Effective Date: January 1, 2010
THIS POLICY 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 Policy applies to the delivery of health care by Idaho Therapy Source and its staff in its main clinic.
I. Permitted Use or Disclosure.
Idaho Therapy Source will use and disclose your PHI to provide, coordinate, or manage your health care and related services to carry out treatment functions. The following are examples of how Idaho Therapy Source will use and/or disclose your PHI:
♦ To your attending physician, consulting physician(s), and other health care providers who have a legitimate need for such information in your care and continued treatment.
♦ To coordinate your treatment (e.g., appointment scheduling) with us and other health care providers such as name, address, employment, insurance carrier, etc.
♦ To contact you as a reminder that you have an appointment for treatment or medical care at our facilities.
♦ To provide you with information about treatment alternatives or other health-related benefits or services.
♦ If you are an inmate of a correctional institution or under the custody of a law enforcement officer, Idaho Therapy Source will disclose your PHI to the correctional institution or law enforcement official.
Idaho Therapy Source will use and disclose PHI about you for payment purposes. The following are examples of how Idaho Therapy Source will use and/or disclose your PHI:
♦ To an insurance company, third party payer, third party administrator, health plan or other health care provider (or their duly authorized representatives) for payment purposes such as determining coverage, eligibility, pre-approval / authorization for treatment, billing, claims management, reimbursement audits, etc.
♦ To collection agencies and other subcontractors engaged in obtaining payment for care.
C. Health Care Operations.
Idaho Therapy Source will use and disclose your PHI for health care operations purposes. The following are examples of how Idaho Therapy Source will use and/or disclose your PHI:
♦ For case management, quality assurance, utilization, accounting, auditing, population based activities relating to improving health or reducing health care costs, education, accreditation, licensing and credentialing activities of Idaho Therapy Source.
♦ To consultants, accountants, auditors, attorneys, transcription companies, information technology providers, etc.
D. Other Uses and Disclosures.
As part of treatment, payment and health care operations,
Idaho Therapy Source may also use your PHI for the following purposes:
♦ Fundraising Activities: Idaho Therapy Source will use and may also disclose some of your PHI to a related foundation for certain fundraising activities. For example, Idaho Therapy Source may disclose your demographic information, your treatment dates of service, treating physician information, department of service and outcomes information to the foundation who may ask you for a monetary donation. Any fundraising communication sent to you will let you know how you can exercise your right
to opt-out of receiving similar communications in the future.
♦ Medical Research: Idaho Therapy Source will use and disclose your PHI without your authorization to medical researchers who request it for approved medical research projects. Researchers are required to safeguard all PHI they receive.
♦ Information and Health Promotion Activities: Idaho Therapy Source will use and disclose some of your PHI for certain health promotion activities. For example, your name and address will be used to send you general newsletter or specific information based on your own health concerns.
E. More Stringent State and Federal Laws
The State law of Idaho is more stringent than HIPAA in several areas. Certain federal laws also are more stringent than HIPAA. Idaho Therapy Source will continue to abide by these more stringent state and federal laws.
i. More Stringent Federal Laws: The federal laws include applicable internet privacy laws, such as the Children’s Online Privacy Protection Act and the federal laws and regulations governing the confidentiality of health information regarding substance abuse treatment.
ii. More Stringent State Laws: State law is more stringent when the individual is entitled to greater access to records than under HIPAA. State law also is more restrictive when the records are more protected from disclosure by state law than under HIPAA. In cases where Idaho Therapy Source provides treatment to a patient who resides in a neighboring state Idaho Therapy Source will abide by the more stringent applicable state law.
II. Permitted Use or Disclosure with an Opportunity for You to Agree or Object
Idaho Therapy Source will disclose PHI about you to a friend or family member who is involved in or paying for your medical care. You have a right to request that your PHI not be shared with some or all of your family or friends. In addition, Idaho Therapy Source will disclose PHI about you to an agency assisting in disaster relief efforts so that your family can be notified about your condition, status, and location.
