Privacy Policy
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
TENDER LOVING CARE HOME HOSPICE may use your health information, information that constitutes protected health information (PHI) as defined in the Privacy Rule of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act [HIPAA]of 1996, for purposes of providing you treatment, obtaining payment for your care and conducting health care operations. The Agency 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 Treatment . TLC Home Hospice may use your health information to coordinate care with the people involved in your care, such as your attending physician, members of TLC Home Hospice Interdisciplinary Team and other health care professionals who have agreed to assist TLC Home Hospice in coordinating care, including, but not limited to family members, clergy whom you have designated, pharmacists, suppliers of medical equipment or other health care professionals. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications.
To Obtain Payment . TLC Home Hospice may include your PHI in invoices to collect payment from third parties for the care you receive from the Agency. For example, TLC may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or TLC.
To Conduct Health Care Operations . TLC Home Hospice may use and disclose PHI for its own operations in order to facilitate the functions of TLC and as necessary to provide quality care to all of TLC‘s patients. For example TLC Home Hospice may use your PHI to evaluate its staff performance, or combine your health information with other hospice patients in evaluating how to more effectively serve all hospice patients.
For Fundraising Activities . TLC Home Hospice may contact you or your family to raise money for Loving Heart Hospice Foundation, a non-profit 501©(3) Organization sponsored by TLC Home Hospice. If you do not want TLC Home Hospice to contact you or your family, notify TLC Home Hospice Administration in writing and indicate that you do not wish to be contacted.
THE FOLLOWING IS A SUMMARY OF SPECIFIC CIRCUMSTANCES AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY ALSO BE USED AND DISCLOSED.
TLC Home Hospice will disclose your PHI when required by Federal, State or local law or the Joint Commission on Accreditation for Healthcare Organizations. These specific circumstances include, but are not limited to: Emergencies and/or Disaster Relief, Legal Requirements, and/or Risks to Public Health, Abuse, Neglect Or Domestic Violence, Judicial And Administrative Proceedings and Law Enforcement Purposes, Coroners, Medical Examiners and Funeral Directors, and Research Purposes.
AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION
Except as described in this Notice, TLC Home Hospice will not use or disclose your PHI without your written Authorization. And, if you or your representative authorize TLC to use or disclose your health information, you may rescind or cancel that authorization in writing at any time.
YOUR RIGHTS WITH RESPECT TO YOUR PROTECTED HEALTH INFORMATION
Listed below are your rights regarding your PHI. Each of these rights is subject to certain requirements, limitations and exceptions. Exercise of these rights will require submitting a written request to TLC. At your request, TLC will supply with the appropriate form to complete your requests.
You have the right to:
* Request restrictions.
* To receive confidential communications.
* To inspect and copy your health information.
* Request an amendment.
* To an accounting of disclosures of your PHI made by the TLC Home Hospice
* To a paper copy of this notice. A copyof the current version of the Agency’s Notice of Privacy Practices at the website:* www.tlchomehospice.com.*
DUTIES OF THE AGENCY
Tender Loving Care Home Hospice is required by law to maintain the privacy of your PHI and to provide to you and your representative this Notice of its duties and privacy practices. TLC is required to abide by the terms of this Notice as may be amended from time to time. TLC 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.
CONTACT PERSON
TLC Home Hospice has designated a HIPAA Privacy Official as its contact person for all issues regarding patient privacy and your rights under the Federal privacy standards. Please contact the HIPAA Privacy Official at 5400 Atlantis Court, Moorpark, CA 93021 or telephone (805) 517-1620
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT TLC HOME HOSPICE
EFFECTIVE DATE This Notice is effective April 14, 2003.
