Notice of Privacy Practices
Changes to this Notice
Our Pledge
We are required by law to:
- Make sure that health information that identifies you is kept private in accordance with relevant law.
- Give you this notice of our legal duties and privacy practices with respect to your PHI.
- Follow the terms of the notice that is currently in effect for all of your PHI.
How FHCN May Use and Disclose Your Health Information
We may use and disclose your PHI for these purposes:
For Treatment: FHCN will use and disclose your PHI to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party that has already obtained your permission to have access to your PHI. For example, we would disclose your PHI, as necessary, to a home health agency that provides care to you. We will also disclose PHI to physicians who may be treating you, when we have the necessary permission from you to disclose your PHI. For example, your PHI may be provided to a physician as a referral or in a consult to ensure that the physician has the necessary information to diagnose or treat you. As another example, your PHI may be provided to a physician treating you at another practice through the health information exchange.
In addition, we may disclose your PHI from time to time to another physician or health care provider (e.g., a specialist or laboratory) who, at the request of your physician, becomes involved in your care by providing assistance with your health care diagnosis or treatment to your physician.
For Payment: We may use and disclose health information about you to bill and collect payment from you, your insurance company, including Medicaid and Medicare, or other third parties that may be available to reimburse us for some or all of your health care. For example, if you have health insurance, we may need to share information about treatment that you need to obtain your health plan’s prior approval or to determine whether your plan will cover the treatment.
Out-of-Pocket Payments. If you paid out-of-pocket in full for a specific item or service, you have the right to ask that your PHI with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations.
For Health Care Operations: We may use or disclose, as needed, your PHI in order to support the business activities of FHCN. These activities include, but are not limited to, quality assessment, employee reviews, licensing, and conducting or arranging for other business activities. For example, FHCN may use a sign-in sheet at the front desk where you will be asked to sign your name. We may also call you by name in the waiting room when you are ready to be seen. We may use or disclose your PHI, as necessary, to contact you to remind you of your appointment.
We will share your PHI with third-party “business associates” that perform various activities (e.g., billing, transcription services) for the provider. Whenever an arrangement between our office and a business associate involves the use or disclosure of your PHI, we will have a written contract that contains terms that will protect the privacy of your PHI.
Health-Related Services and Treatment Alternatives: We may use and disclose health information to tell you about health-related services or recommend treatment options or alternatives that may be of interest to you. Please let us know if you do not wish us to contact you with this information or if you wish to have us use a different address when sending this information to you.
Individuals Involved in Your Care or Payment for Your Care: Unless you object, we may release health information about you to a friend or family member who is involved in your health care or the person who helps pay for your care.
Organ and Tissue Donation: If you are an organ donor, we may discuss health information about you with organizations that handle organ procurement or organ, eye, or tissue transplantation, or to an organ donation bank, as necessary, to facilitate organ or tissue donation and transplantation.
As Required By Law: We will disclose health information about you when required to do so by federal, state, or local law.
To Avert a Serious Threat to Health or Safety: We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat (e.g., law enforcement officers).
Military and Veterans: When the appropriate conditions apply, we may use or disclose PHI of individuals who are armed forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits; or (3) to foreign military authority if you are a member of that foreign military service. We may also disclose your PHI to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.
Workers’ Compensation: We may release health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illnesses.
Public Health Activities: We may disclose health information about you for public health activities. These activities generally include the following:
- To prevent or control disease, injury, or disability.
- To report child abuse or neglect.
- To report reactions to medications or problems with products.
- To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
- To notify people of recalls of products.
- To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
Health Oversight Activities: We may disclose health information about you to a health oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system and government programs to ensure compliance with applicable civil rights laws.
Lawsuits and Disputes: We may disclose health information about you in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request, or another lawful process that is not accompanied by a court or administrative order, but only if efforts have been made to tell you about the request or obtain an order protecting the information requested.
Law Enforcement: We may release health information about you if asked to do so by a law enforcement official:
- In response to a court order, subpoena, warrant, summons or similar process.
- To identify or locate a suspect, fugitive, material witness or missing person.
- Under certain limited circumstances, about the victim of a crime.
- About a death we believe may be the result of criminal conduct.
- About criminal conduct at the health center.
- In emergency circumstances to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.
Coroners, Health Examiners, and Funeral Directors: We may release health information about our patients to a coroner or health examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release health information to funeral directors as may be necessary for them to carry out their duties.
Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose to the institution health information necessary for your health and the safety of others.
Your Rights
You have certain rights with respect to your PHI. This section of our notice describes your rights and how to exercise them:
Right to Access PHI: Subject to certain exceptions, you have the right to view or receive an electronic or paper copy of your PHI in your medical and billing records, or in any other group of records that we maintain and use to make health care decisions about you. This right does not include the right to inspect and receive a copy of psychotherapy notes, although your behavioral/mental health provider may provide you with a summary of these notes.
