Introduction
At Neuroglee Clinical Care, we are committed to treating and using Protected Health Information about you responsibly. This Notice of Privacy Practices describes how and when Neuroglee Care, PLLC and Independent Care Medical PLLC. (“Neuroglee Clinical Care”) use and disclose your Protected Health Information. It also describes your individual rights as they relate to your Protected Health Information.This Notice is effective September 01, 2024, and applies to all Protected Health Information as defined by federal regulations.
Understanding Your Health Record/Information
Each time you visit Neuroglee Clinical Care, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your chart or medical record, serves as a:• Basis for planning your care and treatment.
• Means of communication among the many health professionals who contribute to your care.
• Legal document describing the care you received.
• Means by which you or a third-party payer can verify that services billed were provided.
• Source of data for medical research.
• Source of information for public health officials charged with improving the health of this state and the nation.
• Source of data for our planning and marketing; and
• Tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.
Disclosures and Uses of Your Protected Health Information that do not require your Authorization Treatment.
We may use Protected Health Information about you to provide you with medical treatment or services. We may disclose Protected Health Information about you to doctors, nurses, technicians, medical students, or other personnel involved in taking care of you at the practice or hospital. For example, we may disclose Protected Health Information about you to people outside the practice who may be involved in your medical care, such as your other treating providers, your family members, clergy, or other persons who are part of your care.Payment. We may use and disclose Protected Health Information about you so that the treatment and services you receive at the practice may be billed to and payment may be collected from you, an insurance company, or a third party. For example, we may disclose your records to an insurance company, so that we can get paid for treating you; we may disclose your account information to our third-party business associates for payment(s).
Healthcare Operations. We may use Protected Health Information about you for healthcare operations. These uses and disclosures are necessary to run the practice and provide your healthcare. We also may disclose information to doctors, nurses, technicians, medical students, and other practice personnel for review and learning purposes. For example, we may review your record to assist our quality improvement efforts.
Health Information Exchanges. We may participate in certain health information exchanges whereby we may disclose your health information, as permitted by law, to other health care providers or entities for treatment.
Business Associates. There are some services provided in our organization through contacts with business associates. An example is certain tests performed by outside laboratories. When these services are contracted, we may disclose your health information to our business associates so that they can perform the job we have asked them to do and bill you or your third- party payer for services rendered. To protect your health information, however, we require the business associates to appropriately safeguard your information.
Research. We may use and disclose your Protected Health Information for research purposes, but we will only do that if the research has been specially approved by an authorized institutional review board or a privacy board that has reviewed the research proposal and has set up protocols to ensure the privacy of your Protected Health Information.
As Required by Law. We will disclose Protected Health Information about you when required to do so by international, federal, state, or local law.
To Avert a Serious Threat to Health or Safety. We may use and disclose Protected Health Information when necessary to prevent a serious threat to your health or safety or to the health or safety of others. But we will only disclose the information to someone who may be able to help prevent the threat.
Public Health. As required by law, we may disclose your Protected Health Information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
Health Oversight Activities. We may disclose your Protected Health Information to an agency that oversees the health care system and is charged with responsibility for ensuring compliance with the rules of government health programs such as Medicare or Medicaid.
Judicial and Administrative Proceedings. We may disclose your Protected Health Information in the course of a judicial or administrative proceeding in response to a legal order or other lawful process.
Law enforcement. We may disclose Protected Health Information for law enforcement purposes as required by law or in response to a valid subpoena.
Data Breach Notification Purposes. We may use or disclose your Protected Health Information to provide legally required notices of unauthorized access to or disclosure of your health information.
Abuse, Neglect, or Domestic Violence. We may disclose Protected Health Information to the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence and the patient agrees or if we are required or authorized by law to make that disclosure.
Military and Veterans. If you are a member of the armed forces, we may disclose Protected Health Information as required by military command authorities. We also may disclose Protected Health Information to the appropriate foreign military authority if you are a member of a foreign military.
Decedents. We may disclose your Protected Health Information to a coroner or medical examiner as authorized by law.
Organ and Tissue Procurement. We may disclose your Protected Health Information to organizations that facilitate organ, eye or tissue procurement, banking or transplantation.
