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 respect patient confidentiality and only release protected health information (“PHI”) about you in accordance with Ohio and federal law. Our internal policies and procedures are designed to control and protect the
confidentiality and security of your personal information whether in written, oral, or electronic format. We train our employees on these policies and procedures. Employees who violate our confidentiality and security policies are subject to disciplinary action. You may also file a complaint with the Secretary of Health and Human Services if you believe Care Alliance has violated your privacy rights. No action will be taken against you as a result of filing a complaint.
NOTICE OF PRIVACY AS IT RELATES TO ELECTRONIC MEDICAL RECORDS
Care Alliance is part of an organized health care arrangement including participants in OCHIN. A current list of OCHIN participants is available at http://www.community-health.org/partners.html. As a business associate of Care Alliance, OCHIN supplies information technology and related services to Care Alliance and other OCHIN participants. OCHIN also engages in quality assessment and improvement activities on behalf of its participants. For example, OCHIN coordinates clinical review activities on behalf of participating organizations to establish best practice standards and assess clinical benefits that may be derived from the use of electronic health record systems. OCHIN also helps participants work collaboratively to improve the management of internal and external patient referrals. Your health information may be shared by Care Alliance with other OCHIN participants when necessary for health care operations purposes of the organized health care arrangement and treatment. Patient hereby authorizes the electronic transfer of information contained in a patient’s medical record to specific third parties. Such authorization permits medical records to be released to the following parties: OCHIN and its members; insurance company; government agencies; health information exchange; and other health care third parties.
Once the patient has given consent to release the electronic record, the disclosure requirement is valid unless a written request from the patient is otherwise received. Care Alliance maintains an integrated electronic health record. This means that medical providers and behavioral health practitioners document necessary health information in one electronic record. Care Alliance medical providers and behavioral health practitioners routinely share relevant patient health information as it relates to treatment, payment, and health care operations. For health information exchange (HIE): We may make your PHI available electronically through an information exchange service to other health care providers, health plans, and health care clearinghouses that request your information for treatment or payment for that treatment. Participation in health information exchange services also provides that we may see information about you from other participants. Your participation in a HIE is subject to your right to opt-out. Where possible, you will be provided with educational information prior to the enrollment to these services.
USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION
In order to effectively provide health care, there are times when we will need to share your PHI with others outside Care Alliance. Below describes different ways that we will use and disclose your medical information. Not every use or disclosure in a category will be listed. However, all of the ways that we are allowed to use or disclose your Medical Information should fall within one of these categories:
- Treatment. We may share PHI about you with others to provide, coordinate, or manage your care or any related services. For example, to coordinate the different ways that Care Alliance needs to care for you, such as for prescriptions, we may need to disclose PHI to non-Care Alliance health care providers Payment. PHI will be used to obtain payment for the treatment and services provided. This may include contacting your health insurance company for prior approval of treatment or for billing purposes.
- Health Care Operations. We may use information about you to coordinate certain business activities; for example, setting up appointments and reviewing your care. Care Alliance is part of an organized health care arrangement including participants in OCHIN. Your health information may be shared by Care Alliance with other OCHIN participants when necessary for health care operations purposes of the organized health care arrangement.
- Emergencies. Information may be shared to address the immediate emergency you are facing.
- Follow Up Appointments/Care. We may contact you to remind you of future appointments or to provide information about treatment alternatives or other health-related benefits and services.
- As Required by Law. This would include situations where we have a subpoena, court order or are mandated to provide public health information, such as information regarding communicable diseases or suspected abuse and neglect.
- Coroners, Funeral Directors. We may disclose PHI to a coroner, personal health examiner or funeral director for the purpose of carrying out their duties.
- Governmental Requirements. We may disclose information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections and licensure. There might also be a need to share information with the Food and Drug Administration related to adverse events or product defects. If requested we are required to share information with the Department of Health and Human Services to determine our compliance with federal health care laws.
- Criminal Activity or Danger to Others. If a crime is committed on our premises or against our personnel, we may share information with law enforcement officials to assist in the apprehension of the criminal. Also, if we believe you present an immediate danger to yourself or others, we may share information with appropriate law enforcement officers.
- Other Uses of PHI. Other uses and disclosures of PHI not covered by this Notice or the laws that apply to Care Alliance will be made only with your written authorization. Disclosures and internal sharing of any psychotherapy notes (process notes externally maintained from your integrated health record) will be made only with your written authorization. You may cancel that authorization at any time by sending a written request to our Privacy Officer. Care Alliance is unable to take back any disclosures we have already made with your authorization.
- Health Information Exchange. We participate in one or more Health Information Exchanges. Your healthcare providers can use this electronic network to securely provide access to your health records for a better picture of your health needs. We and other healthcare providers, may allow access to your health information through the Health Information Exchange for treatment, payment or other healthcare operations. This is a voluntary agreement. You may opt-out at any time by notifying the Care Alliance.
Care Alliance Health Center is part of an organized health care arrangement including participants in OCHIN. A current list of OCHIN participants is available at www.ochin.org as a business associate of Care Alliance Health Center OCHIN supplies information technology and related services to Care Alliance Health Center and other OCHIN participants. OCHIN also engages in quality assessment and improvement activities on behalf of its participants. For example, OCHIN coordinates clinical review activities on behalf of participating organizations to establish best practice standards and assess clinical benefits that may be derived from the use of electronic health record systems. OCHIN also helps participants work collaboratively to improve the management of internal and external patient referrals. Your health information may be shared by Care Alliance Health Center with other OCHIN participants when necessary for health care operations purposes of the organized health care arrangement.
WHERE TO FILE A COMPLAINT
You have the right to complain to CAHC or Secretary of the Department of Health and Human Services if you believe your rights to privacy have been violated. All complaints will be investigated. No personal issue will be raised for filing a complaint with the CAHC. If you feel your privacy rights have been violated or you want further information about our Notice of Privacy Practices, please write or call CAHC privacy contact person at:
Attn: Privacy Officer
Care Alliance Health Center
1530 St Clair NE
Cleveland, Ohio 44114
Tel. (216) 535-9100
You may also file a written complaint with the Secretary of the U.S. Department of Health and Human Services, 200 Independence Avenue SW, Washington, D.C., 20201 or call toll-free (877) 696-6775, by e-mail to OCRComplaint @ hhs.gov, or to Region V, Office for Civil Rights, U.S. Department of Health and Human Services, 233 N. Michigan Ave., Suite 240, Chicago, Ill. 60601, Voice Phone (312) 886-2359, FAX (312) 886-1807, or TDD (312) 353-5693.
HOW TO CONTACT US:
Practice Name: Care Alliance Health Center. Email: email@example.com Address: 1530 St. Clair Ave NE, Cleveland, Ohio 44114