Notice of Phycinity’s Privacy 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. Phycinity, PLLC (“Phycinity”) and its affiliates and subsidiaries 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 healthcare providers. 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 as allowed by law to enable us to meet our professional and legal obligations to operate this medical practice properly.
We are required by law to provide you with this Notice explaining Phycinity’s Privacy Practices with regard to your medical information and how we may use and disclose your protected health information (“PHI”) for treatment, payment, and for health care operations, as well as for other purposes that are permitted or required by law. You have certain rights regarding the privacy of your protected health information and we also describe those rights in this notice.
We are required by law to make sure that medical information about you is kept private. We are required to give you this privacy notice of our legal duties and privacy practices with respect to medical information about you. Each time you register for treatment, we will make available a copy of the current notice in effect. We are required to abide by the terms of the notice currently in effect; and Phycinity reserves the right to change the provisions of our privacy notice and make new provisions effective for all PHI we maintain. We are required to obtain from you a written acknowledgment stating the receipt of this privacy notice. If Phycinity makes a material change to our privacy notice, we will post the changes promptly on our website at https://www.phycinity.com.
What is protected health information?
PHI consists of individually identifiable health information, which may include demographic information Phycinity collects from you or creates or receives from a health care provider, a health plan, your employer or a health care clearinghouse and that relates to: (a) you and/or your children past, present or future physical or mental health or condition; (b) the provision of health care to you and/or your children; or (c) the past, present or future payment for the provision of health care to you and/or your children.
This Notice of Privacy Practices became effective on June 15, 2016.
Ways in which we may use and disclose your protected health information
We will use and disclose your protected health information to provide, coordinate or manage you and/or your children health care and any related services. We will also disclose your health information to other providers who may be treating you and/or your children. Additionally, we may from time to time disclose your health information to another provider who has been requested to be involved in your and/or your children care. For example, we may share information about you and/or your children with referring physicians, other primary care physicians, a medical specialist or a pharmacy.
We may disclose protected health information (PHI) to your family member(s) or individuals identified by you, as long as the protected health information disclosed is relevant to the person’s involvement with your and/or your children care or payment related to your and/or your children health care.
Health care operations
We will use and disclose your protected health information to support the business activities of our facilities. For example, we may use medical information about you and/or your children to review and evaluate our treatment and services or to evaluate our staff’s performance while caring for you and/or your children. In addition, we may disclose your health information to third-party business associates who perform billing, consulting or transcription or other services for our practice.
Other ways we may use and disclose your protected health information
As required by law
In certain situations, we may disclose your and/or your children protected health information without your consent, authorization or the opportunity to agree or object, as required by applicable state and federal laws.
We may use and disclose protected health information to remind you about appointments. Telephone messages and appointment reminders may be left with the person answering your phone or on answering machines and voice mail systems, unless you have requested an alternative means of communication with us.
We may disclose your and/or your children protected health information to our contracted business associates for the purpose of providing services, including our business associates that provide radiography, laboratory tests, billing clearinghouse services in order that they perform their duties. Phycinity requires our business associates to appropriately safeguard your information.
Lawsuits and disputes
We may disclose medical information about you and/or your children in response to a court or administrative order. We may also disclose medical information about you and/or your children in response to a subpoena, discovery request or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain a court order protecting the information requested.
Health oversight activities
Phycinity and its associates may disclose protected health information without written authorization, to appropriate state or federal health authorities conducting public health investigations or interventions, and to the Food and Drug Administration for regulatory oversight. We will release your PHI and other required information in accordance with federal laws and regulations to the manufacturer (and the Food and Drug Administration, if applicable) of any product administered by Phycinity. This information may be used to locate you should there be a need with regard to such medical product(s).
Victims of abuse, neglect or domestic violence
When required by law and/or if you agree to the report and if we believe that you and/or your children have been a victim of abuse, neglect or domestic violence, we may use and disclose your protected health information to notify a government agency.
