Notice of Protected Health Information Practices
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.
Purpose of Notice
Each time that you visit a hospital, physician or other healthcare provider, a record of your visit is made. Typically, this record contains your health history, symptoms, examination and test results, diagnoses, treatment, a plan for future care or treatment and claims and payment history. This information, often referred to as your health or medical record serves as a:
· Basis for planning your care and treatment;
· Means of communication among the many health professionals who contribute to your care;
· Legal document describing the care you received;
· Means by which you or a third-party payer can verify that services billed were actually provided;
· A tool in educating health professionals
· A source of data for medical research;
· A source of information for public health officials charged with improving the health of the nation;
· A source of data for facility planning and marketing; and
· A tool with which a healthcare provider or facility can access and continually work to improve the care that it renders and outcomes that it achieves.
Understanding what is in your record and how your health information is used helps you to:
· Ensure its accuracy;
· Better understand who, what, when, where and why others may access your health information;
· Make more informed decisions when authorizing disclosures to others.
Under the federal health care privacy regulations pertaining to the Health Insurance Portability and Accountability Act of 1996 set forth at 45 CFR § 160.101 et seq. (the Privacy Regulations), Allegheny Valley School ("AVS") is required to protect the privacy of your individually identifiable health information which appears in your medical record. We are also required to provide you with this Notice of Protected Health Information Practices regarding our legal duties, policies and procedures to protect and maintain the privacy of your health information and your medical record (the "Notice"). We will not use or disclose your health information except as provided for in this Notice. However, we reserve the right to change the terms of this Notice and make new notice provisions for all your health information that we maintain. Should such terms change, we will mail a revised Notice to the mailing address most recently listed in your medical record.
Permitted Uses and Disclosures of Your Health Information
1. Uses and Disclosures with Patient Consent: Under the Privacy Regulations, after having made good faith efforts to obtain your acknowledgement of receipt of this Notice, we are permitted to use and disclose your health information for the following purposes:
a. Treatment. We are permitted to use your health information in the provision and coordination of your health care. We may disclose information contained in your medical record as necessary to anyone involved in your care and treatment. For example, information obtained by a nurse, physician or other member of your healthcare team will be recorded in the record and used to determine the course of treatment that should work best for you. Your physician will document in your medical record his or her expectations of the members of your healthcare team. Members of your healthcare team will then record the actions they took and their observations. In that way, the physician will know how you are responding to treatment. Additionally, members of your healthcare team may disclose your health information when consulting with other members of the healthcare team regarding your medical condition or course of treatment. AVS will also provide your physician or a subsequent healthcare provider with copies of various reports that could assist him or her in treating you.
b. Payment. We are permitted to use your health information for the purposes of determining coverage, billing, claims management, medical data processing and reimbursement. This information may be released to an insurance company, third party payer or other authorized entities involved in the payment of your medical bill and may include copies or portions of your medical record that are necessary for payment of your account. For example, a bill sent to Medicaid may include information that identifies you, your diagnosis, and the procedures and supplies used in your treatment.
c. Health Care Operations. We are permitted to use and disclose your health information during AVS's routine health care operations, including, but not limited to, quality assurance, utilization reviews, medical reviews, auditing, accreditation, certification, licensing or credentialing activities and for education purposes. For example, members of the medical staff, the risk or quality improvement manager or members of the quality improvement team may use information in your medical record to assess the care and outcomes in your case and others similar to it. This information will then be used in an effort to continually improve the quality and effectiveness of the health care and service that AVS provides.
2. Uses and Disclosures With Patient Authorization. Under the Privacy Regulations, we can use and disclose your health information for purposes other than treatment, payment or health care operations with your written authorization. For example, with your authorization we can provide your name and medical condition to companies who might be able to provide you useful items or services. Under the Privacy Regulations, you may revoke your authorization; however, such revocation will not have any effect on uses or disclosures of your health information prior to our receipt of the revocation.
3. Uses and Disclosures With Patient Opportunity to Verbally Agree or Object. Under the Privacy Regulations, we are permitted to disclose your health information without your written consent or authorization in certain circumstances. In the following circumstances, where feasible, you will be notified in advance of the use or disclosure and will have the opportunity to verbally agree or object:
a. Disclosures to Those Involved in Your Care. We may, in the exercise of professional judgment, disclose your health information to a family member, a close personal friend or any other person identified by you, if the information is directly relevant to that person's involvement in your care or treatment.
b. Directory Purposes. Unless you notify us that you object, we will use your name, location in the facility, general condition and religious affiliation for directory purposes. This information may be provided to members of the clergy and except for religious affiliation, to other persons who ask for you by name.
4. Uses and Disclosures Without an Acknowledgement, Authorization or Opportunity to Verbally Agree or Object. Under the Privacy Regulations, we are permitted to use or disclose your health information without your consent, authorization or the opportunity to verbally agree or object with regard to the following:
a. Uses and Disclosures Required by Law. We will disclose your health information when required to do so by law.
b. Public Health Activities. We may disclose your health information for public health reporting, reporting of communicable diseases and vital statistics and similar other circumstances.
c. Abuse and Neglect. We may disclose your health information if we have a reasonable belief of abuse, neglect or domestic violence.
d. Regulatory Agencies. We may disclose your health information to a health care oversight agency for activities authorized by law, including, but not limited to, licensure, certification, audits, investigations and inspections. These activities are necessary for the government and certain private health oversight agencies to monitor the health care system, government programs and compliance with civil rights. For example, we may disclose to the Food and Drug Administration (FDA) health information relating to adverse events with respect to food, supplements, product and product defects or post marketing surveillance information to enable product recalls, repairs or replacements.
