Notice of Privacy
THIS NOTICE DESCRIBES
HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU
CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
notices serves as the ongoing corporate compliance effort of
Provider Plus, Inc., hereafter referred to as
"Organization", to assure quality care and services to
the individuals we serve.
Our organization is
privacy of your health information
provide you with
a notice as to our legal duties and privacy practices with
respect to information we collect and maintain about you
abide by the
terms of this notice
notify you if we
are unable to provide the requested medical service or supply
reasonable requests you may have to communicate health
information by alternative means or at alternative locations
We reserve the right
to change our practices and to make the new provisions effective
for all protected health information we maintain. We will
post a copy of the current notice in the Organization. The
notice will contain on the first page, the effective date.
We will not use or
disclose your health information without your authorization,
except as described in this notice.
How We Will
Use or Disclose Your Health Information
categories describe different ways that we use and disclose
medical information. For each category, we will explain what
we mean and give examples. Not every use or disclosure in a
category will be listed. However, all of the ways we are
permitted to use and disclose information will fall within one of
We will use your health information for payment. For
example, a bill may be sent to you or a third-party payer,
including Medicare or Medicaid. The information on or
accompanying the bill may include information that identifies
you, as well as your diagnosis, procedures and supplies used.
operations. We will use your health information for
regular health operations. For example, members of our
respiratory team may use information in your health record to
assess the care and outcomes in your case and others like
it. This information will then be used in an effort to
continually improve the quality and effectiveness of the
service we provide.
associates. There are some services provided in our
organization through contacts with business associates.
Examples include our accountants, consultants and
attorneys. When these services are contracted, we may
disclose your health information to our business associates so
that they can perform the job we've asked them to do. To
protect your health information, however, we require the
business associates to appropriately safeguard your
We may use or disclose information to notify or assist in
notifying a family member, personal representative or another
person responsible for your care. If we are unable to
reach your family member or personal representative, then we
may leave a message for them at the phone number that they
have provided us, e.g., on an answering machine.
with people involved in your care or payment for your care.
Health professionals, using their best judgment, may disclose
to a family member, other relative, close personal friend or
any other person your identity, health information relevant to
that person's involvement in your care or payment related to
We may contact you to provide appointment reminders or
information about treatment alternatives or other
health-related benefits and services that may be of interest
compensation. We may disclose health information to
the extent authorized by and to the extent necessary to comply
with laws relating to workers compensation or other similar
programs established by law.
health. As required by law, we may disclose your
health information to public health or legal authorities
charged with preventing or controlling disease, injury or
institution. Should you be an inmate of a
correctional institution, we my disclose to the institution or
agents thereof health information necessary for your health
and the health and safety of other individuals.
enforcement. We may disclose health information for
law enforcement purposes as required by law or in response to
a valid subpoena.
disputes. If you are involved in a lawsuit or
dispute, we may disclose medical information about you in
response to a court or administrative order. We may also
disclose medical information about you in response to a
subpoena, discovery request, or other lawful process by
someone else in the dispute.
Federal law makes provision for your health information to be
released to an appropriate health oversight agency, public
health authority of attorney, provides that a work force
member or business associate believes in good faith that we
have engaged in unlawful conduct or have otherwise violated
professional or clinical standards and are potentially
endangering one or more patients, workers or the public.
law. We may disclose your health information as may
be required by state and federal law.
security. We may disclose your health information to
federal and state officials as may be required for national
Although your health
record is the physical property of the Organization, the
information in your health record belongs to you. You have
the following rights:
You may request
that we not use or disclose your health information for a
particular reason related to treatment, payment, the
Organization's general operations, and/or to a particular
family member, other relative or close personal friend.
We ask that such requests be made in writing. Although
we will consider your request, please be aware that we are
under no obligation to accept it or to abide by it. For
more information about this right, see 45 Code of Federal
Regulations (C.F.R.) § 164.522(b).
You may request
to inspect and/or obtain copies of health information about
you, which will be provided to you in the time frames
established by law. Usually this includes medical and
billing records, but does not includes psychotherapy
notes. To inspect or copy your medical records, please
contact the Privacy Officer. If you request copies, we
will charge you a reasonable fee. We may deny your
request to inspect and copy in certain very limited
circumstances. If you are denied access to medical
information, you may request that the denial be
reviewed. For more information about this right, see 45
C.F.R. § 164.524.
If you believe
that any health information in your record is incorrect or if
you believe that important information is missing, you may
request that we correct or amend the existing information or
add the missing information. Such requests must be made
in writing to the Privacy Officer, and must provide a reason
to support the amendment. We may deny your request for
an amendment if it is not in writing or does not include a
reason to support the request. In addition, we may deny
your request if you ask us to amend information that: (1) was
not created by us; (2) is not part of the medical information
kept by the organization; (3) is not part of the information
which you would be permitted to inspect and copy; or (4) is
accurate and complete. For more information about this
right, see 45 C.F. R. § 164.526.
You may request
that we provide you with a written accounting of all
disclosures made by us during the time period for which you
request (not to exceed 6 years). We ask that such
requests be made in writing. Please note that an
accounting will not apply to any of the following types of
disclosures: disclosures made for reasons of treatment,
payment or health care operations; disclosures made to you or
your legal representative, or any other individual involved
with your care; national security purposes; and disclosures
made before April 16, 2003. You will not be charged for
your first accounting request in any 12 month period.
However, for any requests that you make thereafter, you will
be charged a reasonable, cost-based fee. For more
information about this right, see 45 C.F.R. § 164.528.
You have the
right to obtain a paper copy of our Notice of Information
Practices upon request.
You may revoke
an authorization to use or disclose health information, except
to the extent that action has already been taken. Such a
request must be made in writing.
Information or To Report a Problem
If you have questions and would like additional information, you
may contact our Privacy Officer at:
Provider Plus, Inc.
7748 Watson Road
St. Louis, MO 63119