HIPAA Notice

THIS NOTICE EXPLAINS HOW YOUR MEDICAL INFORMATION MAY BE USED AND SHARED, AND HOW YOU CAN GET ACCESS TO IT. PLEASE READ IT CAREFULLY.

Throughout this Notice, “we” and “us” refer to Agency Healthspan, along with the licensed providers and staff who deliver care through our practice. Federal law requires us to protect the privacy of your protected health information (“PHI”), to operate according to the terms of whichever version of this Notice is currently active, to provide you with a copy explaining our privacy obligations and practices, and to notify you if a breach of your unsecured PHI ever occurs.

This document outlines the ways we’re permitted to use and share your PHI, the rights you hold regarding that information, and the legal responsibilities we carry as a result. We may update this Notice from time to time. Whenever a meaningful change is made, an updated copy will be made available at our office, published on our website, and offered to you directly.

I. How We Use and Share Your PHI

We use and share PHI mainly to provide treatment, process payment, and run our day-to-day operations. In some cases, the law allows or requires other uses, and in others we’ll only proceed once you’ve given written authorization. You’re free to withdraw that authorization at any point by notifying us in writing. Below are common examples of how your information may be handled.

A. Treatment. Your PHI may be used and shared so we can provide prescriptions and related services. This can include sharing relevant details with other pharmacists, technicians, or providers involved in your care. Where applicable, you’ll be notified separately and given the chance to decline subsidized treatment communications.

B. Payment. We use and disclose PHI as needed to bill for services and collect payment, including confirming coverage or getting prior approval from your insurer before a prescription or service is provided.

C. Operations. PHI may also support internal functions such as quality reviews, compliance audits, staff performance evaluations, and general administrative or business management activities.

D. Refill Reminders and Related Outreach. We may contact you about refilling a prescription, let you know about alternative treatment options, or share information on health-related services that might benefit you.

E. Family, Friends, and Others Involved in Your Care. Unless you tell us not to, we may share relevant PHI with a spouse, relative, close friend, or anyone else you’ve identified as part of your care or payment process. If you’re unavailable to approve or object, our staff will use professional judgment to decide whether sharing the information serves your best interest, limiting any disclosure strictly to what’s relevant.

F. Other Situations Permitted or Required by Law. In certain circumstances, we may use or disclose PHI without your authorization and without offering you a chance to object, including:

when a law specifically requires it, always within the bounds of that law;
to public health authorities (or a foreign government agency working with one) for things like disease prevention, death reporting, adverse drug event reporting, communicable disease notification, or reporting abuse or neglect;
to agencies overseeing healthcare compliance, including audits, inspections, or civil, administrative, and criminal proceedings; in response to a subpoena, court order, or discovery request, provided reasonable steps were taken to notify you or seek a protective order;
to law enforcement for purposes such as reporting certain injuries, complying with a warrant, identifying a suspect or missing person, or reporting a crime;
to a coroner or medical examiner carrying out duties like identifying a deceased person or determining cause of death;
to funeral directors as needed to perform their legally authorized duties;
to organizations that facilitate organ, eye, or tissue donation; for approved research purposes, once the required safeguards and approvals are in place;
to prevent or reduce a serious threat to someone’s health or safety, shared only with someone positioned to act on it; for authorized military, veterans’, national security, or intelligence activities;
to protect the President, other officials, or foreign heads of state, or to support related investigations;
to correctional facilities or law enforcement if you’re incarcerated or in custody; and as needed to comply with workers’ compensation laws.

II. Your Rights Regarding Your PHI

A. Request Limits on Use or Disclosure. You can ask us to restrict how your PHI is used or shared. We aren’t obligated to agree, except when you’ve paid for a service entirely out of pocket. A written request should state what you want restricted, what information is involved, and who the restriction applies to. Even if we agree, we may still share your PHI with you directly, when the law requires it, or in an emergency.

B. Request Alternative Communication. You may ask to receive PHI-related communications in a different way or at a different location, for example, at a P.O. box instead of your home address. Submit this request in writing to our Privacy Officer. We’ll accommodate reasonable requests.

C. Access Your Records. You can ask to view or receive a copy of your PHI, including electronic records, with a few exceptions carved out by HIPAA. If we hold the records electronically, we’ll provide them in the format you request when possible. If we don’t have the records ourselves, we’ll direct you to the right contact.

A reasonable fee may apply to cover copying and mailing costs. If a request is denied, you can ask for that decision to be reviewed, and you’re entitled to a written explanation.

D. Request a Disclosure History. You may ask for a list of certain disclosures we’ve made of your PHI over the past six years, or a shorter period if you prefer. The first request each year is free; later requests within the same twelve months may carry a reasonable fee, which we’ll tell you about in advance so you can adjust or cancel the request if you choose.

E. Request a Correction. If you think something in your PHI is wrong or incomplete, you can ask us in writing to correct it, along with your reasoning. We may deny the request, for instance if the information wasn’t created by us or is already accurate. You can respond with a written statement of disagreement, and we may issue a rebuttal. Both statements can then be attached to future disclosures of that information.

F. Get a Paper Copy. Even if you’ve received this Notice electronically, you can request a printed copy at any time by writing to our Privacy Officer.

G. Opt Out of Fundraising. You have the right to decline any fundraising communications, and your PHI will never be sold or used for fundraising without your explicit, prior authorization.

III. Questions, Requests, or Complaints

To exercise any of the rights above, or if you have questions about this Notice, reach out to our Privacy Officer:
support@agencyhealthspan.com