health care providers, health care clearinghouses, or health plans that have a relationship with you. They may request this information to help them with their quality assessment and improvement activities, their patient-safety activities, their population-based efforts to improve health or reduce health care costs, their protocol development, case management or care-coordination activities, their review of competence, qualifications and performance of health care professionals, their training programs, their accreditation, certification or licensing activities, or their health care fraud and abuse detection and compliance efforts. We may also share your PHI with the other health care providers, health care clearinghouses and health plans that participate with us in "organized health care arrangements" (OHCAs) for any of the OHCAs' health care operations. OHCAs include hospitals, physician organizations, health plans, and other entities which collectively provide health care services. A listing of the OHCAs we participate in is available from the Privacy Official.
Appointment Reminders. Centric Health may use and disclose PHI to contact and remind you about appointments. We may also use and disclose PHI to tell you about health-related benefits and services that may be of interest to you.
Notification of Individuals Involved in Your Care. Centric Health may disclose your PHI to a family member, your personal representative or another person responsible for your care. We may also notify your family or authorized person about your location , your general condition or, unless you have instructed us otherwise, in the event of your death. In the event of a disaster, we may disclose information to a relief organization so that they may coordinate these notification efforts. We may also disclose information to someone who is involved with your care or helps pay for your care. If you are able and available to agree or object, we will give you the opportunity to do so prior to making these disclosures. We may disclose this information in a disaster, even over your objection, if we believe it is necessary to respond to the emergency circumstances. 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.
Business Associates. Centric Health may disclose PHI to its business associates to perform certain business functions or provide certain business services to Centric Health. For example, we may use another company to perform billing services on our behalf. All of our business associates are required to maintain the privacy and confidentiality of your PHI. In addition, at the request of your health care providers or health plan, we may disclose PHI to their business associates for purposes of performing certain business functions or health care services on their behalf. For example, we may disclose PHI to a business associate of Medicare for purposes of medical necessity review and audit.
Marketing. Provided we do not receive any payment for making these communications, we may contact you to give you information about products or services related to your treatment, case management or care coordination, or to direct or recommend other treatments, therapies, health care providers or settings of care that may be of interest to you. We will not otherwise use or disclose your medical information for marketing purposes or accept any payment for other marketing communications without your prior written authorization. The authorization will disclose whether we receive any compensation for any marketing activity you authorize, and we will stop any future marketing activity to the extent you revoke that authorization.
Sale of Health Information. We will not sell your health information without your prior written authorization. The authorization will disclose that we will receive compensation for your health information if you authorize us to sell it, and we will stop any future sales of your information to the extent that you revoke that authorization.
Required by Law. Centric Health must disclose PHI if required to do so by federal, state or local law, but we will limit our use or disclosure to the relevant requirements of the law.
Judicial or Administrative Proceedings. Under certain circumstances, Centric Health may disclose your PHI in the course of a judicial or administrative proceeding, including in response to a court or administrative order, subpoena, discovery request or other lawful purpose.
Public Health. Centric Health may, and is sometimes required by law, to disclose your PHI to public health authorities for purposes related to: preventing or controlling disease, injury or disability; reporting child, elder or dependent adult 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. When we report suspected elder or dependent adult abuse or domestic violence, we will inform you or your personal representative promptly unless in our best professional judgment, we believe the notification would place you at risk of serious harm or would require informing a personal representative we believe irresponsible for the abuse or harm.
Health Oversight Activities. Centric Health may, and is sometimes required by law, to disclose your PHI to health oversight agencies during the course of audits, investigations, inspections, licensure and other proceedings, subject to the limitations imposed by law.
Coroners, Medical Examiners and Funeral Directors. Centric Health may disclose PHI to a coroner, medical examiner, or funeral director for the purpose of identifying a deceased person, determining cause of death, or for performing some other duty authorized by law.
Personal Representative. Centric Health may disclose PHI to your personal representative, as established under applicable law, or to an administrator, executor, or other authorized individual associated with your estate.
Correctional Institution. Centric Health may disclose the PHI of an inmate or other individual when requested by a correctional institution or law enforcement official for health, safety, and security purposes.
Serious Threat to Health or Safety. Centric Health may disclose PHI if necessary to prevent or lessen a serious and/or imminent threat to health or safety to a person or the public or for law enforcement authorities to identify or apprehend an individual.
Judicial and Administrative Proceedings. Centric Health may, and is sometimes required by law, to disclose your health information in the course of any administrative or judicial proceeding to the extent expressly authorized by a court or administrative order. We may also disclose information about you in response to a subpoena, discovery request or other lawful process if reasonable efforts have been made to notify you of the request and you have not objected, or if your objections have been resolved by a court or administrative order
Law Enforcement. Centric Health may, and is sometimes required by law, to disclose your PHI for law enforcement purposes, including reporting of certain types of wounds or physical injuries or in response to a court order, warrant, subpoena, summons or similar process authorized by law. We may also disclose PHI when the information is needed for identifying or locating a suspect, fugitive, material witness or missing person; about a victim of a crime; about an individual who has dies; in relation to criminal conduct on our premises; or in emergency circumstances to report a crime, the location of a crime, or victims, or the identity, description or location of a person who has committed a crime.
Workers’ Compensation. Centric Health may disclose your PHI as necessary to comply with workers’ compensation laws. For example, to the extent your care is covered by workers' compensation, we will make periodic reports to your employer about your condition. We are also required by law to report cases of occupational injury or occupational illness to the employer or workers' compensation insurer.
