IMPORTANT: EliteHealth is not a health insurance company and is not licensed to sell health insurance. We are in no way affiliated with EliteHealth Care Inc.
ELITEHEALTH.MD, LLC - NOTICE OF PRIVACY PRACTICES
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.
This Notice of Privacy Practices is provided to you as a requirement of the Health Insurance Portability and Accountability Act (“HIPAA”). It describes how EliteHealth.MD, LLC (“we,” “us,” or “EliteHealth”) may use or disclose your Protected Health Information, with whom that information may be shared, and the safeguards we have in place to protect it. This notice also describes your rights to access and amend your Protected Health Information. You have the right to approve or refuse the release of specific information outside of our system except when the release is required or authorized by law or regulation. This notice takes effect on November 24th 2009. We reserve the right to revise or change this notice and to make the revised or changed notice effective for Protected Health Information we already have as well as any information we receive in the future. We will post a copy of the most current notice at our offices and on our website (www.elitehealth.md). The notice will contain the most current revision date on the first page, in the top left-hand corner.
WHAT IS PROTECTED HEALTH INFORMATION?
Protected Health Information is information which identifies you, is created or received by EliteHealth, and relates to your past, present, or future physical or mental health condition or to past, present, or future provision of health care to you.
ACKNOWLEDGMENT OF RECEIPT OF THIS NOTICE
You will be asked to provide acknowledgment of receipt of this notice either in writing or electronically. Our intent is to make you aware of the possible uses and disclosures of your Protected Health Information and your privacy rights. The delivery of your health care services will not be conditioned upon your signed acknowledgment. If you decline to provide acknowledgment, we will continue to provide your treatment, and will use and disclose your Protected Health Information, as necessary, for treatment, payment, and health care operations, as well as when permitted or required by law.
When this notice applies
This notice summarizes the privacy practices of EliteHealth, EliteHealth’s affiliates, and the medical staff and personnel who provide you with care and/or services within EliteHealth’s offices or elsewhere, including through EliteHealth’s website (www.elitehealth.md). We may share information with each other for the purposes described in this notice.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION
The following are examples of permitted uses and disclosures of your Protected Health Information. These examples are not exhaustive.
Required Uses and Disclosures
By law, we must disclose your Protected Health Information to you unless it has been determined by a competent medical authority that it would be harmful to you. Except for the purposes described below, we will use and disclose Protected Health Information only with additional written permission from you. If you give us permission to use or disclose Protected Health Information for a purpose not discussed in this notice, you may revoke that permission by sending a written request to our Privacy Officer at the address listed at the end of this notice.
We will use and disclose your Protected Health Information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, we would disclose your Protected Health Information, as necessary, to a third party who provides care to you. We may disclose your Protected Health Information to another physician, nurse, technician or health care provider (for example, a specialist, pharmacist, or laboratory) who, at the request of your physician, becomes involved in your care by providing assistance with your health care diagnosis or treatment. This includes pharmacists who may be provided information on other drugs you have been prescribed to identify potential interactions. In emergencies, we will use and disclose your Protected Health Information to provide the treatment you require.
Your Protected Health Information will be used, as needed, to obtain payment for your health care services. This may include certain efforts EliteHealth might undertake before it provides the health care services recommended for you such as determining eligibility or coverage for benefits, reviewing services to be provided to you for medical necessity, and undertaking utilization review activities. For example, we may give your health plan information about your treatment so that they will pay for such treatment. We may also tell your health plan about treatment you are going to receive in order to obtain prior approval or to determine whether your plan will cover treatment.
Health Care Operations
We may use or disclose, as needed, your Protected Health Information to support the daily activities related to health care. These activities include, but are not limited to, quality assessment activities, investigations, staff performance oversight or reviews, training of medical students, licensing, communications about a product or service, and conducting or arranging for other health care related activities. For example, we may disclose your Protected Health Information to medical school students seeing patients in the chemotherapy suites, we may call you by name in the waiting room when your physician is ready to see you, or we may use or disclose your Protected Health Information to contact you to remind you of your appointment. We will share your Protected Health Information with third-party business associates who perform various activities (for example, billing and transcription services) for EliteHealth or any corresponding health plan (“Business Associates”). The Business Associates will also be required to ensure the privacy of your Protected Health Information. We may use or disclose your Protected Health Information, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that might interest you. For example, your name and address or email address may be used to send you a newsletter about EliteHealth and the services we offer. We may also send you information about products or services that we believe might benefit you.
Required by Law
We may use or disclose your Protected Health Information if a law or regulation requires the use or disclosure.
We may disclose your Protected Health Information to a public health authority that is permitted by law to collect or receive the information. The disclosure may be necessary to do the following:
· Prevent or control disease, injury, or disability.
· Report births and deaths.
· Report child abuse or neglect.
· Report reactions to medications or problems with products.
· Notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
· Notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence.
We may disclose your Protected Health Information, if authorized by law, to a person who might have been exposed to a communicable disease or might otherwise be at risk of contracting or spreading the disease or condition.
We may disclose Protected Health Information to a health oversight agency for activities authorized by law such as audits, investigations, and inspections. These health oversight agencies might include government agencies that oversee the health care system, government benefit programs, other government regulatory programs, and civil rights laws.
Food and Drug Administration
We may disclose your Protected Health Information to a person or company required by the Food and Drug Administration (“FDA”) to do the following:
· Collect or report adverse events (or similar activities with respect to food or dietary supplements), product defects or problems (including problems with the use or labeling of a product), or biological product deviations.
· Track FDA-regulated products.
· Enable product recalls, repairs or replacements.
· Conduct post-marketing surveillance as required.
