Effective Date: September 23, 2013
Reviewed Date: October 21, 2019
Reviewed: October 19, 2021
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION, PLEASE REVIEW THIS NOTICE CAREFULLY.
Our Pledge
Your medical information is personal and private and Riverhills Neuroscience is committed to protecting your confidentiality. We need your medical record to provide you with quality care but we have certain obligations regarding how we use and disclose your information. This notice will tell you about the ways in which we may use and disclose medical information about you. This notice will also tell you about your rights to privacy.
Riverhills Neuroscience obligations required by law:
- To protect the health information that identifies you
- Provide to you a notice of our information practice policies and procedures
- Abide by the terms of the notice currently in effect
How we may use and disclose your medical information:
- For your Treatment: We may use your health information to provide you with medical treatment or services. Other employees within our office may also use this information when coordinating the different parts of your treatment. Some people outside of the office may need your information. These would include family members, laboratories, referring physicians, or others that may be involved with your care.
- For Payment of Services: We may use and disclose medical information about you so that the treatment and services you receive at this office may be billed to and payment may be collected from you, an insurance company, or a third party. An example would be when we need to disclose your information to receive prior approval for a specific treatment.
- For Health Care Operations: We may use and disclose medical information about you for office operations. These uses and disclosures are necessary to run the office and make sure that all of our patients receive quality care. For example, we may need your information to review our treatment and services and to evaluate our staff.
- Appointment Reminders: We may use your information to contact you as a reminder of an upcoming appointment.
- Individuals Involved with your Care or Payment for your Care: We may release medical information about you to a friend, physician, or family member who is involved with your medical care. We may also give information to someone who helps pay for your care.
- As Required by Law: We may disclose your medical information when required to do so by federal, state, or local law. (e.g., when we are appointed by a court to evaluate you.)
- To Avert a Serious Threat to Health or Safety: Your medical information may be disclosed if necessary to prevent a serious threat to your health and safety or the health and safety of another person. The disclosure would only be to someone who could prevent that threat.
- As a Result of Your Waiving Your Rights to Confidentiality: This may occur, e.g., if you file a lawsuit.
Special Situations
- Worker’s Compensation: We may release your medical information to Workers' Compensation or similar programs. These programs provide benefits for work-related injuries or illnesses.
- Public Health Risks: Your medical information may be disclosed for public health activities such as:
- To report of abuse or neglect, with your permission
- To prevent spread or to control disease, injury, or disability
- To report reactions to medications or problems with products
- To notify patients of recall of products they may be using
- To notify a person of a risk of spreading or contracting a disease after exposure
- To report child abuse or neglect
- Lawsuits and Disputes: We may have to disclose your medical information in response to a court or administrative order.
- Law Enforcement: If asked by a law enforcement official, we may release your medical information:
- In response to a court order, subpoena, warrant, or similar process
- To identify or locate a suspect, fugitive, material witness, or missing person
- About the victim of a crime if we are unable to obtain the person's agreement
- About a death we believe may be the result of criminal conduct
- About criminal conduct at the office
- In emergency circumstances to report a crime, the location of a crime or victims, or the identity, description, or location of the person who committed the crime
- Abuse and Neglect: We may disclose your protected health information to a public health authority authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to a governmental entity or agency authorized to receive such information. In such cases, the disclosure will only be made in accordance with Ohio law
- Business Associates: Certain aspects and components of our services are performed through contracts with outside persons or organizations, such as auditing, billing, legal services, etc. At times, it may be necessary for us to provide your PHI to one or more of these outside persons or organizations who assist us with our health care operations. In all cases, those business associates are required to appropriately safeguard the privacy of your information.
- Research: We may disclose medical information about you to researchers when we have documentation that the research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of the health information.
- Marketing: We must receive your authorization for any use or disclosure of PHI for marketing, except if the communication is in the form of a face-to-face communication made to you personally; or a promotional gift of nominal value provided by us. It is not considered marketing to send you information related to your individual treatment, case management, care coordination or to direct or recommend alternative treatment, therapies, health care providers or settings of care. These may be sent without written permission. If the marketing is to result in financial remuneration to us by a third party, we will state this on the authorization.
- Fundraising: We may contact you to donate to a fundraising effort for or on our behalf. You have the right to “opt-out” of receiving fundraising materials/communications. We will not condition treatment or payment on your choice with respect to the receipt of fundraising communications.
- Sale of PHI: We must receive your authorization for any disclosure of your PHI which is a sale of PHI. Such authorization will state that the disclosure will result in remuneration to us.
