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.
USE AND DISCLOSURE OF HEALTH INFORMATION
CareLink may use and disclose your health information, information that constitutes protected health information as defined in the Privacy Rule of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996, for purposes of providing you services, obtaining payment for your care and conducting health care operations. CareLink has established policies to guard against unnecessary disclosure of your health information.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED:
To Provide Services. CareLink may use and disclose your health information to coordinate care within CareLink and with others involved in your care, such as your attending physician and other health care professionals who have agreed to assist CareLink in coordinating care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications. CareLink also may disclose your health care information to individuals outside of CareLink involved in your care, including family members, pharmacists, suppliers of medical equipment or other health care professionals.
To Obtain Payment. CareLink may include your health information in invoices to collect payment from third parties for the care you receive from CareLink. For example, CareLink may be required to provide information to a payer regarding your health care status in order to receive payment.
To Conduct Health Care Operations. CareLink may use and disclose health information for its own operations in order to facilitate the function of CareLink and as necessary to provide quality care to all of CareLink clients. For example, CareLink may use your health information to evaluate its staff performance, combine your health information with other CareLink clients in evaluating how to more effectively serve all CareLink clients, or disclose your health information to CareLink staff and contracted personnel for training purposes.
For Fundraising Activities. CareLink may use information about you, including your name, address, phone number and the dates you received care in order to contact you to raise money for CareLink. CareLink may also release this information to a related CareLink foundation. If you do not want CareLink to contact you, notify the CareLink Privacy Official at (501) 372-5300 and indicate that you do not wish to be contacted.
For Appointment Reminders and Service Alternatives. CareLink may use and disclose your health information to contact you as a reminder that you have an appointment for a
home visit or tell you about or recommend possible treatment options or alternatives that may be of interest to you.
THE FOLLOWING IS A SUMMARY OF ADDITIONAL CIRCUMSTANCES UNDER WHICH YOUR HEALTH INFORMATION MAY ALSO BE USED AND DISCLOSED:
When there are risks to public health
To report abuse, neglect or domestic violence
To conduct health oversight activities
In connection with judicial and administrative proceedings
For law enforcement purposes
To coroners, medical examiners and funeral directors about decedents
For organ, eye or tissue donation
For research purposes after an approval process
To avert a serious threat to health or safety
For specified government functions
For worker’s compensation purposes
When legally required
AUTHORIZATION TO USE OR DISCLOSE OTHER HEALTH INFORMATION
Other than what is stated above, CareLink will not disclose your health information without your written authorization. If you or your representative authorizes CareLink to use or disclose your health information, you may revoke that authorization in writing at any time, unless CareLink has taken action in reliance thereon.
DUTIES OF CARELINK
CareLink is required by law to maintain the privacy of your health information and to provide to you or your representative this Notice of its duties and privacy practices. CareLink is required to abide by the terms of this Notice as may be amended from time to time. CareLink reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all health information that it maintains. If CareLink changes its Notice, CareLink will post a copy of the Notice at its offices and on its Web site.
YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
You or your representative has the following rights regarding your health information that CareLink maintains:
- To request restrictions. You may request restrictions on certain uses and disclosures of your health information. You also have the right to request a limit on CareLink’s disclosure of your health information to someone who is involved in your care or the payment of your care. However, CareLink is not required to agree to your request.
- To receive alternative communications. You have the right to request that your protected health information be provided by alternative means or at alternative locations.
- To inspect and copy your health information. You have the right to inspect and copy your health information, including billing records. If you request a copy of your health information, CareLink may charge a reasonable fee for copying and assembling costs associated with your request.
- To request amendment of your health care information. You have the right to request that CareLink amend your records if you believe that your health information maintained by CareLink is incorrect or incomplete. CareLink may deny the request if it does not include a reason for the amendment. The request also may be denied if your health information records were not created by CareLink, if the records you are requesting are not part of CareLink’s records, if the health information you wish to amend is not part of the health information you are permitted to inspect and copy, or if, in the opinion of CareLink, the records containing your health information are accurate and complete.
- To an accounting. You have the right to request an accounting of disclosures of your health information made by CareLink for certain reasons, including reasons related to public purposes authorized by law and certain research. CareLink will provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.
- To a paper copy of this notice. You have a right to a separate paper copy of this notice at any time even if you have received this Notice previously. You may also obtain a copy of the current version of CareLink’s Notice of Privacy Practices at its Web site, www.care-link.org
- To express complaints. You have the right to express complaints to CareLink and to the Secretary of DHHS if you or your representative believes that your privacy rights have been violated. You will not be retaliated against in any way for filing a complaint.
CONTACT PERSON
CareLink has designated the CareLink Privacy Official as its contact person for all issues regarding client privacy and your rights under the federal privacy standards. To exercise any of the rights listed above, you may contact this person at 501-372-5300 or P.O. Box 5988, North Little Rock, Arkansas, 72119-5988. Requests to receive alternative communications, to inspect and copy, to amend and to an accounting, as well as any complaints, must be in writing.
EFFECTIVE DATE
This Notice is effective April 14, 2003.
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT THE CARELINK PRIVACY OFFICIAL, CARELINK, P.O. BOX 5988, NORTH LITTLE ROCK, AR 72119-5988, (501) 372-5300.
