Notice of Privacy Practices*
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.
Welcome to Aspire!
At Aspire Health Concepts, Inc. (Aspire), we strive to provide all of our patients with excellent health care and a warm personal experience. We are equally committed to keeping your protected health information (PHI) both private and secure. Please read this notice carefully to ensure that you have a sufficient understanding of how your health information may be used and disclosed; including both our legal duties and your rights as specified by the Privacy Rule, under the Health Insurance Portability and Accountability Act (HIPAA) of 1996.
Under HIPAA, the U.S. Department of Health and Human Services (HHS) was required to provide standards that would assure the privacy and security of individually identifiable health information, while permitting appropriate use. This set of standards is called the Privacy Rule. In short, the Privacy Rule defines and limits the circumstances in which we can use and disclose your PHI. We will not use or disclose your protected health information unless it is necessary to provide and promote high quality health care, or to protect the public’s health, and only if it is permitted or required by the Privacy Rule, or when otherwise specifically authorized, in writing, by you or your personal representative.
Important Privacy Rule Definitions
The following definitions, selected from the HIPAA Privacy Rule and/or the Privacy Rule Summary located on the HHS website (www.hhs.gov/hipaa), may be helpful to your understanding:
- Covered entities include health plans, health care clearinghouses and health care providers who transmit health information electronically in connection with a standard transaction; as a covered entity, Aspire is subject to the Privacy Rule
- Personal representatives are persons with legal authority to make health care decisions on behalf of the patient, which is generally the parent or legal guardian for un-emancipated minors
- Protected Health Information (PHI) is individually identifiable health information that is transmitted or maintained by electronic media, or any other form or medium
Uses And Disclosures
The Privacy Rule specifies that there are only two situations that require us to disclose your PHI. The first, is to you or your personal representative when you request access to, or an accounting or disclosure of, your personal health information. The second is to the HHS when it is undertaking a compliance investigation, review or enforcement action. Under the Privacy Rule, there are a number of circumstances for which we are permitted to use or disclose your PHI to you, other persons or entities. Typically, we may use or disclose your PHI for treatment, payment and health care operations (TPO) as follows:
- We may use your health information and share it with other professionals who are treating you (e.g., a doctor treating you for an injury asks another doctor about your overall health condition)
- We may use and share your health information to bill and get payment from health plans or other entities (e.g., we give information about you to your health insurance plan so it will pay for services)
- We may use and share your health information to run our practice, improve your care, and contact you when necessary (e.g., we use health information about you to manage your treatment and services)
In addition, we may use or disclose your PHI in other ways that require additional conditions to be met before we use or share your information (see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html).
- We may share health information about you for certain situations such as: preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect or domestic violence, and preventing or reducing a serious threat to anyone’s health or safety; for workers’ compensation claims, law enforcement purposes or with a law enforcement official, with health oversight agencies for activities authorized by law and for special government functions such as military, national security, and presidential protective services
- We may use or share your information for health research
- We may share information about you if state or federal laws require it, including with HHS if it wants to see that we are complying with federal law
- We may share health information about you with organ procurement organizations
- We may share health information with a coroner, medical examiner, or funeral director when an individual dies
- We may share health information about you in response to a court or administrative order, or in response to a subpoena
Aspire is not required to obtain written authorization to use or disclose your PHI for the purposes of TPO. For most other uses and disclosures, the Privacy Rule mandates that you provide written authorization. Aspire will only use or disclose the minimum amount of information necessary to accomplish the intended purpose under the given circumstance.
You have choices with respect to certain uses and disclosures of your PHI. If you have a clear preference for how we share your information in the situations below, please let us know.
- You have both the right and choice to tell us to share information with your family, friends or others involved in your care; to share information in a disaster relief situation
- We will never share your information for marketing purposes, sale of information, or for most psychotherapy notes, unless you give us written permission (i.e., authorization)
- We may contact you for fundraising efforts, but you can tell us not to contact you again
Under the Privacy Rule, we have the following duties with respect to the use and disclosure of your PHI:
- We are required by law to maintain the privacy and security of your PHI; 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, but must let us know
- 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
Under the Privacy Rule, you have certain rights with respect to your PHI, which are listed here below:
- You may ask to see or get an electronic copy of your medical record and other health information we have about you; we will typically provide you with a copy or summary of your health information within thirty (30) days of your request, for which we will charge a reasonable, cost-based fee
- You may ask us to correct health information about you that you think is incorrect or incomplete; we may decline your request, but we will explain why in writing within sixty (60) days
- You may ask us to contact you in a specific way (for example, at home) or to send an e-mail to a different address
- You may ask us to limit what we use or share for treatment, payment or health care operations (TPO); we are not required to agree to your request if it would affect your care
- You may ask for a list of the times we have shared your health information over the past six (6) years, who we shared it with and why; we will include all the disclosures except those for TPO, and certain other disclosures; we will provide one accounting a year for free, but we will charge a reasonable, cost-based fee if you ask for another on in twelve (12) months
- You may ask for a paper copy of this notice at any time, even if you agreed to receive the notice electronically; we will provide you with a paper copy promptly
- You may have a personal representative exercise your rights and make choices about your PHI; we will make sure the person has this authority and can act for you
- You may file a complaint with us directly, in writing, to the Privacy Officer listed below; you may also choose to file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/hipaa/filing-a-complaint/index.html.
Please contact the Privacy Officer at the following address or telephone number for any questions regarding this Notice of Privacy Practices:
Aspire Health Concepts, Inc.
Attn: Angie Neely, Privacy Officer
49 Prince Street, Harrisburg, PA 17109
This Notice of Privacy Practices is effective June 1st, 2016 and applies to all PHI contained in your health records, electronic or otherwise, that we maintain. We reserve the right to change the terms of this Notice of Privacy Practices at any time, making the new provisions effective for all PHI and health records.
*Significant portions of the text in this notice are adapted from the HIPAA Privacy Rule, the Privacy Rule Summary, and/or the HHS Model Notices of Privacy Practices (NPP) Booklet – HC Provider. The HHS Model Notices of Privacy Practices NPP Booklet – HC Provider can be located at the following website: http://www.hhs.gov/hipaa/.