To avert a serious threat to public health or safety
We may, consistent with applicable law and ethical standards, use or disclose protected health information(PHI) if Phycinity, in good faith, believe such use and disclosure (i) is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public and the disclosure is to a person or persons reasonably able to prevent or lessen the threat, including the target of the threat; or (ii) is necessary for law enforcement authorities to identify or apprehend an individual who (a) has made a statement admitting participation in a violent crime that Phycinity reasonably believes may have caused serious physical harm to the victim (provided that no disclosure may be made under this circumstance if the disclosure is made during the course of treatment to affect the propensity to commit the criminal conduct that is the basis for the disclosure, or actual counseling or therapy, or if the disclosure is made during a request to initiate such treatment); or (b) escaped from a correctional institution or from lawful custody.
We may use or disclose your protected health information (PHI) when necessary to prevent a serious and imminent threat to you and/or your children health or safety, or the health or safety of another person or the public. In such cases, we will only disclose your information with someone able to help prevent the threat or to law enforcement officers if you and/or your children tell us participation has occurred in a violent crime that may have caused serious physical harm to another person, or if we determine that you and/or your children escaped from lawful custody.
National security/intelligence activities/protective services/military and veterans
We may disclose PHI to authorized government officials who are conducting national security and intelligence activities or providing protective services to the President of the United States or other officials. If you are a military personnel, we may disclose health information about you and/or your children to appropriate military command authorities for activities they deem necessary to carry out their military mission.
Inmates and correctional institutions
If you are an inmate or you are in the lawful custody of a law enforcement officer, we may disclose your health information to the prison officers or law enforcement officers if necessary to provide you with health care, or to carry out activities to maintain safety, security and good order at the place where you are confined; including disclosing information that is necessary to protect the health and safety of other inmates or persons involved in supervising or transporting inmates.
We may use or disclose you and/or your protected health information as a research participant, which has been de-identified, and is in accordance with law; though, in most cases, we will ask for your written authorization as a research participant before you and/or your children health information is used or disclosed to others, in order to conduct research.
In accordance with the law and only in certain circumstances; during the preparation of future research, we may also use or disclose you and/or your children protected health information without your written authorization to determine if you are eligible to participate in a research study. If you are eligible for inclusion in a study, we will contact you to discuss your and/or your children potential participation and the related consent process.
We may, without obtaining your authorization and so long as we do not receive payment from a third party for doing so: provide you with marketing materials in a face-to-face encounter, give you a promotional gift of nominal value, or tell you about our own health care products and services. We will ask your permission to use your health information for any other marketing activities.
We will use and disclose your protected health information for workers’ compensation or similar programs that provide benefits for work-related injuries or illness.
Uses and disclosures that require Phycinity to give the opportunity to object or opt-out
Others involved in your care
We may provide relevant portions of your PHI to a family member, a relative, a close friend or any other person you identify as being involved in your and/or your children medical care or payment for care. In an emergency or when you are not capable of agreeing or objecting to these disclosures, we will disclose PHI as we determine is in your best interest, but will tell you about it after the emergency, and give you the opportunity to object to future disclosures to family and friends.
Facility electronic system/directory
Unless you object, we may use and disclose certain limited information about you in our electronic system/directory while you are in our facilities. This information may include your name and your location within our facility, but will not include specific medical information about you and/or your children and we may disclose electronic system/directory information to people who ask for you and/or your children by name.
Uses or disclosures not covered by this privacy notice
Uses or disclosures of your health information not covered by this privacy notice or the laws that apply to us may only be made with your written authorization. You may revoke such authorization in writing at any time and we will no longer disclose health information about you and/or your children for the reasons stated in your revocation. Disclosures made in reliance on the authorization prior to the revocation are not affected by the revocation.
Patient rights related to protected health information
Although your health record is the physical property of the facility that compiled it, the information belongs to you. You have the right to:
Request an amendment
You have the right to request that we amend your and/or your children medical information if you feel that it is incomplete or inaccurate. You must make this request in writing to Phycinity PLLC, stating what information is incomplete or inaccurate and the reasoning that supports your request.
