Phone: (304) 872-6503
Notice
of Privacy Practices
This
Notice describes how medical information about you may be used and disclosed
and how you can obtain access to this information. Please review it carefully.
This
Notice is effective April 14, 2003.
Our Duty to Safeguard Your
Protected Health Information
Individually
identifiable information about your past, present, or future health or
condition, the provision of health care to you, or payment for health care is
considered, “Protected Health Information” (PHI). We are required to extend certain protections
to your PHI, and to give you this Notice about our privacy practices that
explains how, when and why we may use or disclose your PHI. Except in specified circumstances, we must
use or disclose only the minimum necessary PHI to accomplish the intended
purpose of its use or disclosure.
We
are required to follow the privacy practices described in this Notice though we
reserve the right to change our privacy practices and the terms of this Notice
at any time.
How We May Use and Disclose
Your Protected Health Information
We use and
disclose Protected Health Information for a variety of reasons. We have a limited right to use and/or
disclose your PHI for purposes of treatment, payment, and for our health care
operations. For uses beyond that, we
must have your written authorization unless the law permits or requires us to
make the use or disclosure without your authorization. If we disclose your PHI to an outside entity
in order for that entity to perform a function on our behalf, we must have in
place an agreement with the outside entity that it will extend the same degree
of privacy protection to your information that we must apply to your PHI. However, the law provides that we are
permitted to make some uses/disclosures without your consent or
authorization. The following describes
and offers examples of our potential uses/disclosures of your PHI.
Uses and Disclosures
Relating to Treatment, Payment, or Health Care Operations.
Generally, we
may use or disclose your PHI as follows:
For
treatment: We
may disclose your PHI to doctors, nurses, and other health care personnel who
are involved in providing your health care.
For example, your PHI will be shared among members of your treatment
team, or with the pharmacy. Your PHI may
also be shared with outside entities performing ancillary services relating to
your treatment, such as lab work or x-rays, or for consultation purposes,
and/or community mental health agencies involved in provision or coordination
of your care.
To obtain
payment: We
may use/disclose your PHI in order to bill and collect payment for your health
care services. For example, we may
contact your employer to verify employment status, and/or release portions of your
PHI to the Medicaid program, the Department of Health and Human Resources
(DHHR) central office, the Bureau for Behavioral Health and Health Facilities
(BBHHF), and/or a private insurer to get paid for services that we delivered to
you. We may release information to the
Office of the Attorney General for collection purposes.
For health care
operations: We
may use/disclose your PHI in the course of operating our mental health
programs. For example, we may take your
photograph for medication identification purposes, use your PHI in evaluating
the quality of services provided or disclose your PHI to our accountant or
attorney for audit purposes. Since we
are an integrated system, we may disclose your PHI to designated staff in our
other facilities, programs, or our business office for similar purposes. Release of your PHI to DHHR and BBHHF and/or
state agencies might also be necessary to determine your eligibility for
publicly funded services.
Appointment
reminders:
Unless you provide us with alternative instructions, we may send
appointment reminders and other similar materials to your home.
Uses and Disclosures of PHI
Requiring Authorization
For uses and
disclosures beyond treatment, payment and operations purposes we are required
to have your written authorization, unless the use or disclosure falls within
one of the exceptions described below.
Authorizations can be revoked at any time to stop future
uses/disclosures except to the extent that we have already undertaken an action
in reliance upon your authorization.
Uses and
Disclosures of PHI from Mental Health Records Not Requiring Consent or
Authorization.
The law provides
that we may use/disclose your PHI from mental health records without consent or
authorization in the following circumstances:
When required by
law: We
may disclose PHI when a law requires that we report information about suspected
abuse, neglect or domestic violence, or relating to suspected criminal
activity, or in response to a court order.
We must also disclose PHI to authorities that monitor compliance with
these privacy requirements.
For public
health activities: We
may disclose PHI when we are required to collect information about disease or
injury, or to report vital statistics to the public health authority.
For health
oversight activities: We
may disclose PHI to our business office, the protection and advocacy system, or
another agency responsible for monitoring the health care system for such
purposes as reporting or investigation of unusual incidents, and monitoring of
the Medicaid Program.
Relating to
decedents: We
may disclose PHI related to a death to coroners, medical examiners or funeral
directors, and to organ procurement organizations relating to organ, eye, or
tissue donations of transplants.
To avert threat
to health or safety: In
or to avoid a serious threat to health or safety, we may disclose PHI as
necessary to law enforcement or other persons who can reasonably prevent or
lessen the threat of harm.
For specific
government functions: We
may disclose PHI of military personnel and veterans in certain situations, to
correctional facilities, in certain situations, to government benefit programs
relating to eligibility and enrollment, and for national security reasons, such
as protection of the President.