We may disclose Protected Health Information during any judicial or administrative proceeding, in response to a court order or administrative tribunal (if such a disclosure is expressly authorized), and in certain conditions in response to a subpoena, discovery request, or other lawful process.
We may disclose Protected Health Information for law enforcement purposes, including the following:
· Responses to legal proceedings.
· Information requests for identification and location.
· Circumstances pertaining to victims of a crime.
· Deaths suspected from criminal conduct.
· Crimes occurring on EliteHealth’s premises.
· Medical emergencies (not on EliteHealth’s premises) believed to result from criminal conduct.
Coroners, Funeral Directors, and Organ Donations
We may disclose Protected Health Information to coroners or medical examiners for identification to determine the cause of death or for the performance of other duties authorized by law. We may also disclose Protected Health Information to funeral directors as authorized by law. Protected Health Information may be used and disclosed for cadaveric organ, eye, or tissue donations.
We may disclose your Protected Health Information to researchers when authorized by law. For example, if an institutional review board has reviewed a research proposal, established protocols to ensure the privacy of your Protected Health Information, and has approved the research.
Under applicable Federal and state laws, we may disclose your Protected Health Information if we believe that its use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose Protected Health Information if it is necessary for law enforcement authorities to identify or apprehend an individual.
Military Activity and National Security
When the appropriate conditions apply, we may use or disclose Protected Health Information of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities to ensure the proper execution of the military mission; (2) for determination by the Department of Veterans Affairs (VA) of your eligibility for benefits; or (3) to a foreign military authority if you are a member of that foreign military service. We may also disclose your Protected Health Information to authorized Federal officials for conducting national security and intelligence activities including protective services to the President or others.
We may disclose your Protected Health Information to comply with workers’ compensation laws and other similar legally established programs.
We may use or disclose your Protected Health Information to a correctional institution if you are an inmate of that correctional institution and the disclosure would be necessary (1) for the provision of health care to you; (2) for your health and safety or the health and safety of others; (3) law enforcement on the premises of the correctional institution; or (4) for the administration and maintenance of the safety, security, and good order of the correctional institution.
Some state laws concerning minors permit or require disclosure of Protected Health Information to parents, guardians, and persons acting in a similar legal status. We will act consistently with the law of the state where the treatment is provided and will make disclosures following such laws.
Individuals Involved in Your Health Care
Unless you object, we may disclose to a member of your family, a relative, a close friend, or any other person you identify, your Protected Health Information that directly relates to that person’s involvement in your health care. We may also give information to someone who helps pay for your care. Additionally we may use or disclose Protected Health Information to notify or assist in notifying a family member, personal representative, or any other person who is responsible for your care of your location, general condition, or death. Finally, we may use or disclose your Protected Health Information to an authorized public or private entity to assist in disaster relief efforts and coordinate uses and disclosures to family or other individuals involved in your health care.
We will only use your Health Information for marketing communications when you have provided EliteHealth with written consent.
RIGHTS REGARDING YOUR
You may exercise the following rights by submitting a written request or electronic message to the EliteHealth Privacy Officer. Depending on your request, you may also have rights under the Privacy Act of 1974. The EliteHealth Privacy Officer can guide you in pursuing these options. Please be aware that the EliteHealth might deny your request; however, you may seek a review of the denial.
Right to Inspect and Copy
You may inspect and obtain a copy of your Protected Health Information that is contained in a “designated record set” for as long as we maintain the Protected Health Information. A designated record set contains medical and billing records and any other records that EliteHealth uses for making decisions about you. This right does not include inspection and copying of the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and Protected Health Information that is subject to law that prohibits access to Protected Health Information.
Right to Request Restrictions
You may ask us not to use or disclose any part of your Protected Health Information. Please note that we will not grant requests for restrictions that pertain to your treatment. The request must be made to the Privacy Officer. In your request, you must tell us (1) what information you want restricted; (2) whether you want to restrict our use, disclosure, or both; and (3) to whom you want the restriction to apply (for example, disclosures to your spouse). If EliteHealth believes that the restriction is not in the best interest of either party, or EliteHealth cannot reasonably accommodate the request, EliteHealth is not required to agree. If the restriction is mutually agreed upon, we will not use or disclose your Protected Health Information in violation of that restriction, unless it is needed to provide emergency treatment. You may revoke a previously agreed upon restriction, at any time, in writing.
Right to Request Confidential Communications
You may request that we communicate with you using alternative means or at an alternative location. We will not ask you the reason for your request. We will accommodate reasonable requests, when possible.
Right to Request Amendment
If you believe that the information we have about you is incorrect or incomplete, you may request an amendment to your Protected Health Information as long as we maintain this information. While we will accept requests for amendment, we are not required to agree to the amendment.
Right to an Accounting of Disclosures
You may request that we provide you with an accounting of the disclosures we have made of your Protected Health Information. This right applies to disclosures made for purposes other than treatment, payment, or health care operations as described in this Notice of Privacy Practices. The disclosure must have been made after April 14, 2003, and no more than 6 years from the date of request. This right excludes disclosures to you, disclosures authorized by you, disclosures to family members or friends involved in your care of your location, general condition, or death, disclosures for national security or intelligence purposes, and disclosures to correctional institutions or law enforcement officials.
Right to Obtain a Copy of this Notice
You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at any of the EliteHealth offices or on the EliteHealth website (www.elitehealth.md).
Questions and Concerns
If you believe these privacy rights have been violated, you may file a written complaint with the Privacy Officer or the Department of Health and Human Services. No retaliation against you will occur for filing a complaint.
Contact: Kimberly Hernandez (Privacy Officer)
Miami Beach, FL 33140
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