e. Judicial and Administrative Proceedings. We may disclose health information in judicial and administrative proceedings, as well as in response to an order of a court, administrative tribunal, or in response to a subpoena, summons, warrant, discovery request or similar legal request.
f. Law Enforcement Purposes. We may disclose your health information to law enforcement officials when required to do so by law.
g. Coroners, Medical Examiners, Funeral Directors. We may disclose your health information to a coroner or medical examiner. This may be necessary, for example, to determine a cause of death. We may also disclose your health information to funeral directors, as necessary, to carry out their duties.
h. Research. Under certain circumstances, we may disclose your health information to researchers when their clinical research study has been approved by an institutional review board that has reviewed the research proposal and provided that certain safeguards are in place to ensure the privacy and protection of your health information.
i. Threats to Health and Safety. We may use or disclose your health information if we believe, in good faith, the use or disclosure is necessary to prevent or lessen a serious or imminent threat to the health or safety of a person or the public.
j. Organ Procurement Organizations. Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs for the purpose of tissue donation or transplant.
k. Workers' Compensation. We may disclose your health information to the extent necessary to comply with laws relating to workers' compensation or other similar programs.
l. Marketing. Allegheny Valley School may request an authorization from an Individual or his/her personal representative granting permission to record and use stories and/or image(s). Once an authorization has been received, Allegheny Valley School reserves the right to utilize the stories and/or images(s) for purposes including, but not limited to, its web site, newsletter, brochures and its marketing display used at job fairs and other events. Authorizations will remain in effect for as long as the Individual resides at Allegheny Valley School unless a change is requested by a client or his/her personal representative..
m. Appointment Reminders and Treatment Alternatives. We may use and disclose your health information to remind you of an appointment for treatment and medical care or to provide you with information about treatment alternatives or other health related benefits that may be of interest to you.
n. Fundraising. As permitted in the Privacy Regulations, we may contact you as part of a fundraising effort.
o. Other Uses and Disclosures. In addition to the reasons outlined above, we may use and disclose your health information for other purposes permitted by the Privacy Regulations.
5. Uses and Disclosures to Business Associates. With an acknowledgement or a proper authorization, we are permitted to disclose your health information to Business Associates and to allow Business Associates to receive your health information on our behalf. A Business Associate is defined under the Privacy Regulations as an individual or entity under contract with us to perform or assist us in a function or activity which requires the use of your health information. Examples of business associates include, but are not limited to, consultants, accountants, lawyers, medical transcriptionists and third party billing companies. Additionally, AVS sometimes contracts with independent contractors such as physicians, laboratory testing facilities and other similar contractors. We require all Business Associates to protect the confidentiality of your health information.
Although your medical record is the physical property of AVS, since AVS compiled it, the information contained in the medical record belongs to you. Accordingly, you have the following rights concerning your medical record and health information:
1. Right to Request Restrictions on the Use and Disclosure of Your Health Information. You have the right to request restrictions on the use and disclosure of your health information for treatment, payment and health care operations. However, we are not required to agree with such a request. If, however, we agree to the requested restriction, it is binding on us. We will notify you if we are unable to agree to a requested restriction.
2. Right to Inspect and Copy Your Health Information. You have the right to inspect and copy your own health information upon request. However, we are not required to provide you access to all the health information that we maintain. For example, this right does not extend to psychotherapy notes, information compiled in reasonable anticipation of, or for use in, a civil, criminal or administrative proceeding, or subject to or exempt from Clinical Laboratory Improvements Amendments of 1988. Access may also be denied if we determine that the disclosure could reasonably endanger you or another person.
3. Right to Verbally Object. You have the right to verbally object to certain disclosures that are routinely made for treatment, payment or healthcare operations or for other purposes without an Authorization. For example, we are required to give you an opportunity to object to the sharing of your health information with a person or family member accompanying you for treatment.
4. Right to Seek an Amendment of Your Health Information. You have the right to request an amendment of your health information. If we disagree with the requested amendment, we will permit you to include a statement in the record. Moreover, we will provide you with a written explanation of the reasons for the denial and the procedures for filing appropriate complaints and appeals.
5. Right to an Accounting of Disclosure of Your Health information. You have the right to receive an accounting of disclosures made by us of your health information within six (6) years prior to the date of your request; provided, however that we need not provide an accounting for any information disclosed prior to April 14, 2003. The accounting will not include disclosures related to treatment, payment or health care operations, disclosures made to you, disclosures made pursuant to a validly executed authorization, disclosures permitted by the Privacy Regulations, disclosures to persons involved in your care, or disclosures that occurred prior to the April 14, 2003 compliance deadline under the Privacy Regulations. The accounting of disclosures shall include the date of each disclosure, name and address of the person or organization who received your health information, a brief description of the information disclosed, and the purpose for the disclosure.
6. Right to Confidential Communications. You have the right to receive confidential communications of your health information by alternative means or alternative locations. For example, you may request that we not contact certain family members or that we contact you only at a certain location. We will accommodate reasonable requests by you to communicate health information by alternative means or at alternative locations.
7. Right to Revoke Your Authorization. You have the right to revoke a validly executed authorization for the use or disclosure of your health information. However, such revocation will not have any effect on uses or disclosures prior to the receipt of the revocation.
8. Right to Receive Copy of this Notice. You have the right to receive a copy of this Notice.
Contact Information and How to Report a Privacy Rights Violation
If you have questions and would like additional information regarding the uses and disclosures of your health information, you may contact your individual Case Worker. Moreover, AVS has established an internal complaint process for reporting privacy rights violations. If you believe that your privacy rights have been violated, you may file a complaint with us or the Secretary of the Department of Health and Human Services at 200 Independence Avenue, S.W., Washington, D.C. 20201. To file a complaint with us, please contact the Privacy Officer at 1996 Ewings Mill Rd. Coraopolis, PA 15108.