- Confidentiality of Alcohol and Drug Abuse Records: Federal law and regulations protect the confidentiality of alcohol and drug program records. To the extent PHI in our possession contains information on your alcohol or drug use, it may not be disclosed without 1) your written authorization; 2) a court order; or 3) unless the disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit or program evaluation. Federal law or regulations do not protect any information about a crime committed by you at our facility or about any threat to commit a crime. Federal laws and regulations do not protect any information about suspected child abuse or neglect from being reported under State law to appropriate State or local authorities.
- Confidentiality of Psychotherapy Notes: We must receive your authorization for any use or disclosure of psychotherapy notes, unless otherwise permitted or required by law
- Confidentiality of HIV Test or Diagnosis of AIDS or AIDS-Related Condition: In most instances, Ohio law requires that we have your authorization or a court order before disclosing the results of an HIV test or diagnosis of AIDS or AIDS- related conditions.
- If a use or disclosure of health information described above in this notice is prohibited or materially limited by other laws that apply to us, it is our intent to meet the requirements of the more stringent law.
Your Rights Regarding your Medical Information
- Right to Inspect and Copy: You have the right to request access to, inspect, and copy of your medical information. This includes medical and billing information but does not include psychotherapy notes. To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to: Barb Dechering, Privacy Officer, 4805 Montgomery Road, Cincinnati, OH 45212. If you request a copy we may charge a fee. Our standard policy is to release a copy of your chart to your current provider upon obtaining a separate signed release form. We may deny your request to inspect and copy in certain limited areas. If you are denied access to medical information, you may request that the information be sent to another health care provider.
- Right to Amend: You have the right to ask us to amend or change any information you feel is incorrect or incomplete. You have the right to ask for this amendment for as long as the information is kept in this office. An amendment request must be made in writing, including the reason you are requesting the amendment. You may be denied if it is not in writing or does not include a reason for the request. In addition, we may deny your request if you ask us to amend information that:
- Was not created by us
- Is not part of the medical information kept by or for this office
- Is not part of the information which you would be permitted to inspect and copy
- Is accurate and complete
- Right to an Accounting of Disclosures: You have the right to an "accounting of disclosures of." This is a list of the disclosures we have made of your medical information for reasons other than what was stated above. To request this list you must again request it in writing. Your request must state a time period and cannot include dates before April 2003. The first list you request within a 12-month period will be free. For additional lists, you may be charged a fee for providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request.
- Right to Request Restrictions: You have a right to request a restriction or limitation on your medical information. This includes the amount of information we provide to a friend, family member, or one involved with your care or payment of treatment. 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 emergency care. To request restrictions, the request must be in writing and include: what information you want to limit, whether you want to limit, whether you want to limit our use, disclosures or both and to whom you want the limits to apply. (Example: disclosures to your spouse) You have the right to require restrictions on disclosure of your PHI to a health plan where you paid out of pocket, in full, for items or services and we are required to honor this request.
- Right to Request Confidential Communications: You also have the right to request that we communicate with you about your medical matters in a certain way. For example, you may request us to contact you only at work and not at home. Again, your request must be made in writing and express how or where you want to be contacted. We will honor all reasonable requests and not ask for a reason.
- Right to a Paper Copy of this Notice: You have the right to a paper copy of this notice. You may request a copy at any time. If you are accessing this policy on Riverhills Neuroscience's website, you may print a copy.
- Right to Breach Notification: In the event of any Breach of Unsecured PHI, we will fully comply with the HIPAA Breach Notification Rule, which will include notification to you of any impact that Breach may have had on you and/or your family member(s) and actions we undertook to minimize any impact the Breach may or could have on you.
Changes to this Notice
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we received in the future.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with this office or with the Secretary of the Department of Health and Human Services.
You will not be penalized for filing a complaint in good faith.
Other Uses of Medical Information
If at any time, your medical or billing information has been requested by outside entities or you wish to disclose your information to outside entities, such as new physicians, law firms, research organizations, etc., a separate specific authorization will need to be completed. If at any time you want to authorize disclosure of any type of psychotherapy records, this also will require a separate authorization.
Other uses and disclosures of medical information not covered by this notice or the laws that apply to use will be made only with your written consent. If you provide us permission to use or disclose medical information, you may revoke that permission at any time, in writing. If you revoke your permission, we will no longer use or disclose your medical information for the reason covered in your request. You understand we cannot take back any disclosures we have already made with your permission and that we are required to retain our records of the care that we provided to you.
All written requests can be made to:
Barb Dechering
Privacy Officer
Riverhills Neuroscience
4805 Montgomery Road, Ste. 150 Cincinnati, OH 45212