Notice of Privacy Practices
Family HealthSM Virtual Visit complies with, and wants to explain, the federal regulations regarding your information and the measures we take to safeguard your personal privacy.
This Notice explains how Family Health Virtual Visit, its employees, medical/dental staff, students and trainees, volunteers, all departments and clinics, and other healthcare providers whose names will be made available upon request, may use and provide your Protected Health Information (PHI) to others for treatment, payment, and healthcare operations as described below, and for other purposes allowed or required by law.
PHI is information that you provide Family Health Virtual Visit, or that we create or receive about your healthcare. PHI contains a patient’s age, race, gender, and other personal health information that may identify the patient. The information relates to the patient’s past, present, or future physical or mental health and to related treatment, services, and payment for care.
Understanding your health information
Each time you visit Family Health Virtual Visit, a record of your visit is made in order to manage the care you receive. Family Health Virtual Visit understands that PHI is personal, and the confidentiality of PHI is protected under both state and federal law.
Family Health Virtual Visit has an electronic health record and will not use or release your PHI without your written authorization, except as described in this Notice. Use or disclosure pursuant to this Notice may include electronic transfer of your PHI.
In certain instances, you have the right to be notified in the event that Family Health Virtual Visit, or one of our business associates, discovers an unauthorized use or disclosure of your unsecured health information. Notice of any such use or disclosure will be made as required by state and federal law.
Family Health Virtual Visit use and release of PHI without your authorization
The following section explains the various purposes for which Family Health Virtual Visit is permitted to use and release PHI.
In providing healthcare services at Family Health Virtual Visit, your PHI may be shared with your treating healthcare providers to the extent necessary to provide treatment and care to you. These healthcare providers may include doctors, nurses, pharmacists, labs, and other healthcare providers who are involved in your care both at Family Health Virtual Visit and at outside healthcare providers.
Family Health Virtual Visit may need to share your PHI in connection with payment for services you receive. For example, Family Health Virtual Visit may contact and share information with an insurance company, a government program, or other third parties to determine eligibility status, obtain prior approval, determine if your health plan will pay for treatment, and to file claims.
Health Care Operations Purposes
Family Health Virtual Visit may use and release your PHI for general healthcare operations purposes, including the following:
- Quality Improvement Activities: Information may be shared to improve the quality or cost of care. For example, your PHI may be reviewed by Family Health Virtual Visit or outside agencies to evaluate and improve the quality of care and services we provide.
- Medical Residents, Students and Trainees (Students) and Volunteers: Students and volunteers may have access to your PHI for training, education, and service purposes as they participate in educational programs, training, internships, residency programs, or Family Health Virtual Visit volunteer program.
- Appointment Reminders: Family Health Virtual Visit may provide you with appointment reminders and inform you of treatment alternatives, benefits, or services related to your health.
- Care Everywhere Program: Your PHI is kept in an electronic format and may be electronically shared with certain Family Health Virtual Visit health care partners. Care Everywhere is designed to link participating facilities so that those facilities may have access to your PHI to coordinate care more easily. Participation is voluntary, unless required by law, and you may opt out of participation at any time by noting this on the Protected Health Information section of the General Consent for Treatment and Acknowledgements form that you complete at registration or by contacting Family Health Virtual Visit Privacy Office. If you opt out, your PHI will not be electronically shared with other healthcare partners. You can change your mind or withdraw consent at any time, unless disclosure is required by law; however, Family Health Virtual Visit cannot take back information that has already been shared.
- Health Information Exchange: Your electronic medical records may be shared with electronic Health Information Exchanges (HIEs) (sometimes referred to as Regional Health Information Organizations or RHIOs). Participation is voluntary, unless required by law, and you may opt out of participation at any time by noting this on the Protected Health Information section of the General Consent for Treatment and Acknowledgements form that you complete at registration or by contacting Family Health Virtual Visit Privacy Office. If you opt out, identifiable PHI will not be shared with an HIE, unless required by law. An HIE is helpful if you require treatment at another facility that participates with Family Health Virtual Visit in an HIE because it enables the other facility to gather PHI through the HIE to obtain your medical history and coordinate care. Unless disclosure is required by law, you can change your mind and withdraw consent at any time; however, Family Health Virtual Visit cannot take back information that has already been shared.