To access or receive a copy of your PHI, you must submit your request in writing to FHCN. If you request a copy of the information, we may charge a fee for the copying and the mailing costs, and for any other costs associated with your request.
In certain very limited circumstances, we may deny your request to access and receive a copy. If your request is denied, you may request that the denial be reviewed. We will designate a licensed health care professional to review the decision. The person conducting the review will not be the same person who denied your request. We will comply with the outcome of this review.
Right to Amend PHI: If you feel that the PHI we maintain about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for any information that we maintain about you. To request an amendment, your request must be made in writing (legibly handwritten or typed), submitted to our Privacy Officer, and must be contained on one piece of paper. In addition, you must provide a reason that supports your request for an 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:
- Was not created by us, unless the person or organization that created the information is no longer available to make the amendment.
- Is not PHI kept by or for FHCN.
- Is not part of the information which you would be permitted to access and receive a copy, or
- Is determined to be accurate and complete.
As previously described in this notice, any amendment we make to your PHI will be disclosed to the health care professionals involved in your care and to others involved in payment and health care operations, as necessary.
Right to Receive an Accounting of Disclosures: You have the right to receive an accounting of certain disclosures of your health information that we have made. Any accounting will not include all disclosures that we make. For example, an accounting will not include disclosures:
- To carry out treatment, payment, and health care operations as previously described in this notice.
- Pursuant to your written authorization.
- To a family member, other relative, or personal friend involved in your care or payment for your care when you have given permission to do so.
- To law enforcement officials.
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 more than six (6) years prior to the date you ask, and may not include dates before April 14, 2003. The first list you request within a 12-month period will be free. For additional requests within the same 12-month period, we may charge you the costs of providing the additional disclosures. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred. We will mail you a list of disclosures in paper form within 30 days of your request, or notify you if we are unable to supply the list within that time period.
Right to Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your case or payment for your care, such as a family member or friend. For example, you may request that we not disclose information about you to a certain doctor or other health care professional, or that we not disclose information to your spouse about certain care that you received.
We are not required to agree to your request for restrictions if it is not feasible for us to comply with your request or if we believe that it will negatively impact our ability to care for you. However, if we do agree, we will comply with your request unless the information is needed to provide emergency treatment. To request a restriction, you must make your request in writing to our Privacy Officer. In your request, you must tell us what information you want to limit and to whom you want the limits to apply.
Right to Opt Out of Fundraising Communications: We may contact individuals to raise funds for the organization but the individual has a right to opt out of receiving such communications.
Your Written Authorization is Required for Other Uses and Disclosures: The following uses and disclosures of your PHI will be made only with your written authorization:
- Most uses and disclosures of psychotherapy notes;
- Uses and disclosures of PHI for marketing purposes; and
- Disclosures that constitute a sale of your PHI.
Other uses and disclosures of PHI not covered by this Notice or the laws that apply to us will be made only with your written authorization. If you do give us an authorization, you may revoke it at any time by submitting a written revocation to our Privacy Officer and we will no longer disclose PHI under the authorization. However, disclosure(s) that we made in reliance on your authorization before you revoked it will not be affected by the revocation.
Right to Get Notice of a Breach. You have the right to be notified upon a breach of any of your unsecured PHI.
Right to Receive Confidential Communication: You have the right to request that we communicate with you about health matters in a certain way. For example, you can ask that we only contact you by mail to a specified address. To request that we communicate with you in a certain way, you must make your request in writing to the Privacy Officer. We will not ask you the reason for your request. Your request must specify how or where you wish to be contacted. We will attempt to accommodate all reasonable requests.
Right to a Copy of this Notice: You have the right to receive a paper copy of this notice at any time. To receive a copy, please request it at any of our health centers. You may also obtain a copy of this notice on our website at www.fhcn.org.
Changes to this Notice
We reserve the right to change this notice and to make the changed notice effective for all of the health information that we maintain about you. We will post a copy of our current notice in our facilities. Our notice will indicate the effective date on the first page. We will also give you a copy of our current notice upon request.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. You may file a complaint by mailing, faxing, or e-mailing us a written description of your complaint at the address below or by telling us about your complaint in person or over the telephone at (559) 737-4700:
Attn: Privacy Officer
Family HealthCare Network
305 East Center Street
Visalia, CA 93291
When filing a complaint, please describe what happened and give us the dates and names of anyone involved. Please also let us know how to contact you so that we can respond to your complaint. You will not be penalized or retaliated against for filling a privacy complaint.
Other Uses and Disclosures of Your PHI
Other uses and disclosures of PHI not covered by this notice or applicable law will be made only with your written authorization. If you give us your written authorization to use or disclose your PHI, you may revoke your authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose your PHI for the reason covered by your written authorization. Please understand that we are unable to take back any uses and disclosures that we have already made with your authorization and that we are required to retain our records of the care that we have provided to you.
