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.
United Hearts Health Care is committed to maintaining the confidentiality of all information it receives. The purpose of this notice is to inform you of how United Hearts Health Care may use and disclose Protected Health Information (PHI). United Hearts Health Care is required by law to maintain the privacy of PHI and to provide all individuals served with notice of United Hearts Health Care legal duties and privacy practices with respect to PHI. United Hearts Health Care will abide by the terms set forth in this Notice.
HOW WE USE OR DISCLOSE YOUR MEDICAL INFORMATION - Without separate authorization
1. Treatment - United Hearts Health Care will use medical information about you to provide you with home care services and treatment. For example, information may be shared with members of our staff, your doctors, or health care facilities.
2. Payment - United Hearts Health Care is normally required to disclose your medical information to: obtain prior approval from an insurer before providing services to you; bill and collect payment for the services we provided to you.
3. Individuals Involved in Your Care - United Hearts Health Care may disclose medical information about you to a family member, other relative, close friend or any other person identified by you if they are involved in your care or payments related to your care. We may disclose medical information about you if they need to be notified of your location, general condition or death. Please advise us if there is someone living in your home, a close friend or a caregiver that you do not want us to share information with, or if you do not want us to leave any messages on your telephone answering machine.
4. Uses or Disclosures That Are Required or Permitted by Law - United Hearts Health Care may use or disclose medical information about you as necessary as required by law and for the following reasons: Disaster relief efforts; public health activities to report, prevent or control diseases; research under certain limited circumstances; reporting of abuse, neglect or domestic violence; health oversight agencies, to Food and Drug Administration to monitor drugs/devices; to the police or law enforcement officials as required by law or in compliance with a court order or other process authorized by law, to units of the government with special functions, such as the U.S. Military or the U.S. Dept. of State, and to prevent a threat to public health or safety, funeral directors, coroners and medical examiners; organ donation; Workers' Compensation to provide benefits for work-related injuries or illnesses.
Uses or Disclosures That Require Your Authorization
Other uses and disclosures will be made only with your written authorization, which you may cancel at any time by notifying Our Designee in writing of your desire to cancel it. Examples of this type of disclosure would include: Drug companies request for your information for marketing purposes, or an attorney requesting your medical information for use in a civil law suit.
The information contained in your health or medical record is the physical property of United Hearts Health Care. The information in it belongs to you. You have the following rights:
Right to Request Restrictions - You have the right to ask us not to use/disclose your medical information for a particular reason related to treatment, payment or our operations. You may ask that family members or other individuals not be informed of specific medical information. Requests must be made in writing to Our Designee. We do not have to agree to your request. If we agree to your request, we must keep the agreement, except in the case of a medical emergency. Either you or United Hearts Health Care can stop a restriction at any time.
Right to Receive Confidential Communications - You have the right to ask that we communicate with you in a certain manner or at a certain place. A request for confidential communications must be made in writing to Our Designee. We must agree with the request if it is reasonable.
Right to Inspect and Copy Your Medical Information - You have the right to request, inspect, and obtain a copy of your medical information. You must submit a request in writing to Our Designee. We may charge a fee for the costs of copying, summarizing and/or mailing information to you. If we agree to your request, we will tell you. We may deny your request under certain limited circumstances, and we will let you know in writing, if your request is denied. You may be able to request a review of our denial.
Right to Request Amendments to Your Medical Information - You have the right to request that we correct your medical information. You must submit your request for an amendment in writing to Our Designee, if you believe that any medical information in your record is incorrect or that important information is missing. We do not have to agree to your request. If we deny your request, we will tell you why. You have the right to submit a statement disagreeing with our decision. We may deny a request if we determine that the information: 1. Was not created by us, 2. Is not part of the medical information that we maintain, 3. Is in records that you are not allowed to inspect and copy, and 4. Current medical information is already accurate and complete.
Right To Obtain a Copy of the Notice - You have the right to request and get a paper copy of this notice. United Hearts Health Care reserves the right to change its privacy practices at any time, and any such change shall apply to all PHI United Hearts Health Care maintains, including information created or received by United Hearts Health Care prior to issuing a new Notice. If United Hearts Health Care materially changes its privacy practices, this Notice shall be amended and disseminated to all clients.
Questions/Complaints - If you believe that your privacy rights have been violated, you may contact United Hearts Health Care Resources, Inc. directly or the United States Secretary of the U.S. Department of Health and Human Services. You will not be retaliated against for reporting a violation of your privacy rights. If you have any questions, want more information, or wish to file a complaint with us, please contact by phone, or by mail:
Health Care Privacy Officer
3515 Springdale Road
Cincinnati, OH 45251