Notice of Privacy Practices (NPP) for Protected Health Information (PHI)

UNDERSTANDING YOUR MEDICAL RECORD AND HEALTH INFORMATION

Each time you visit a hospital, doctor, or other healthcare provider, your visit is documented. Typically, such documentation contains information about your health signs and symptoms; results of your physical examination and diagnostic tests; an assessment of your current medical condition; and a plan for your future care or treatment. Often referred to as your health or medical record, this body of information is considered protected health information (PHI), and it also serves as a basis for planning and tracking your care and treatment, as well as a means of communication among the individual healthcare professionals who participate in your care.

The medical record is a legal document, describing in detail the care you received and is the means by which you and your insurance carrier can verify that the services billed were actually provided. The medical record serves as a tool in educating health professionals and can provide a valuable source of data for medical research and for quality improvement initiatives. It may also be utilized by public health officials charged with improving the overall health of the community. Moreover, the medical record may be used as a resource for information needed in organization planning and service marketing.

Therefore, understanding what is contained in your medical record and how your PHI is or may be used helps you (a) to examine and ensure its accuracy; (b) to understand more clearly how others may access your health information; and (c) to make more informed decisions when authorizing use or disclosure of that information to others.

While the medical record is the property of Evolved Medical Health, the information contained therein belongs to you. Subsequent sections of this Notice delineate how the law permits us to use, share, or disclose your protected health information and define your rights and choices with respect to your PHI and our responsibilities as custodian and steward of your health record.

 

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION FOR TREATMENT, PAYMENT AND HEALTHCARE OPERATIONS

 

Evolved Medical Health requests that you sign a General Consent for Treatment form whenever necessary to keep your medical record accurate and up-to-date. This General Consent allows the organization, to use or disclose your health information for purposes relating to treatment, payment, and healthcare operations, as follows:

For treatment. We can use your health information and share it with other professionals who are treating you. Information obtained by a nurse, physician, health educator, and other members of your healthcare team will be documented in your medical record and will be used to determine the appropriate course of treatment for your particular medical issues, problems, or concerns, as well as to ensure that there will be continuity when transitions in your care occur. Your record may also contain copies of results from tests performed in the Clinic (e.g. laboratory and radiology studies) and correspondence from other healthcare professionals who have been or are treating you outside the Clinic. We may share your medical information 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 for you. Hence, your physician will have an accurate, timely, and complete picture of your medical history and overall health condition when viewing your PHI and will be better able to treat your current medical problems safely.

For payment. When applicable, we can use and share your health information to bill and get payment from health plans and other payers. Following your treatment, a bill for services rendered is sent to you or to a third party payer (e.g. insurance company, health plan, etc.). The information on the bill may include information that identifies you, as well as your diagnosis, any procedure performed, and medications and supplies used. However, you may request that PHI associated with that portion of your healthcare for which you paid out-of- pocket in full not be disclosed to your health plan or insurance company.

For our operations. We can use and share your health information to run our practice, improve care, and plan for the future. We may use and disclose information about you to keep Evolved Medical Health in operation. Medical staff, the risk manager, quality management personnel, or members of the process and quality improvement team may use information in your medical record to assess the care and outcomes in your case and others like it. This information will then be used to enhance the quality and improve the effectiveness of the healthcare and services we provide all our patients. We may also use and disclose PHI when necessary for medical reviews, attorney services and legal audits, including fraud and abuse detection and compliance programs, as well as business planning and facility management.

For working with our business associates. There are services provided in our organization through agreements with contractors or “business associates.” Examples include consultants we may hire to assist us in various aspects of health care administration. When these services are contracted, we may disclose your protected health information to such business associates and their subcontractors so that they can perform the job they are contracted to do. These business associates must agree to safeguard your PHI.

For continuity of care. As indicated earlier, we may share PHI with, or permit access to your PHI to, authorized providers and outside healthcare entities (i.e. covered entities) responsible for your care and treatment. When clinical records are available to the provider at the point of care, the patient receives more accurate and timely service that leads to improved overall patient experience.

For notifications and reminders. We may contact you by SMS, e-mail, or telephone in order to remind you of an upcoming appointment or to inform you about test results. Evolved Medical Health takes privacy and security matters very seriously, and in the event of a privacy violation or security breach involving your PHI, we are also obligated to notify you in accordance with Federal privacy regulations and/or State confidentiality requirements.

For communicating with your family and patient representatives. We can use your health information for internal and external communications. Using their best judgment and your authorization, Clinic healthcare professionals may disclose PHI to your family member, patient representative, or any other person you identify as being involved in your personal care or bill payment.

For research. We can use or share your information for health research activities. We may disclose information to researchers when an institutional review board (IRB) or privacy board, which among other requirements has reviewed the research proposal and established protocols to ensure the privacy and confidentiality of your health information, has approved the research. Identifying information is typically removed when data is collected for research purposes.

For marketing. We can use your protected health information for marketing purposes.We may contact you to provide information about treatment alternatives, new medications, or other health-related benefits, programs, and services that may be of interest to you.