- Business Associates: There are some services that Family Health Virtual Visit provides through contracts with third party business associates. Examples include transcription agencies and copying services. Your PHI may be disclosed to our business associates to perform the services they have been contracted to perform. To protect your PHI, Family Health Virtual Visit requires these business associates to appropriately protect your PHI in compliance with all laws.
- Hospital Directory: Unless you object, Family Health Virtual Visit may include certain limited information about you in the hospital directory while you are in the hospital. This information may include your name, location in the hospital, general condition (for example: good, stable, critical, etc.), and religion. This information may be provided to members of the clergy. This information, except for religious affiliation, may also be provided to people who contact the hospital and ask for you by name. If you do not wish to be included in the hospital directory, please check the box on the General Consent for Treatment and acknowledgements form under Directory Information requesting you be designated a “no information patient.”
- Continuity of Care: Once you have been discharged, your information may be shared with other healthcare providers, such as home health agencies and community service agencies, in order to obtain their services on your behalf. Also, we may use your PHI to contact you with information about disease prevention and health management.
Other Disclosure Purposes
- Required by Law: Family Health Virtual Visit must report certain parts of your PHI to legal officials or authorities, including law enforcement, the court system, or government agencies. Examples include: reporting suspected abuse or neglect, domestic violence, or certain physical injuries, and responding to a court order, subpoena, warrant, or lawsuit request.
- Public Health: Family Health Virtual Visit may be required to report certain parts of your PHI to public health authorities. Examples include reporting certain diseases, injuries, and birth or death information. Family Health Virtual Visit may also be required to report certain information to the Food and Drug Administration (FDA), or information related to child abuse or neglect.
- Health Oversight Agencies: Family Health Virtual Visit may be required to release certain information to state or federal agencies so they can monitor, investigate, or discipline those who work in the healthcare system.
- Research Purposes: Family Health Virtual Visit may use or release your PHI for research purposes. If you are involved in a research study, there will be a specific approval process which includes your authorization to participate. In some instances, PHI may be used without your authorization, but your identifying information will not be released without your authorization.
- Notification/Disaster Relief: Family Health Virtual Visit may use or release your PHI for disaster relief efforts.
- Activities Related to Death: Family Health Virtual Visit may release your PHI for organ and tissue donation or to coroners, medical examiners, or funeral directors so they can carry out their duties related to death. Examples include: determining cause of death, and carrying out funeral preparation activities.
- To Avoid Serious Threat to Health or Safety: Family Health Virtual Visit may use and disclose your PHI to the proper authorities when necessary to prevent a serious threat to the health and safety of the public or another person.
- Military: Family Health Virtual Visit may release your PHI to the proper requesting authorities if you are a member of the armed forces.
- Law Enforcement Custody or National Security: Family Health Virtual Visit may release your PHI to a correctional institute or law enforcement official if you are under the custody of state or federal law enforcement officials or incarcerated, for the purpose of providing you with healthcare, to protect your health and safety or the health and safety of others, or for the safety and security of the law enforcement official or correctional institute.
- Workers’ Compensation: Family Health Virtual Visit may be required to release your PHI regarding workers’ compensation benefits and activities.
- Fundraising: Family Health Virtual Visit may use your limited PHI to contact you regarding fundraising for the purpose of and in conjunction with Family Health Virtual Visit mission to provide healthcare and make life better for children. You have the right to not receive these communications. You may contact the Privacy Office if you want to exercise your right to not receive these communications. Family Health Virtual Visit will not condition your treatment on whether you have agreed to receive fundraising communications.