Specialized Government Functions. We may use and disclose your Protected Health Information to units of the government with special functions, such as the U.S. military or the U.S. Department of State under certain circumstances.
Workers’ Compensation. We may disclose your Protected Health Information as authorized by and to the extent necessary to comply with state law relating to workers’ compensation or other similar programs.
Disclosures and Uses of Your Protected Health Information that require your Authorization
For any purpose other than the ones described above, we only use or disclose your Protected Health Information when you give us your written authorization.Marketing. We must obtain your written authorization prior to using your Protected Health Information for purposes that are marketing under the HIPAA privacy rules. For example, we will not accept any payments from other organizations or individuals in exchange for making communications to you about treatments, therapies, health care providers, settings of care, case management, care coordination, products or services unless you have given us your authorization to do so or the communication is permitted by law.
We may provide refill reminders or communicate with you about a drug or biologic that is currently prescribed to you so long as any payment we receive for making the communication is reasonably related to our cost of making the communication. In addition, we may market to you in a face-to-face encounter and give you promotional gifts of nominal value without obtaining your written authorization.
Sale of Protected Health Information. We will not make any disclosure of Protected Health Information that is a sale of Protected Health Information without your written authorization.
Psychotherapy Notes. We will not use or disclose psychotherapy notes about you without your authorization except for use by the mental health professional who created the notes to provide treatment to you, for our mental health training programs or to defend ourselves in a legal action or other proceeding brought by you.
Uses and Disclosures of Your Highly Confidential Information. Federal and state law requires special privacy protections for certain health information about you (“Highly Confidential Information”), including Alcohol and Drug Abuse Treatment Program records and other health information that is given special privacy protection under state or federal laws other than HIPAA. We generally do not maintain any Highly Confidential Information. However, in order for us to disclose any Highly Confidential Information for a purpose other than those permitted by law, we must obtain your authorization.
Your Health Information Rights
You have the following rights:• Right to a Paper Copy of this Notice. You may ask us to give you a copy of this Notice at any time.
• Right to Inspect and Copy. You have the right to inspect and copy Protected Health Information that may be used to make decisions about your care. We may deny your request to inspect and copy in certain very limited circumstances.
• Right to Amend. You may request that we amend the Protected Health Information Neuroglee Therapeutics has about you if you feel it is incorrect or incomplete. You may request an amendment for as long as the information is kept by the practice.
• Right to an Accounting of Disclosures. You may request an “accounting of disclosures.” This is a list of the disclosures Neuroglee Clinical Care has made of Protected Health Information about you.
• Right to Request Confidential Communications. You may request that we communicate with you about medical matters in a certain way or at a certain location.
• Right to Request Restrictions. You have the right to request a restriction or limitation on the Protected Health Information we use or disclose about you for treatment, payment, or healthcare operations. You also have the right to request a limit on the Protected Health Information we disclose about you to someone who is involved in your care or the payment for your care, such as a family member or friend. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment.
• Out-of-Pocket Payments. If you paid out-of-pocket or in full for a specific item or service, you have the right to ask that your Protected Health Information with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations, and we will honor that request.
Neuroglee Clinical Care Responsibilities
Neuroglee Clinical Care will:• Maintain the privacy of your Protected Health Information.
• Provide you with this 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 agree to a requested restriction.
• Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.
• Notify you in the event of a breach of your unsecured Protected Health Information
We reserve the right to change this Notice and to make the new provisions effective for all Protected Health Information we maintain. We will post any revised copy of this Notice to our website. You are entitled to a paper copy of our Notice of Privacy Practices at any time at your request.
We will not use or disclose your Protected Health Information without your authorization, except as described in this Notice. If we obtain your authorization to use or disclose your Protected Health Information, we will also discontinue using or disclosing your Protected Health Information after we have received a written revocation of your authorization.
For More Information or to Report a Problem
If you have questions, would like additional information, or believe your privacy rights have been violated and would like to file a complaint, you can contact:Neuroglee Therapeutics Attn: Privacy Officer
101 Arch St, FL 08
Boston, MA 02110
or
Office for Civil Rights
U.S. Department of Health and Human Services 200 Independence Avenue, S.W.
Room 509F, HHS Building Washington, DC 20201
There will be no retaliation for filing a complaint with either the Privacy Officer or the Office for Civil Rights.