Patient Privacy Practices

YOUR RIGHTS​

 

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

To receive an electronic or paper copy of your medical record.

• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.

• We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record.

• You can ask us to correct health information about you that you think is incorrect or incomplete.

• We may say “no” to your request, but we will tell you why in writing within 60 days.

Request confidential communications.

• You can ask us to contact you in a specific way (home, office, etc.) or to send mail to a different address.

• We will say “yes” to all reasonable requests.

Ask us to limit what we use or share.

• You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and may say “no” if care is affected.

• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we have shared information.

• You can ask for a list (accounting) of the times we have shared your health information for six years prior to the date you ask, who we shared it with, and why.

• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We may charge a reasonable, cost-based fee if you ask for multiple accounts within 12 months.

Get a copy of this privacy notice.

• You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you.

• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

• We will make sure the person has this authority and can act for you before we take any action.

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FILE A COMPLAINT IF YOU FEEL YOUR RIGHTS ARE VIOLATED​

You have the right to complain as follows:

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• Through our Compliance Department: 325-947-5630

• Through the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR).

  • by mailing a letter:
    Mail Code E-249
    P.O Box 149030
    ​Austin, TX 78714-9030

  • by phone: 1-800-458-9858, option 5

  • online: www.hhs.gov/ocr/privacy/hipaa/complaints/

• We will not retaliate against you for filing a complaint.

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YOUR CHOICES

Tell us how you want us to share your information and we will follow your instructions.

If you have a clear preference for how we share your information in the situations described below, talk to us.

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care.

• Share information in a disaster relief situation.

• Include your information in a clinic directory.

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases, we never share your information unless you give us written permission:

• Marketing purposes.

• Sale of your information.

• Most sharing of psychotherapy notes.

• Substance use disorder (SUD)

In the case of fundraising:

• We may contact you for fundraising

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OUR USES AND DISCLOSURES

How do we typically use or share your health information? We typically use or share your health information in the
following ways:

To treat you.

• We can use your health information and share it with other professionals who are treating you.

• Example: A doctor treating you for an injury asks another doctor about your overall health.

Run our organization.

• We can use and share your health information to run our practice, improve your care, and contact you when necessary.

• Example: We use health information about you to manage your treatment and services.

Bill for services.

• We can use and share your health information to bill and get payment from health plans or other entities.

• Example: We give information about you to your Medicare plan so it will pay for your services.

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HOW ELSE CAN WE USE OR SHARE YOUR HEALTH INFORMATION?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good. We have to meet many conditions in the law before we can share your information for these purposes.

For more information see:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues. We can share health information about you related to:

• Preventing disease.

• Helping with product recalls.

• Reporting adverse reactions to medications.

• Reporting suspected abuse, neglect, or domestic violence.

• Preventing or reducing a serious threat to anyone’s health or safety.

• Social service for purposes of, but not limited to; supportive housing, public benefits, counseling, and job readiness.

Do research.

• We can use or share your information for health statistics.

Comply with the law.

• We will share information about you if state or federal laws require it, including with the Department of Health and Human Services to see that we are complying with federal privacy law.

• We can share health information with a coroner, medical examiner, or funeral director.

Address workers’ compensation, law enforcement, and other government requests.
We can use or share health information about you:

• For workers’ compensation claims.

• For law enforcement purposes or with a law enforcement official.

• With health oversight agencies for activities authorized by law.

• For special government functions such as military, national security, and protective services.

Respond to lawsuits and legal actions.

• We can share health information about you in response to a court or administrative order, or in response to a subpoena.

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SMS - HOW WE COLLECT YOUR INFORMATION

We may collect personal information directly from you, for example through a web form, during registration, and while
making an appointment. Personal information we collect directly from you may include first and last name, address, email address, and phone number.

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OTHER USES OF HEALTH INFORMATION

Notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will stop the uses and disclosures allowed by that permission, except to the extent that we have already acted in reliance on your permission. For example, we are unable to take back any disclosures we have already made with your permission.

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OUR RESPONSIBILITIES

 

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• We are required by law to maintain the privacy and security of protected health information.

• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

• We must follow the duties and privacy practices described in this notice and give you a copy of it.

• We will not use or share your information other than as described here unless you tell us we can in writing. Let us know in writing if you change your mind.

For more information see:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

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CHANGES TO THE TERMS OF THIS NOTICE

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.

OTHER INSTRUCTIONS FOR NOTICE

• LEC Compliance Department: 325-947-5630

Please ask any La Esperanza Clinic staff member for help with any item above and we will assist you.