Notice of Privacy Practices

Notice of Privacy Practices

Notice Effective Date: December 2021

This notice describes how medical information about you may be used and disclosed. It also tells you how you can review or obtain a copy of this information.

USES AND DISCLOSURES OF HEALTH INFORMATION

How do we typically use or share your health information? We typically use or share your health information in the following ways:

Treatment: We can use your health information and share it with other professionals who are treating you, like your physician or healthcare provider.

Business Operations:  We can use and share your health information to run our practice, improve your care, and contact you when necessary. Operations include quality assessment and enhancement activities, evaluating performance, conducting training programs, accreditation, certification, or licensing activities.

Payment:  We may use and disclose your health information to obtain payment for services we provide to you.

As Required By Law:  We may use and disclose your health information when required to do so by federal, state or local law. 

Threat to Health or Safety:  We may use and disclose your health information for health and safety reasons, when necessary.

There are times when uses and disclosures will be made only with your consent:  Any use of protected health information for marketing and research purposes, any clinical notes. You can revoke consent in writing at any time.

INDIVIDUAL RIGHTS

Get an electronic copy of your medical record: You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge reasonable, cost-based fee.

Ask us to correct your medical record:  You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications: You can ask us to contact you in a specific way (for example, in person or in writing) or to send mail to a different address or email.

Request Restrictions:  You can ask us not to use or share certain health information for treatment, payment, or our operations.  We are not required to agree to your request and we may say “no” if it would affect your care.

Accounting:  You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.  We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make).  We’ll provide one accounting a year for free but will charge you a reasonable, cost-based fee if you ask for another one within 12 months.

Choose someone to act for you: If you have given someone medical power of attorney of if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.

Copy of this Notice:  You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.  We will provide you with a paper copy promptly.

In the case of fundraising: we may contact you for fundraising efforts, but you can tell us not to contact you again.

OUR RESPONSIBILITIES

We are required by law to maintain the privacy and security of your protected health information. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. We must follow the duties and privacy practices described in this notice and give you a copy of it.

We will not use or share your information other than as described here unless you tell us we can in writing.  If you tell us we can, you may change your mind at any time.  Let us know in writing if you change your mind.

We can change the terms of this notice, and the changes will apply to all information we have about you.  The new notice will be available upon request, in our office, and on our website. 

COMPLAINTS

It is ok to file a complaint. Aspire will not retaliate against you. You can complain if you feel we have violated your rights by contacting the Privacy Officer at (978) 602-7405 or smacneil@allinc.org.

You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, 200 Independence Avenue, S.W., Washington, D.C. 20201, by calling 1-877-696-6775 or by visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.

Questions about this notice should be directed to the Privacy Officer at (978) 602-7405 or smacneil@allinc.org.