74529542.1,Effective Date: September 4, 2020,NOTICE OF HEALTH INFORMATION PRIVACY PRACTICES,THE FOLLOWING NOTICE DESCRIBES HOW YOUR HEALTHINFORMATION MAY BE USED AND DISCLOSED AND HOW YOU ,CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW THE INFORMATION BELOW CAREFULLY.THIS NOTICE APPLIES TO Q ,CAREPLUS, INC.
AND Q CARE PLUS MEDICAL, P.
C .,This Notice informs you about our possible uses and disclosures of your health information.
It also describes your ,rights and our obligations regarding your personal health information.,How we use and disclose your PHI:Except where prohibited by other laws that require special privacy ,protections, we may use and disclose your health information without your prior authorization as follows:,•Treatment: We may use your PHIand share itwithother healthcare providerswho are treating you, such as ,when necessary toorder laboratory tests and to receive the associated test results.You may be contacted ,by us to remind you of any appointmentsor refill reminders, or todiscuss yourhealthcare treatment options.,•Payment: We may use your PHIand share it with payors/insurers in order tobill and receivepayment for the ,health care services we provide to you.We may also contact you to discuss your insurance/billing options.,•Operations: We may use your PHIand share it when necessarytooperate our company, such as performing ,quality improvement activities, conducting patient satisfaction surveys, andassessing staffing needs.
We may ,also share your information with business associates who are contractually obligated to protect the privacy ,of your health information the same way we are.,•Non-Routine Situations: Your PHImay be released in other non-routinesituations,such as:,•To address public health and safety issues, including reportingcommunicable diseaseswhen required ,by law, reporting adverse reactionsto health oversight agencies, reporting suspected abuse, neglect, ,or domestic violence, and preventing or reducing a serious threat to your or someone’s health or safety ,•For health research purposes, subject to a special approval process,•To organ procurement organizationsand similar entitiesrelated to organ and tissue donation/transplant,requests,•To a coroner, medical examiner, or funeral director when necessary for them todo their job,•To government agencies responsible for overseeing health care providerquality or billing practices,•As requiredor permittedby state law governing workers’ compensation programs,•To law enforcement officials in certain limited circumstances, including in response to an investigative ,demand or tohelp identify or locate a suspect, fugitive, material witness, or missing person,•In response to a courtor administrativeorder, a subpoena,or as otherwise required or allowed by law,•For special government functions such as military, national security, and presidential protective services,•Friend and Family Membersand Disaster Organizations: You may agree for us to communicate with a family ,member or friend tohelp facilitate your treatment or payment for your treatment.If there is an emergency ,situation and you are unable to agree, we mayalsogo ahead and share your PHIto the extent necessary ,with your friends, family, and disaster relief organizations, unless you have indicated to us that you do not ,want your PHI shared in such situations.
,•Authorizations: Exceptas described above, we may not use or disclose your PHI without first receiving written ,authorization from you.We will never sell your PHI or use or disclose your PHI for marketing purposes without ,your written authorization.If you sign an authorization, you may revoke your authorization at any time by ,contacting the Privacy Officer at the addressor telephone numberbelow, but only for information we have ,not already released in reliance upon your initial authorization.,•State Lawand Disease Specific Privacy Protections.
In some instances state law related to certain conditions, ,such as sexually transmitted infections, or otherwise, may require your prior written consent before we can ,use or disclose such information for certain purposes, including those described above.
In such instances ,prior to using or disclosing your information, we will comply with all requirements of such applicable law.,Your rights related to your PHI:Please contact the Privacy Officer to exercise any of the following rights.
You ,have the right to:,•Request restrictions on the waywe useor discloseyour PHIfor treatment, payment, or operationspurposes.,We are not required to agree to your request, unless your request relates to information about a service or ,health care item that you paid for out-of-pocket in full, and the disclosure is to your health insurer for payment ,74529542.1,or operations purposes.
,•To beinformed promptly if a breach occurs that may have compromised the privacy or security of your ,unsecured PHI.,•Receivepaper or electroniccopies ofPHIwe use to make decisions about you, such as your medical or billing ,records.We may charge a reasonable,cost-based fee for such copies.,•Requestchanges to correct your PHI.
We will review your request and make changes if we agree they are ,reasonable, and if we do not, we may say “no” and tell you why in writing within 60 days.,•Ask us to contact or communicate with you in a certain way (e.g.,home or mobile phone) or to send mail to ,a different address.
We will agree to all reasonable requests.,•Request a list of whoaccessedor receivedyour PHIand for what purposeduring the 6 years preceding your ,request.This list will not includeall disclosures of your PHI that we have made, includingroutine disclosures of ,your information for treatment, payment and health care operations purposes.We will provide you with one ,accounting a year for free, but may charge a reasonable, cost-based fee if you ask for another list within 12 ,months.,• C omplain to usand/or any applicable federal or state agency about our privacy practices.
You may contact us by writingto,the Privacy Officer.We will not retaliate against you for filing any complaint.,•Keepa copy of this noticeand to request a copy at anytime, even if you have also received it electronically.
,We may make changes to this Notice at any time, and the changes will apply to all information we have about ,you.
You may request a copy of any revised Notice, and we will post the latest version on our website.
All ,questions should be directed to the Privacy Officer atprivacy@qcareplus.comor by telephone at888.708.0561, ,ext 1.