We are permitted to deny your request if it is not in writing or does not include a reason to support the request. We may also deny your request if:
You have the right to request a restriction of how we use or disclose your and/or your children medical information for treatment, payment or health care operations. For example, you could request that we not disclose information about a prior treatment to a family member (ex. Grandparents) or friend who may be involved in your and/or your children care or payment for care. Your request must be made in writing to Phycinity PLLC. We are not required to agree to your request if we feel it is in your and/or your children best interest to use or disclose that information. If we do agree, we will comply with your request except for emergency treatment.
As stated later in this Notice, under the Health Information Technology for Economic and Clinical Health Act (“HITECH”), if a patient pays in full for his or her and/or children services out of pocket they can demand that the information regarding the service not be disclosed to the patient’s third-party payer since no claim is being made against the third-party payer.
Inspect and copy
You have the right to inspect and copy the protected health information that we maintain about you and/or your children in our designated record set for as long as we maintain that information. This designated record set includes your medical and billing records as well as any other records we use for making decisions about you and/or your children. We may charge you a fee for the costs of copying, mailing or other supplies used in fulfilling your request.
If you wish to inspect or copy your medical information, you must submit your request in writing to Phycinity PLLC.
Attention: Medical Records Review
450 Carthage St #158
Cameron, NC 28326
You may mail your request to the address listed or bring the request to our facility. We will have thirty (30) days to respond to your request for information that we maintain at our facility. If the information is stored off-site, we are allowed up to sixty (60) days to respond but must inform you of this delay. As stated later, HITECH expands this right, giving individuals the right to access their own e-health record in an electronic format and to direct Phycinity to send the e-health record directly to a third party. Phycinity may only charge for labor costs under electronic transfers of e-health records.
An accounting of disclosures
You have the right to request a list of the disclosures of your health information we have made outside of our facility that were not for treatment, payment or health care operations. Your request must be in writing and must state the time period for the requested information. You may not request information for any dates prior to September 18, 2016, nor for a period of time greater than six (6) years (our legal obligation to retain information).
Your first request for a list of disclosures within a twelve (12) month period will be free. If you request an additional list within twelve (12) months of the first request, we may charge you a fee for the costs of providing the subsequent list. We will notify you of such costs and afford you the opportunity to withdraw your request before any costs are incurred.
Request confidential communications
You have the right to request how we communicate with you to preserve your privacy. For example, you may request that we call you only at your work number, email or by mail at a special address or postal box. Your request must be made in writing and must specify how or where we are to contact you. We will accommodate all reasonable requests.
File a complaint
If you believe we have violated your medical information privacy rights, you have the right to file a complaint with Phycinity which we recommend you do in writing. Provide as much detail as you can about the suspected violation and send to:
Attention: Compliance Department
450 Carthage St #158
Cameron, NC 28326
You may also file a complaint directly to the Secretary of the United States Department of Health and Human Services:
U.S. Department of Health & Human Services
200 Independence Ave. SW
Washington, D.C. 20201
Phone: 1-202-690-7000; toll free: 1-877-696-6775
You will not be retaliated against for filing a complaint.
A paper copy of this Notice
You have the right to receive a paper copy of this Notice, even if you agreed to receive this privacy notice electronically. You may request a copy of this privacy notice at any time by contacting our office in writing or by phone.
Phycinity is including HITECH Act provisions to its Notice as follows:
HITECH notification requirements
Under HITECH, Phycinity is required to notify patients whose PHI has been breached. Notification must occur by first class or certified mail within thirty (30) days of the event. A breach occurs when an unauthorized use or disclosure that compromises the privacy or security of PHI poses a significant risk for financial, reputational or other harm to the individual. This notice must:
Phycinity’s Business Associate Agreements have been amended to provide that all Health Insurance Portability and Accountability Act (“HIPAA”), security administrative safeguards, physical safeguards, technical safeguards and security policies, procedures and documentation requirements apply directly to the business associate.
HITECH states that if a patient pays in full for his or her services out of pocket they can demand that the information regarding the service not be disclosed to the patient’s third-party payer since no claim is being made against the third-party payer.
Access to e-health records
HITECH expands this right, giving individuals the right to access their own e-health record in an electronic format and to direct Phycinity to send the e-health record directly to a third party. Phycinity may only charge for labor costs under the new rules.