Notice of Privacy Practices
Last Updated: January 10, 2017 | Effective: July 1 2015
THE NOTICE DESCRIBES HOW Primary Assessment Medical Services, P.C. (“we,” “our” or “First Opinion NY PC”) MAY USE AND DISCLOSE YOUR HEALTH INFORMATION AND HOW YOU MAY ACCESS IT. PLEASE REVIEW THE NOTICE CAREFULLY.
We create a digital record of health information we receive about you and the services we provide. We understand that this information may be private, and much of it is protected health information (“PHI”) under the Health Insurance Portability and Accountability Act and its implementing regulations (“HIPAA”). The protections described in the Notice of Privacy Practices and future versions (the “Notice”) reflect our commitment to your privacy. We are required by law to maintain the privacy of PHI, to provide you with notice of our legal duties and privacy practices with respect to PHI, to notify you if you are affected by a breach of unsecured PHI, and to abide by the terms of the Notice currently in effect.
Availability of Notice, Revisions, and Right to Copies.The Notice will be available to you at all times to review, print, and/or save, at https://legal.firstopinionapp.com/pc-privacy-policies.html.
Revisions.If First Opinion NY PC revises the Notice and revisions are material, you will be provided with information as required by law. The Notice applies to PHI we already have about you and to PHI we receive in the future.
Right to Receive a Paper Copy of Notice.You may obtain a paper copy of the Notice, even if you receive it electronically, by contacting our office by telephone, mail or in-person.
Questions.If you have questions about the Notice or our privacy practices, please contact our Privacy Officer at: First Opinion Privacy Officer, 3430 W Bayshore Road, Suite #104, Palo Alto, CA 94303.
Capitalized Terms.Capitalized terms not otherwise defined herein have the definition given them under HIPAA.
Persons Subject to The Notice.You are subject to the Notice if you use First Opinion NY PC’s services, as are First Opinion NY PC’s health care providers, Workforce Members, employees, staff, and independent contractors.
How We May Use and Disclose Your PHI.The following describes how we may use and disclose your PHI with and without your authorization. If authorization is required by law or the Notice, we will seek appropriate authorization or a valid court order before using or disclosing PHI, and will comply with lawful restrictions, such as those that may apply to disclosure of information regarding reproductive health, HIV and other sexually transmitted diseases, substance abuse, mental health, and genetic test results. When we use or disclose your PHI, we will limit the use or disclosure to the amount of PHI necessary to the legitimate purposes of the disclosure.
Permitted and Required Uses and Disclosures.We will use or disclose your PHI without authorization:
Payment.We may use your PHI to obtain payment for services rendered to you.
Treatment.We may receive, use, and/or disclose your PHI to physicians, therapists, psychotherapists, pharmacists, or other health care providers as necessary to provide you with health treatment or services and/or, based upon the professional judgment of an appropriate provider, if you present an imminent threat to yourself or others, and/or in an emergency situation
Health Care Operations.We may use or disclose your PHI in connection with managing and operating First Opinion NY PC. For example, we may use and/or share your PHI to provide you with appointment reminders, evaluate the First Opinion NY PC’s performance and the quality of care provided, obtain legal services, perform audit functions, maintain compliance programs, maintain licenses, determine whether services are appropriate and effective, and for business planning and development. We may also disclose your PHI to Business Associates with whom we contract to provide services where such Business Associates agree to appropriately safeguard your PHI.
Marketing and Sale.We may use your PHI for certain marketing and sales purposes, as permitted by HIPAA, for example, when marketing our own services.
Research.First Opinion NY PC may use and share PHI for research projects if approved through a process that evaluates a proposed research project and its use of PHI, and balances the research needs with patients’ need for privacy of their PHI. For example, research may include comparing the health and recovery of all patients who have the same condition, but were treated differently, where the condition is apparent to all. However, First Opinion NY PC may share PHI with researchers without authorization or approval if the PHI is not shared outside First Opinion NY PC, for example, to identify patients who may want to participate in a research study.
Government Authority.First Opinion NY PC may disclose your PHI to a State or Federal agency, including the United States Department of Health and Human Services, as required by law, including for national security, intelligence activities, activities such as audits, investigations, oversight, and inspections, and/or to a public health authority permitted by law to collect or receive such information for the purpose of (i) preventing or controlling disease, injury, vital events such as death, child abuse, domestic violence, and/or neglect; (ii) conducting public health surveillance, investigation and/or intervention; or (iii) reporting adverse reactions to medications or problems with regulated products.
