How We May Use or Disclose Your Protected Health Information
- We may use or disclose your protected health information to arrange for the provision of your medical treatment or services. For example, the provider providing health care services to you will record information in your record that is related to your treatment. This information is necessary for us to perform certain functions that include, but are not limited to medical records reviews; to investigate quality of care complaints; to perform quality improvement studies and other functions, as FLORIDA HEALTH SOLUTION is required under applicable law and regulation.
- We may use or disclose your protected health information in order to process claims or make payment for covered services you receive under your benefit plan. For example, you provider may submit a claim to us for payment. The claim form will include information that identifies you, your diagnosis, and treatment or supplies used in the course of treatment.
- Health Care Operations
- We may use or disclose your protected health information for health care operations. Health care operations include, but are not limited to, quality assessment and improvement activities, underwriting, premium rating, management, and general administrative activities. For example, members of our quality improvement team may use information in your health record to assess the quality of care that you receive and determine how to continually improve the quality and effectiveness of the services we provide in accordance with applicable state and federal laws and regulations and applicable accreditation organization requirements.
- Business Associates
- There may be instances where services are provided to our organization through contracts with third-party "business associates." Whenever a business associate arrangement involves the use or disclosure of your protected health information, we will have a written contract that requires the business associate to maintain the same high standards of safeguarding your privacy that we require of our own employees and affiliates.
- Required by Law
- We will disclose protected health information about you when required to do so by federal, state, or local law.
- Communication With Family or Friends
- Our service professionals, using their best judgment, may disclose to a family member, other relative, close personal friend, or any other person you identify, protected health information relevant to that person's involvement in your care or payment related to your care.
- We may use or disclose your protected health information, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you.
- We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected information.
- Coroners, Medical Examiners, and Funeral Directors
- We may disclose protected health information to a coroner or medical examiner. We may also disclose protected health information to funeral directors consistent with applicable law to carry out their duties.
- 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.
- Food and Drug Administration (FDA)
- We may disclose to the FDA protected health information relative to adverse events with respect to food, supplements, product and product defects, or post-marketing surveillance information to enable product recalls, repairs, or replacement.
- Workers' Compensation
- We may disclose protected health information to the extent authorized by and to the extent necessary to comply with laws relating to workers' compensation or other similar programs established by law.
- To Avert a Serious Threat to Health or Safety
- Consistent with applicable federal and state laws, we may use and disclose protected health information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
- Military and Veterans
- If you are a member of the armed forces, we may disclose protected health information about you as required by military command.
- Health Oversight Activities
- We may disclose protected health information to a health oversight agency for activities authorized by law, including audits, investigations, inspections, and licensure.
- Protective Services for the President, National Security, and Intelligence Activities
- We may disclose protected health information about you to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state or to conduct special investigations, for intelligence, counterintelligence, and other national security activities authorized by law.
- Law Enforcement
- We may disclose protected health information when requested by a law enforcement official as part of law enforcement activities; investigations of criminal conduct; in response tocourt orders; in emergency circumstances; or when required to do so by law.
- We may disclose protected health information about an inmate of a correctional institution or under the custody of a law enforcement official to the correctional institution or law enforcement official.
- Lawsuits and Disputes
- We may disclose protected health information about you in response to a subpoena, discovery request, or other lawful order from acourt.
- Plan Sponsors
- We may disclose protected health information about you to your plan sponsor to carry out plan administration functions that the plan sponsor performs upon certification by the plan sponsor that the plan documents have been amended as set forth under HIPAA regulations.
- Our Rights Regarding Your Protected Health Information
- The following describes your rights regarding the health information we maintain about you. To exercise your rights, you must submit your request in writing to our Privacy Officer at 7350 NW 7th ST Suite 204, Miami, Fl 33126.
- Right to Request Restrictions
- You have the right to request that we restrict uses or disclosures of your protected health information to carry out treatment, payment, health care operations, or communication with family or friends. We are not required to agree to a restriction.
- Right to Receive Confidential Communications
- You have the right to request that we send communications that contain your protected health information by alternative means or to alternative locations. We must accommodate your request if it is reasonable and you clearly state that the disclosure of all or part of that information could endanger you.
- Right to Inspect and Copy
- You have the right to inspect and copy protected health information that we maintain about you in a designated record set. A "designated record set" is a group of records that we maintain such as enrollment, payment, and claims adjudication record systems. If copies are requested or you agree to a summary or explanation of such information, we may charge a reasonable cost-based fee for the costs of copying, including labor and supply cost of copying; postage; and preparation cost of an explanation or summary, if such is requested. We may deny your request to inspect and copy in certain circumstances as defined by law. If you are denied access to your protected health information, you may request that the denial be reviewed.
- Right to Amend
- You have the right to have us amend your protected health information for as long as we maintained such information. Your written request must include the reason or reasons that supportyour request. We may deny your request for an amendment if we determine that the record that is the subject of the request was not created by us, is not available for inspection as specified by law, or is accurate and complete.
- Right to Receive an Accounting of Disclosures
- You have the right to receive an accounting of disclosures of your protected health information made by us in the six years prior to the date the accounting is requested (or shorter period as requested). This does not include disclosures made to carry out treatment, payment, and health care operations; disclosures made to you; communications with family and friends; for national security or intelligence purposes; to correctional institutions or law enforcement officials; or disclosures made prior to the HIPAA compliance date of April 14, 2003. Your first request for accounting in any 12-month period shall be provided without charge. A reasonable cost-based fee shall be imposed for each subsequent request for accounting within the same 12-month period.
- Right to Obtain a Paper Copy
You have the right to obtain a paper copy of this Notice of Privacy Practices at any time.
- How to File a Complaint if You Believe Your Privacy Rights Have Been Violated
If you believe that your privacy rights have been violated, please submit your complaint in writing to:
Florida Health Solution, Corp. Attn: Privacy Officer 7350 NW 7th St Suite 204 Miami, FL 33126
You may also file a complaint with the Secretary of the Department of Health and Human Services.
You will not be retaliated against for filing a complaint.