Triad Health Project's Notice of Privacy Practices
Triad Health Project ensures equality of opportunity and treatment for all clients and employees without regard to gender, race, color, religion, age, national origin, political affiliation, physical disability, sexual orientation, economic status, family status, marital, status, gender identity, or any other basis prohibited by applicable law.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE
USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW THIS NOTICE CAREFULLY.
Your health record contains personal information about you and your health. This information about you that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services is referred to as Protected Health Information (PHI). This Notice of Privacy Practices describes how we may use and disclose your PHI in accordance with applicable laws, including the Health Insurance Portability and Accountability Act (HIPAA). It also describes your rights regarding how you may gain access to and control your PHI. We are required by law to maintain the privacy of PHI and to provide you with notice of our legal duties and privacy practices with respect to PHI.
We are required to abide by the terms of this Notice of Privacy Practices. We reserve the right to change the terms of our Notice of Privacy Practices at any time. Any new Notice of Privacy Practices will be effective for all PHI that we maintain at that time. We will provide you with a copy of the revised Notice of Privacy Practices by posting a copy on our website and by providing one to you at your next appointment.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
For Treatment. Your PHI may be used and disclosed by those who are involved in your care for the purpose of providing, coordinating, or managing your health care treatment and related services. This includes consultation with clinical supervisors or other treatment team members. We may disclose PHI to any others only with your authorization.
For Reimbursement. We may use and disclose PHI so that we can receive reimbursement for the treatment services provided to you. Examples of reimbursement-related activities are: making a determination of HIV positive status, determining reimbursement eligibility under either Ryan White or Medicaid funding or quality assurance activities.
For Health Care Operations. We may use or disclose, as needed, your PHI in order to support our business activities including, but not limited to, quality assurance activities, audits, licensing, and conducting or arranging for other business activities. For example, we may share your PHI with third parties that perform various business activities (e.g., billing) provided we have a written contract with the business that requires it to safeguard the privacy of your PHI. With your written permission, we may also contact you by telephone or mail to remind you of pending appointments.
Required by Law. Under the law, we must make disclosures of your PHI to you upon your request. In addition, we must make disclosures to the Secretary of the Department of Health and Human Services for the purpose of investigating or determining our compliance with the requirements of the Privacy Rule.
Following is a list of the categories of uses and disclosures permitted by HIPAA without an authorization.
Abuse and Neglect: We are required to disclose information about you when it is believed that a child, or elderly, or disabled person has been or will be abused or neglected.
Judicial and Administrative Proceedings: We may share your PHI in response to a subpoena, lawsuit, or administrative order.
Emergencies: In case of a medical emergency, we may disclose PHI to the extent necessary for your care.
National Security: We may release PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Public Safety (Duty to Warn): We may disclose your PHI to the extent necessary to avert a serious threat to your safety or safety of others. The information shared would only be to the extent to help prevent the threat.
Without Authorization. Applicable law and ethical standards permit us to disclose information about you without your authorization only in a limited number of other situations. The types of uses and disclosures that may be made without your authorization are those that are:
- Required by Law, such as the mandatory reporting of child/elder/disabled abuse or neglect or mandatory government agency audits or investigations
- Required by Court Order
- Necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. If information is disclosed to prevent or lessen a serious threat it will be disclosed to a person or persons reasonably able to prevent or lessen the threat, including the target of the threat.
With Authorization. Regardless of any other parts of this Notice, any information relating to HIV status, alcohol or drug treatment or other behavioral health care treatment, including psychotherapy notes, will not be disclosed or released by Triad Health Project except with your written permission, a court order or as required by law. You may revoke this authorization in writing at anytime, except to the extent that action based on this consent has been taken.
YOUR RIGHTS REGARDING YOUR PHI
You have the following rights regarding PHI we maintain about you. To exercise any of these rights, please submit your request in writing to our Privacy Officer at 336.275.1654, extension 19.
- Right of Access to Inspect and Copy. You have the right, which may be restricted only in certain circumstances, to inspect PHI that may be used to make decisions about your care. Your right to inspect PHI will be restricted only in those situations where there is evidence that access would cause harm to you.
- Right to Amend. If you feel that the PHI we have about you is incorrect or incomplete, by submitting a written request, you may ask us to amend the information although we are not required to agree to the amendment.
- Right to an Accounting of Disclosures. You have the right to request an accounting of certain disclosures that we make of your PHI.
- Right to Request Restrictions. You have the right to request a restriction or limitation on the use or disclosure of your PHI for treatment or health care operations. We are not required to agree to your request.
- Right to Request Confidential Communication. You have the right to request that we communicate with you about your PHI in a certain way or at a certain location.
- Right to a Copy of this Notice. You have the right to a copy of this notice.
If you believe we have violated your privacy rights, you have the right to file a complaint in writing with our Privacy Officer, Fran Pearson, at 275.1654, extension 19, or with the Secretary of Health and Human Services at 200 Independence Avenue, S.W., Washington, D.C. 20201, or by calling (202) 619-0257. We will not retaliate against you for filing a complaint.