B. Idaho Therapy Source – Facility Client Contacts List.
Idaho Therapy Source will include certain information about you in its facility client contacts list while you are a patient at Idaho Therapy Source. This information will include your name and your general condition (active, inactive, discharged, etc.). The contacts list information will be disclosed to people who ask for you by name. You have the right to request that your name not be included in Idaho Therapy Source's contacts list. If you request to opt-out of the contacts list, we cannot inform visitors of your presence, location, or general condition.
C. Spiritual Care.
Directory information, including your religious affiliation, will be given to a member of the clergy, even if they do not ask for you by name. Spiritual care providers may be consulted upon regarding your care. You have the right to request that your name not be given to any
member of the clergy.
D. Media Reports.
Idaho Therapy Source will release facility directory information to the media (excluding religious affiliation) if the media requests information about you using your name and after we have given you an opportunity to agree or object.
III. Use or Disclosure Requiring Your Authorization.
Subject to certain limited exceptions, your written authorization is required in cases where Idaho Therapy Source receives any direct or indirect financial remuneration in exchange for making the communication to you which encourages you to purchase a product or service or for a disclosure to a third party who wants to market their products or services to you.
Idaho Therapy Source will obtain your written authorization to use or disclose your PHI for research purposes when required by HIPAA.
C. Psychotherapy Notes.
Most uses and disclosures of psychotherapy notes require your
D. Sale of PHI.
Subject to certain limited exceptions, disclosures that constitute a sale of PHI require your written authorization.
E. Other Uses and Disclosures.
Any other uses or disclosures of PHI that are not described
IV. Use or Disclosure Permitted or Required by Public Policy or Law without your Authorization
A. Law Enforcement Purposes.
Idaho Therapy Source will disclose your PHI for law enforcement purposes as required by law, such as identifying a criminal suspect or a missing person, or providing information about a crime victim or criminal conduct.
B. Required by Law.
Idaho Therapy Source will disclose PHI about you when required by federal, state or local law. Examples include disclosures in response to a court order/subpoena, mandatory state reporting (e.g., gunshot wounds, victims of child abuse or neglect), or information necessary to comply with other laws such as workers’ compensation or similar laws.
C. Public Health Oversight or Safety
Idaho Therapy Source will use and disclose PHI to avert a serious threat to the health and safety of a person or the public. Examples include disclosures of PHI to state investigators regarding quality of care or to public health agencies regarding immunizations, communicable diseases, etc. Idaho Therapy Source will use and disclose PHI for activities related to the quality, safety or effectiveness of FDA regulated products or activities, including collecting and reporting adverse events, tracking and facilitating in product recalls, etc.
D. Coroners, Medical Examiners, Funeral Directors
Idaho Therapy Source will disclose your PHI to a coroner or medical examiner. For example, this will be necessary to identify a deceased person or to determine a cause of death. Idaho Therapy Source may also disclose your medical information to funeral directors as necessary to carry out their duties.
E. Specialized Government Functions.
Idaho Therapy Source will disclose your PHI regarding government functions such as military, national security and intelligence activities. Idaho Therapy Source may disclose PHI to the Department of Veterans Affairs to determine whether you are eligible for certain benefits.
V. Your Health Information Rights.
You have the following individual rights concerning your PHI:
A. Right to Inspect and Copy.
Subject to certain limited exceptions, you have the right to
access your PHI and to inspect and copy your PHI as long as Idaho Therapy Source maintains the data. If Idaho Therapy Source denies your request for access to your PHI, Idaho Therapy Source will notify you in writing with the reason for the denial. For example, you do not have the right to therapy notes or to inspect the information which is subject to law prohibiting access. You may have the right to have this decision reviewed. You also have the right to request your PHI in electronic format in cases where Idaho Therapy Source utilizes electronic health records. You will be charged a reasonable copying fee in accordance with applicable federal or state law.
B. Right to Amend.
You have the right to amend your PHI for as long as Idaho Therapy Source maintains the data. You must make your request for amendment of your PHI in writing to Idaho Therapy Source, including your reason to support the requested amendment. However, Idaho Therapy Source will deny your request for amendment if:
♦ Saint Alphonsus Health System did not create the information;
♦ The information is not part of the designated record set;
♦ The information would not be available for your inspection (due to its condition or nature); or
♦ The information is accurate and complete.