Uses and
Disclosures of PHI from Alcohol and Other Drug Records Not Requiring Consent or
Authorization.
The law provides
that we may use/disclose your PHI from alcohol and other drug records without consent
or authorization in the following circumstances:
When required by
law: We
may disclose PHI when a law requires that we report information about suspected
child abuse and neglect, or when a crime has been committed on the program
premises or against program personnel, or in response to a court order.
Relating to
decedents: We
may disclose PHI relating to an individual’s death if state or federal law
requires the information for collection of vital statistics or inquiry into
cause of death.
For audit or
evaluation purposes: In
certain circumstances, we may disclose PHI for audit or evaluation purposes.
To avert threat
to health or safety: In
order to avoid a serious threat to health or safety, we may disclose PHI to law
enforcement when a threat is made to commit a crime on the program premises or
against program personnel.
Uses and
Disclosures Requiring You to Have an Opportunity to Object
In the following
situations, we may disclose a limited amount of your PHI if we inform you about
the disclosure in advance and you do not object, as long as the disclosure is
not otherwise prohibited by law.
To families, friends or others involved in your
care: We may share with these people information
directly related to their involvement in your care, or payment of your
care. We may also share PHI with these
people to notify them about your location, general condition, or death.
Your Rights Regarding Your Protected Health
Information You have the following
rights relating to your protected health information:
To request restrictions on uses/disclosures: You have the right to ask that we limit how we use
or disclose your PHI. We will consider
your request, but are not legally bound to agree to the restriction. To request a restriction, you must make your
request in writing to Privacy Officer, Seneca Health Services, Inc., 1305
Webster Road, Summersville, WV
26651. 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 or parent).
To the extent that we do agree to any restrictions on our use/disclosure
of your PHI, we will put the agreement in writing and abide by it except in
emergency situations. We cannot agree to
limit uses/disclosures that are required by law.
To choose how we contact you: You have the right to ask that we send you
information at an alternative address or by an alternative means. We must agree to your request as long as it
is reasonably easy for us to do so.
To inspect and request a copy of your PHI: Unless your access to your records is
restricted for clear and documented treatment reasons, you have a right to see
your protected health information upon your written request. We will respond to your request within 30
days. If we deny your access, we will
give you written reasons for the denial and explain any right to have the
denial reviewed. If you want copies of
your PHI, a charge for copying may be imposed, depending on your
circumstances. You have a right to
choose what portions of your information you want copied and to have prior
information on the cost of copying.
To request amendment of your PHI: If you believe that there is a mistake or missing
information in our record of your PHI, you may request, in writing, that we
correct or add to the record. We will
respond within 60 days of receiving your request. We may deny the request if we determine that
the PHI is: (1) correct and complete;
(2) not created by us and/or not part of our records, or; (3) not permitted to
be disclosed. Any denial will state the
reasons for denial and explain your rights to have the request and denial,
along with any statement in response that you provide, appended to your
PHI. If we approve the request for
amendment, we will change the PHI and so inform you, and tell others that need
to know about the change in the PHI.
To find out what disclosures have been made: Your have a right to get a list of when, to whom,
for what purpose, and what content of your PHI has been released other than
instances of disclosure for treatment, payment, and operations: to you, your family; or pursuant to your
written authorization. The list also
will not include any disclosures made for national security purposes, to law
enforcement officials or correctional facilities, or disclosures made before
April 2003. We will respond to your
written request for such a list within 60 days of receiving it. Your request can relate to disclosures going
as far back as six years. There will be
no charge for up to one such list each year.
There may be a charge for more frequent requests.
You Have the Right to Receive
This Notice: You have a
right to receive a paper copy of this notice and/or an electronic copy by email
upon request.
How
to Complain About Our Privacy Practices
If you think we may have violated your privacy
rights, or you disagree with a decision we made about access to your PHI, you
may file a complaint with the person listed below.
You also may file a written complaint with the
Secretary of the U.S. Department of Health and Human Services at 200
Independence Avenue SW, Washington D.C., 20201, or call 1-877-696-8775. Your complaint must be filed with the
Secretary of the US DHHS within 180 days of knowing that an act or omission
occurred.
We will not engage in intimidating or retaliatory
action against you if you make a complaint.
You will not be asked to waive your rights to file a complaint as a
condition of treatment.
Contact Person for Information or to Submit a
Complaint
If you have questions about this Notice or any
complaints about our privacy practices, please contact our Privacy Officer
at:
Seneca Health Services, Inc.
Telephone:
304-872-6503
Effective Date:
This notice is effective on April 14, 2003.