For fundraising. We may contact you as part of a fundraising or philanthropic effort. In this situation you have the right to opt out of the specific fundraising or philanthropic solicitation, and you will be provided timely instructions on how to opt out. You can simply tell us not to contact you again. You also have the option of sending a request to be removed from our mailing list. You may do so by directly emailing help@evolvedmedical.com. Moreover, we may not condition treatment on your decision concerning the receipt of fundraising information, and you may opt-in anytime.

For reporting cases pertaining to public health. As required by law, we may disclose your health information to public health officials or legal authorities charged with preventing or controlling disease, injury, or disability, as well as with helping to recall products. Such information reporting may include, but is not limited to, the documentation and reporting of abuse, neglect, or domestic violence; the reporting of communicable diseases; and the reporting of reactions to medications or problems with products or devices. Additionally, we may share your PHI for the express purpose of preventing or reducing a serious threat to anyone’s health or safety.

For law enforcement purposes. We may disclose your health information if requested by law enforcement, military police, homeland security, presidential protective services, or legal authorities. If asked to do so by such law enforcement officials or legal agencies, we may release your PHI in the following circumstances: (a) suspicion of criminal conduct or potential death due to criminal conduct; or (b) in response to a warrant, summons, administrative order, court order, subpoena or other similar legal process.

For compliance with the law. We will share your health information if Federal or State laws require it. This type of disclosure includes sharing your PHI with the Department of Health and Human Services, the California Department of Public Health, and, more specifically, with the Office of Civil Rights as evidence of compliance with HIPAA Privacy Rules.

AUTHORIZATIONS

When Evolved Medical Health is requesting permission to use your protected health information for purposes other than treatment, payment or healthcare operations (TPO), to disclose your PHI to a third party for purposes not outlined above, or for any use or disclosure for the purpose of marketing or the sale of your PHI, you will be asked to sign an authorization.

YOUR RIGHTS AND CHOICES

Your protected health information as contained in the medical record belongs to you. Hence, you have certain rights and defined choices regarding your PHI that we store and maintain for you. For example, you can make a choice with regard to what we can disclose when sharing information in a disaster relief situation and also when allowing the Clinic to include information about you in one of our publications. Other choices you can make are as follows:

1. Obtain a paper copy of this Notice of Privacy Practices for Protected Health Information (NPP) promptly upon request. A copy of this same NPP is posted on our website, www.evolvedmedical.com. Even if you have obtained this NPP in another form or at another time or somewhere else, you are still entitled to a paper copy of this Notice anytime you request it.

2. Obtain a copy of your medical record. You may obtain a copy of your medical record by putting your request in writing at our clinic location. There may be administrative fees involved in providing you either a paper-based or electronic copy for your personal use. However, once a valid release form is on file, there are no charges if the copy is to go directly from the ROI Correspondence Office to your physician, to another healthcare provider, or to any other third party per your personal directive. Your request will be processed in a timely manner according to policy, format, and type of release, and you will be notified as soon as your request is completed.

3. To be notified promptly by Evolved Medical Health and/or a business associate following a confirmed breach of your Protected Health Information. For example, upon discovery that protected health information about you, such as your lab results or x-ray reports, was sent to an unauthorized recipient, we must inform you within required time limits. Furthermore, without unreasonable delay, we must notify certain government agencies as required by law.

11. To choose someone to act for you as your patient representative. If you have given someone medical power of attorney or if someone is your designated legal guardian, that person can exercise your rights on your behalf and make choices about your health information. Evolved Medical Health will, however, make sure that your personal representative has such authority and can act for you before we take any action.

OUR RESPONSIBILITIES

Evolved Medical Health is required by law to maintain the privacy and security of your protected health information. We must provide you with a notice as to our legal duties and privacy practices with respect to the information we collect and maintain about you. The Clinic must abide by the terms of this Notice of Privacy Practices and must notify you promptly if we are unable to agree to a requested restriction. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your PHI. We reserve the right to change our practices and to make the new provisions effective for all PHI we maintain. We will not use or disclose your PHI without your authorization except as described in this NPP. If you tell us we can use your PHI, you may change your mind at any time as long as you notify us in writing. Should our information practices change, we will post an updated NPP, and it shall be also made available to you though our website, www.evolvedmedical.com in a timely manner or anytime upon request.

FOR MORE INFORMATION, TO REPORT A PROBLEM OR TO FILE A COMPLAINT

If you have questions and would like additional information, you may contact Evolved Medical Health by phone at (925) 433-8444.

Additionally, you may file a complaint with the U. S. Secretary of the Department of Health and Human Services (DHHS), Office for Civil Rights, by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201; by calling (877) 696-6775; or by visiting its official website at https://www.hhs.gov/hipaa/filing- a-complaint/complaint-process/. There will be no retaliation for filing a complaint with us or with the Office for Civil Rights.

 

Neither John Muir Medical Group (JMMG), John Muir Health (JMH) nor the John Muir Physician Network (JMHPN) have any affiliation with this website or the products or practitioners featured on this website. JMH, JMHPN and JMMG do not in any way vet or endorse the products or practitioners featured on this website.

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