Change of Ownership. In the event that this medical practice is sold or merged with another organization, your health information/record will become the property of the new owner, although you will maintain the right to request that copies of your health information be transferred to another physician or medical group.
Research. Centric Health may disclose your PHI for research purposes. Limited data or records may be viewed by researchers to identify patients who may qualify for their research project or for other similar purposes, so long as the researchers do not remove or copy any of the PHI. Before we use or disclose PHI for any other research activity, one of the following will happen: 1) a special committee will determine that the research activity poses minimal risk to privacy and that there is an adequate plan to safeguard PHI; 2) if the PHI relates to deceased individuals, the researchers give us assurances that the PHI is necessary for the research and will be used only as part of the research; or 3) the researcher will be provided only with information that does not identify you directly.
Government Functions. In certain situations, Centric Health may disclose the PHI of military personnel and veterans, including Armed Forces personnel, as required by military command authorities. Additionally, we may disclose PHI to authorized officials for national security purposes, such as protecting the President of the United States, conducting intelligence, counter-intelligence, other national security activities, and when requested by foreign military authorities. Disclosures will be made only in compliance with U.S. Law.
Fundraising. Centric Health may use or disclose your demographic information in order to contact you for our fundraising activities. If you do not want to receive these materials, notify the Privacy Officer listed at the top of this Notice of Privacy Practices and we will stop any further fundraising communications.
De-identified Information and Limited Data Sets: Centric Health may use and disclose health information that has been “de-identified” by removing certain identifiers making it unlikely that you could be identified. Centric Health also may disclose limited health information, contained in a “limited data set”. The limited data set does not contain any information that can directly identify you. For example, a limited data set may include your city, county and zip code, but not your name or street address.
Centric Health is required to provide patient notification if it discovers a breach of unsecured PHI unless there is a demonstration, based on a risk assessment, that there is a low probability that the PHI has been compromised. You will be notified without unreasonable delay and no later than 60 days after discovery of the breach. Such notification will include information about what happened and what can be done to mitigate any harm.
Subject to certain exceptions, HIPAA provides the following patient rights with respect to PHI : Right to Request Confidential Communications. You have the right to request that you receive your PHI in a specific way or at a specific location. For example, you may ask that we send information to a particular e-mail account or to your work address. We will comply with all reasonable requests submitted in writing which specify how or where you wish to receive these communications.
Right to Inspect and Copy. You have the right to inspect and request a copy of your PHI, with limited exceptions. To access your medical information, you must submit in writing a request detailing what information you want to access. Information can be requested in hard copy or electronic format if it is readily producible. We will provide you with an alternative format you find acceptable. We will also send a copy to any other person you designate in writing. We will charge a reasonable fee which covers our costs for labor, supplies, postage, and if requested and agreed to in advance the cost of preparing an explanation or summary. We may deny your request under limited circumstances.
Right to Amend or Supplement. You have a right to request that we amend your PHI that you believe is incorrect or incomplete. You must make a request to amend in writing, and include the reasons you believe the information is inaccurate or incomplete. We are not required to change your health information, and will provide you with information about this medical practice's denial and how you can disagree with the denial.
Right to an Accounting of Disclosures. You have a right to receive an accounting of certain disclosures of your PHI made by this medical practice, except that this medical practice does not have to account for the disclosures provided to you or pursuant to your written authorization.
Right to a Paper or Electronic Copy of this Notice. You have a right to notice of our legal duties and privacy practices with respect to your PHI, including a right to a paper copy of this Notice of Privacy Practices, even if you have previously requested its receipt by e-mail.
Right to Request Limits on Uses and Disclosures of your PHI. You have the right to request that we limit: 1) how we use and disclose your PHI for treatment, payment, and health care operations activities; or 2) our disclosure of PHI to individuals involved in your care or payment for your care. Centric Health will consider your request, but is not required to agree to it unless the requested restriction involves a disclosure that is not required by law to a health plan for payment or health care operations purposes and not for treatment, and you have paid for the service in full out of pocket. If we agree to a restriction on other types of disclosures, we will state the agreed restrictions in writing and will abide by them, except in emergency situations when the disclosure is for purposes of treatment.
To exercise any of your rights described in this notice, you must send a written request to: HIPAA Privacy Officer, Centric Health, 5080 California Ave., Suite 420, Bakersfield, CA 93309. Patients may update insurance and/or billing information through our website or by contacting the Patient Billing Department using the phone number indicated on the billing invoice.
Centric Health reserves the right to make changes to this notice and to our privacy policies from time to time. When changes are made, we will promptly update this notice and post the information on our website. Until such amendment is made, we will comply with the terms of the notice of our privacy policies currently in effect. After an amendment is made, the revised Notice of Privacy Protections will apply to all protected health information that we maintain, regardless of when it was created or received.
If you have questions or comments regarding our Notice of Privacy Practices, or have a complaint about our use or disclosure of your PHI or our privacy practice, please contact our Privacy Officer at (661) 371-2771 or send a written request to: HIPAA Privacy Officer, Centric Health, 5080 California Ave., Suite 420, Bakersfield, CA 93309.
You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services at the address listed below. Centric Health will not take any retaliatory action against anyone for filing a complaint about our privacy practices.
Department of Health and Human Services
Office of Civil Rights
Hubert Humphrey Bldg.
200 Independence Avenue, SW
Room 509F HHH Building
Washington, D.C. 20201
The complaint form may be found at www.hhs.gov/ocr/privacy/hipaa/complaints/hipcomplaint.pdf.