If Idaho Therapy Source denies your request for changes in your PHI, Idaho Therapy Source will notify you in writing with the reason for the denial. Idaho Therapy Source will also inform you of your right to submit a written statement disagreeing with the denial. You may ask that Idaho Therapy Source include your request for amendment and the denial any time that Idaho Therapy Source subsequently discloses the information that you wanted changed. Idaho Therapy Source may prepare a rebuttal to your statement of disagreement and will provide you with a copy of that rebuttal.
B. Right to an Accounting.
You have a right to receive an accounting of the disclosures of
your PHI that Idaho Therapy Source has made, except for the following disclosures:
♦ To carry out treatment, payment or health care operations;
♦ To you;
♦ To persons involved in your care;
♦ For national security or intelligence purposes; or
♦ To correctional institutions or law enforcement officials.
You must make your request for an accounting of disclosures of your PHI in writing to Idaho Therapy Source. You must include the time period of the accounting, which may not be longer than 6 years.
In any given 12-month period, Idaho Therapy Source will provide you with an accounting of the disclosures of your PHI at no charge. Any additional requests for an accounting within that time period will be subject to a reasonable fee for preparing the accounting.
C. Right to Request Restrictions.
You have the right to request restrictions on certain uses and disclosures of your PHI to carry out treatment, payment or health care operations functions or to prohibit such disclosure. However, Idaho Therapy Source will consider your request but is not required to agree to the requested restrictions.
D. Right to Request Restrictions to a Health Plan.
You have the right to request a restriction on disclosure of your PHI to a health plan (for purposes of payment or health care operations) in cases where you paid out of pocket, in full, for the items received or services rendered.
E. Right to Confidential Communications.
You have the right to receive confidential communications of your PHI by alternative means or at alternative locations. For example, you may request that Idaho Therapy Source only contact you at work or by mail.
F. Right to Receive a Copy of this Policy.
VI. Breach of Unsecured PHI.
If a breach of unsecured PHI affecting you occurs, Idaho Therapy Source is required to notify you of the breach.
VII. Sharing and Joint Use of Your Health Information.
In the course of providing care to you and in furtherance of Idaho Therapy Source’s mission to improve the health of its patients, Idaho Therapy Source will share your PHI with other organizations as described below who have agreed to abide by the terms described below:
A. Clinic Staff.
The medical staffs of Idaho Therapy Source participate in an organized health care arrangement to deliver health care to you. Both Idaho Therapy Source and all of its respective clinic staff have agreed to abide by the terms of this Policy with respect to PHI created or received as part of delivery of health care to you by Idaho Therapy Source. Therapists and staff who are members of Idaho Therapy Source will have access to and use your PHI for treatment, payment and health care operations purposes related to your care within Idaho Therapy Source. Idaho Therapy Source will disclose your PHI to the therapy staff for treatment, payment and health care operations.
B. Business Associates.
Idaho Therapy Source will share your PHI with business associates and their subcontractors contracted to perform business functions on Idaho Therapy Source's behalf, including Inversión Consultant Services, which performs certain business functions for Idaho Therapy Source.
VIII. Changes to this Notice.
Idaho Therapy Source will abide by the terms of the Policy currently in effect. Idaho Therapy Source reserves the right to make material changes to the terms of its Notice and to make the new Policy provisions effective for all PHI that it maintains. Idaho Therapy Source will distribute/provide you with a revised Policy at your first visit following the revision of the Policy in cases where it makes a material change in the Policy. You can also ask Idaho Therapy Source for a current copy of the Policy at any time.
If you believe your privacy rights have been violated, you may file a complaint with Idaho Therapy Source’s Privacy Official or with the Secretary of the Department of
Health and Human Services. All complaints must be submitted in writing directly to Idaho Therapy Source’s Privacy Official. Idaho Therapy Source assures you that there will be no retaliation for filing a complaint. You will not be retaliated against for filing any complaint.
X. Privacy Official.
Idaho Therapy Source, PLLC
16171 N. Brinson St.
Nampa, Idaho 83687