Law Enforcement.First Opinion NY PC may disclose your PHI to law enforcement as part of an investigation to a law enforcement official for a law enforcement/emergency purpose as required by law, in compliance with a court order from a court of competent jurisdiction granted after application showing good cause for the issuance of the order, or to investigate a crime;
Judicial Process.First Opinion NY PC may disclose your PHI to a court or administrative law judge or other tribunal for judicial or administrative proceedings and/or as required by court or administrative orders, subpoenas, and/or other lawful process;
Other Public Officials.First Opinion NY PC may disclose your PHI to coroners, medical examiners, or funeral directors consistent with applicable law to carry out their duties.
Authorized and Requested Uses and Disclosures.We will seek your authorization for uses and disclosures not described above, for example when you ask us to provide PHI to a family member, friend, other person involved in or paying for your health care; or other persons you designate.
Mode of Delivery.We will make disclosures you properly request or authorize via email, text message or through a reasonably requested method or medium.
Revocation.You may revoke your authorization in writing at in time.
Your Rights Regarding PHI.You have the following additional rights with regard to your PHI:
Right to Inspect and Copy.You have the right to inspect and obtain a copy of PHI that may be used to make decisions about your care (“Records”). Usually, this includes medical and billing records, but may not include some mental health and laboratory information.
Form.You may obtain a copy of Records in an electronic form and/or in the form you request to the extent it is readily producible.
Fees.If you request a copy of Records, First Opinion NY PC may charge a fee for the associated costs of copying, electronic media, mailing, or other supplies.
Denials.First Opinion NY PC may deny your request to inspect and obtain a copy of Records in limited circumstances. If you are denied access to Records, you may request that the denial be reviewed. Another licensed health care professional chosen by First Opinion NY PC will review your request and the denial. The person conducting the review will not be the person who denied your request. First Opinion NY PC will comply with the outcome of the review.
Right to Amend Your PHI.You have the right to request an amendment to your Records if you believe they are incorrect or incomplete, for so long as First Opinion NY PC maintains your Records. To request an amendment, please submit a written request to our Privacy Officer stating the facts supporting your request. If First Opinion NY PC does not have your Records in its possession, we will provide you with the appropriate contact information when your request is received. We will respond to your request for an amendment no later than sixty (60) days after First Opinion NY PC receives your request. We may deny your request for amendment if you ask us to amend a Record that (i) First Opinion NY PC did not create; (ii) is not part of the Record maintained by First Opinion NY PC; (iii) is not part of the information you are permitted to inspect and copy; or (iv) is accurate and complete. You may respond to our denial by filing a written statement of disagreement, which First Opinion NY PC has the right to rebut. If this occurs, you may ask that your original request, our denial, your statement of disagreement, and our rebuttal be included in future disclosures of your PHI.
Right to Receive an Accounting of Disclosures.You have the right to request an “Accounting of Disclosures,” which is a list of the disclosures First Opinion NY PC made of your PHI other than for treatment, payment, and health care operations (as described above) and other purposes as specified by law. To request an Accounting of Disclosures, you must submit your request in writing to our Privacy Officer. Your request must state a time period, which may not be longer than six (6) years. Your request should also indicate in what form you want the list (for example, on paper or electronically). The first Accounting of Disclosures you request within a 12-month period will be free, but subsequent requests may result in a charge to you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request before incurring any costs.
Right to Notification of a Breach.We will notify you as required by law of any Breach of your PHI.
Right to Request a Restriction on the Use and Disclosure of Your PHI.You have the right to request a restriction or limit on the PHI we use or disclose about you for treatment, payment, or health care operations, and/or the PHI we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you may ask that we not use or disclose information about mental health services.
Required Restrictions.First Opinion NY PC is not required to agree to your request unless you request that we restrict disclosure to a health plan or insurer for payment or health care operations purposes if you or someone on your behalf (other than the health plan or insurer) has paid for the item or service out of pocket in full, and even then, we may disclose the information to a health plan or insurer for treatment purposes.
Other Restrictions.We will agree to other special restrictions if feasible, unless bound to do otherwise by law, and we will comply with your request unless the information is needed to provide you emergency treatment.
Form of Requests for Restrictions.To request restrictions, you must make your request in writing to the Privacy Officer. In your request, you must tell us: (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
Right to Request Confidential Communications Via Alternative Means or Locations.You have the right to request that First Opinion NY PC communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that First Opinion NY PC only contact you at work or by mail. To request confidential communications, you must make your request in writing to our Privacy Officer. We will not ask you the reason for your request and will accommodate all reasonable requests. Your request must specify how and/or where you wish to be contacted.
Complaints.If you believe your privacy rights have been violated, you may file a complaint with First Opinion NY PC or with the Secretary of the Department of Health and Human Services. If you wish to file a complaint with First Opinion NY PC, please contact our Privacy Officer. All complaints must be submitted in writing. First Opinion NY PC is prohibited by law from retaliating against you for filing such complaint.
Right to Foreign Language Version.If you have difficulty reading or understanding English, you may request a copy of the Notice in a different language.