Please Review this Carefully
This Notice of Privacy Practices is NOT authorization. This Notice of Privacy Practices describes how we, Primary Health Network, our Business Associates and their subcontractors, may use and disclose your protected health information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes permitted or required by law. It also describes your rights to access and control your protected health information. “Protected Health Information” is information about you, including demographic information that may identify you and that relates to your past, present or future physical or mental health conditions and related health care services.
Our Legal Duty
Primary Health Network is required by applicable federal and state law to maintain the privacy of your health information. We understand your medical information is personal and we are committed to protecting it. We create a record of care and services that you receive to ensure we are providing quality care and are complying with legal requirements. This Notice applies to all your health information that we maintain, whether created by our staff or others, and tells you about the ways in which we may use or disclose you protected health information.
We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all health information we maintain, including health information we created or received before we made changes. Primary Health Network Notice of Privacy Practices are available upon request and on the Primary Health Network website.
How We May Use & Disclose Your Protected Health Information
Primary Health Network may use and disclose your health records for treatment, payment, and health care operations, and as required by law. Other disclosures will be made only with your authorization. Below are examples of how we use or disclose your protected health information.
- Treatmentmeans providing, coordinating of managed care and related services by one or more health care providers. To promote quality care, Primary Health Network operates an electronic medical record called the "EMR". This is an electronic system that keeps medical information about you. If you see multiple Primary Health Network providers, information in your medical record will be shared between providers. Your medical record may be comprised of information from the EMR and your paper record. If you see both Primary Health Network medical and behavioral health providers, you will have two separate charts within our EMR. To achieve continuity of care, your medication list and allergies will be shared between both specialties. The privacy obligations of your health information rights set forth in this Notice also apply to information stored in the EMR.
- Paymentmeans such activities as planning reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example of this would be sending a bill for your visit to your insurance company for payment.
- Health Care Operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, or management analysis, and customer service. An example would be internal quality assessment review.
- Public Health Activities The Privacy Rule permits Public Health Information (PHI) to be shared for specified public health purposes such as preventing or controlling disease, injury or disability and when required by law.
- Government Activities PHI may be released to government agencies for the purpose of enforcement of the Privacy Rule by the Department of Health and Human Services and the Office of Civil Rights to investigate a complaint and ensure compliance.
- Law Enforcement Purposes PHI may be released to the police or other law enforcement officials as required or permitted by law, or in compliance with a court order or subpoena.
- Fundraising We may use health information to contact you about fundraising efforts for the Primary Health Network; you may elect to opt out of receiving fundraising communications.
Uses & Disclosures that Require your Authorization
Other Permitted and Required Uses and Disclosures will be made only with your consent, authorization or opportunity to object unless required by law. Without your authorization, we are expressly prohibited to use or disclose your protected health information for marketing purposes. We may not sell your protected health information without your authorization. We may not use or disclose most psychotherapy notes contained in your protected health information. We will not use or disclose any of your protected health information that contains genetic information that will be used for underwriting purposes.
You may revoke the authorization, at any time, in writing, except to the extent that Primary Health Network has taken action in reliance on the use or disclosure indicated in the authorization.
The following are statements of rights with respect to your protected health information.
You have the right to inspect and copy your protected health information (reasonable fees may apply) Pursuant to your written request, you have the right to inspect or copy your protected health information whether in paper or electronic format, with limited exceptions. Primary Health Network may use readable electronic form or format to provide you access.
You have the right to request a restriction of your protected health information. This means you may ask Primary Health Network not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care for notification purposes described in this Notice of Privacy Practices. Your written request must state specific restriction requested and to whom you want the restriction to apply. Primary Health Network is not required to agree to your requested restrictions except if your request that Primary Health Network not discloses protected health information to your health plan with respect to healthcare for which you have paid in full out of pocket.
You have the right to receive an accounting of certain disclosures. You have the right to receive an accounting of disclosures, paper or electronic, except for disclosures: pursuant to an authorization, for purposes of treatment, payment, healthcare operations; required by law that occurred prior to April 14, 2003, or six years prior to the date of your request.
You have the right to request an amendment to your protected health information. Your request must be in writing and it must explain why the information should be amended. Primary Health Network may deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.
You have the right to receive a notice of a breach. Primary Health Network will notify you of your unsecured protected health information has been breached.
You have the right to obtain a paper or electronic copy of this notice. Primary Health Network reserves the right to change the terms of this notice. We will also make available copies of our new notice if you wish to obtain one.
You may complain to Primary Health Network or the US Department of Health and Human Services, Office of Civil Rights if you believe your privacy rights have been violated by us. You may file a complaint with Primary Health Network by notifying Customer Service of your complaint. We will not retaliate against you for filing a complaint.
Primary Health Network Customer Service 1-866-276-7018
Department of Health and Human Services 1-877-696-6775