Patient Privacy Protection

How is Patient Privacy Protected? At PromptCare, we understand that information about you and your health is personal. Because of this, we strive to maintain the confidentiality of your health information. We continuously seek to safeguard that information through administrative, physical and technical means, and otherwise abide by applicable federal and state guidelines.

Disclosed Health Information

How do we use and disclose health information? When Promptcare visits you, we use and disclose your health information for the normal business activities that the law sees as falling in the categories of treatment, payment and health care operations. Below we provide examples of those activities, although not every use or disclosure falling within each category is listed:

Treatment - We keep a record of each clinical visit or service. This record may include your test results, diagnoses, medications, and your response to medications or other therapies. We disclose this information so that doctors, nurses, other staff members, and entities such as laboratories can meet your needs. For example, our pharmacist may need to advise your treating physician of medications you may be receiving from another physician that could result in an adverse drug interaction.

Payment - We document the services and supplies you receive at each visit so that you, your insurance company or another third party can pay us. We may alert your health plan to upcoming treatment or services that require prior approval by your health plan. For example, we may need to provide to your health plan, information about a therapy or piece of equipment you received in order for your health plan to authorize service or reimburse for the therapy or piece of equipment.

Health Care Operations - Health information is used to improve the services we provide, to train staff, for business management, quality improvement, and for customer service. For example, we may use your health information to review our treatment and services and to evaluate the performance of our staff in caring for you.

However, we are limited by state law from releasing certain categories of health information for purposes of treatment, payment or health care operations. For example, we will generally not disclose AIDS/HIV, substance abuse treatment or genetic testing information without your permission.

We may also use your health information to:

• Comply with federal, state or local laws that require disclosure.
• Assist in public health activities such as tracking diseases or medical devices.
• Inform authorities to protect victims of abuse or neglect.
• Comply with Federal and state health oversight activities such as fraud investigations.
• Respond to law enforcement officials or to judicial orders, subpoenas or other process.
• Inform coroners, medical examiners and funeral directors of information necessary for them to fulfill their duties.
• Facilitate organ and tissue donation or procurement.
• Conduct research following internal review protocols to ensure the balancing of privacy and research needs.
• Avert a serious threat to health or safety.
• Assist in specialized government functions such as national security, intelligence and protective services.
• Inform military and veteran authorities if you are an armed forces member (active or reserve).
• Inform a correctional institution if you are an inmate.
• Inform workersÕ compensation carriers or your employer if you are injured at work. • Recommend treatment alternatives.
• Tell you about health-related products and services.
• Communicate with other PromptCare organizations for treatment, payment, or health care operations.
• Communicate with other providers, health plans, or their related entities for their treatment or payment activities, or health care operations activities relating to quality assessment or licensing.
• Provide information to other third parties with whom we do business, such as drug safety net program or collection agency. However, you should know that in these situations, we require third parties to provide us with assurances that they will safeguard your information.

We may also use or disclose your personal or health information for the following operational purposes. We may:

• Communicate with individuals involved in your care or payment for that care, such as friends or family member.
• Send scheduling reminders.

You may tell the scheduler or Patient Service Coordinator that you do not want us to use or disclose your information for these two activities.

All other uses and disclosures, not previously described, may only be done with your written authorization. You may revoke your authorization; however, this will not affect prior uses and disclosures.

What are PromptCare's Responsibilities?

PromptCare is required by law to:

• Maintain the privacy of your health information
• Provide this notice of our duties and privacy practices
• Abide by the terms of the notice currently in effect.

We reserve the right to change privacy practices, and make the new practices effective for all the information we maintain. Revised notices will be posted in our facilities and we will offer you a copy when you receive services.

Do you have any Federal Rights?

The law entitles you to:

• Inspect and copy certain portions of your health information.×* This does not include psychotherapy notes and we may deny your request under limited circumstances.

• Request amendment of your health information if you feel the health information is incorrect or incomplete.× (However, under certain circumstances we may deny your request.)

• Receive an accounting of certain disclosures of your health information made after April 14, 2003 although this excludes disclosures for treatment, payment, health care operations.×*

• Request that we restrict how we use or disclose your health information.× (However, we are not required to agree with your requests).

• Request that we communicate with you at a specific telephone number or address.×

• Obtain a paper copy of this notice even if you receive it electronically.

Requests followed by a diamond (×) must be in writing. Fees may apply to request followed by a star (*). Contact the Privacy Officer if you wish to exercise these rights.

[New York: YOU CANNOT BE DENIED ACCESS TO YOUR MEDICAL RECORDS SIMPLY BECAUSE YOU CANNOT PAY THE COSTS OF COPYING OR INSPECTION.]

Who will follow this Notice?

This Notice describes PromptCare's practices and those of:

• Any physician or other health care professional authorized by PromptCare to access and/or enter information into your medical record,

• All departments and units of the facility,

• All affiliates and volunteers, and

• Any PromptCare owned health care entities

Your personal care providers may have different policies or Notices regarding their use and disclosure of your health information created in their offices.