- Marketing: Family Health Virtual Visit may only use your PHI for limited marketing purposes as follows: face-to-face communications, promotional gifts of nominal value, refill reminders, or to otherwise tell you about a drug related to your treatment or our healthcare operations as described in this Notice. Examples of these communications include: case management, care coordination, or treatment alternatives that may be available.
Releases of your PHI that require your authorization
Your authorization is needed for other uses and disclosures of your PHI, except for the types of examples included under the exceptions described above. This includes, unless otherwise required by law, release of psychotherapy notes, broader marketing purposes, sale of your PHI, HIV/AIDS information, substance abuse treatment records, and deceased patients’ records.
If you provide Family Health Virtual Visit the authorization to use or release your PHI, you may revoke that authorization at any time; however, Family Health Virtual Visit cannot take back information that has already been shared.
The authorization can be revoked by following the instructions described on the Authorization for the Inspection, Use, Disclosure and Release of Health Information form, which can be obtained on our website at www.childrens.com or by contacting the Privacy Office.
Your Privacy Rights
Your rights regarding your PHI are as follows.
Right to Receive This Notice of Privacy Practices
You have the right to receive a copy of this Notice at any time. You may obtain a paper copy of the current notice in all clinical areas or an electronic copy by visiting Family Health Virtual Visit website at www.childrens.com.
Right to Review and Ask for a Copy of Your PHI
You have the right to review and request copies of your medical records that may be used to make decisions about your care. Usually this includes medical and billing records, but there may be exceptions for psychotherapy notes or information about third parties.
You may request a paper or electronic copy of your medical record by visiting our Health Information Management department, by completing the Authorization for the Inspection, Use, Disclosure and Release of Health Information form located at www.childrens.com, or by contacting the Privacy Office.
Also, you can sign up for a MyChart account, which allows you to electronically access portions of your health information at www.childrens.com. Family Health Virtual Visit may charge you a fee to copy and/or mail your medical record to you as permitted by law. If we are able, we will provide an electronic copy to you within 15 days of your written request and receipt of appropriate fees.
Right to Request Confidential Communications
You have the right to specify that Family Health Virtual Visit communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you by telephone at work, or that we only contact you by mail at home or by email. We will follow your request whenever it is reasonably possible. You can request an alternate place for communication by completing the form Request for Alternative Communication of Health Information at the time of registration, or on Children’s website at www.childrens.com, or by contacting the Privacy Office at 214-456-4444 to request an alternate place for communication.
Right to Request Restrictions
You have the right to request restrictions or limitations on how your PHI is used or released. We have the right to deny your request, except we must agree when the disclosure of PHI would be to a health plan if the disclosure of PHI is for payment or healthcare operations and is not otherwise required by law, and if the PHI is for a healthcare item or service which was paid in full by you, or was paid in full by a person, other than health plan, on your behalf. You can complete the form Request for Restricting the Use or Disclosure of Health Information which can be found at www.childrens.com or by contacting the Privacy Office at 214-456-4444.
Right to Amend
You have the right to ask that your medical record at Family Health Virtual Visit be changed if it is not correct or complete. Family Health Virtual Visit does have the right to deny your request if we did not create the information; if we do not keep the information; if you are not allowed to see and copy the information; or if the information is already correct and complete. You may request a change by completing the form Request for an Amendment of Health Information which can be found at www.childrens.com or by contacting the Privacy Office at 214-456-4444.
Right to a Record of Releases
You have the right to request a record of releases (accounting of disclosures) when Family Health Virtual Visit has disclosed your PHI. You can request a record of releases of your PHI by submitting the form Request for an Accounting of Disclosures of Health Information to the Health Information Management Department. This form can be found at www.childrens.com or by contacting the Privacy Office at 214-456-4444. If you request this record of releases more than once per year, Family Health Virtual Visit may charge a fee for providing the list. The list will contain only information that is required by law. This list will not include releases for treatment, payment, and healthcare operations, or releases that you have authorized.