Your Personal Information. Your Rights. Our Responsibilities.

These Terms of Services here describe how your medical information may be used and disclosed. Moreover, how you can get access to this information. We request you to review the given terms of services carefully.

Your Rights

You hold all the rights to:

• Get a copy of your medical record through paper or electronic medium.
• Correct any information you find flawed in the record.
• Ask on limiting your information we share
• Request for confidential communication.
• Get a list to whom we’ve shared your information
• Get a copy of this privacy notice
• You can file a complaint anytime if you think your privacy rights have been violated.

Your Choices

You hold some choices in the way that we use and share your personal information:

• Tell family and friends about your condition
• Include you in a hospital directory
• Provide mental health care
• Provide disaster relief
• Market our services and sell your information
• Raise funds for treatment

 

Uses and Disclosures

We hereby declare that we may use and share your information as we:

• Treat you
• Run our organization
• Bill for your services
• Help with public health and safety issues
• Do research
• Comply with the law
• Address law enforcement, workers’ compensation, and other government requests
• Work with a medical examiner
• Respond to lawsuits and legal actions
• Respond to tissue and organ donation requests

 Know & Learn Your Rights

When we talk about your health information, you have certain rights, and we here explain your rights and our responsibilities towards them to help you better understand.

Get a copy of your medical record (paper or electronic copy)

• You hold all the rights to your medical records. And can request to see or get a paper or electronic copy of your records and other health information we have about you.

• We will provide you with a copy of your record in the medium you request, but it might take 30 days. And you may have to pay a reasonable amount of fee.

Request a correction in your record

• If you find an error in your health information, request correction. Not clear how to do this, ask our representative.

• You might hear “no” to your request, but we can explain why and you will receive a written explanation within 60 days.

 Request for Confidential communications

• You hold the right to choose the specific way to communicate (for example, home or office phone) or to send mail to a different address. We keep your privacy.
• We will say “yes” to all reasonable requests.

Request to limit what we use or share

• You can ask us not to involve or share specific wellbeing data for treatment, installment, or our activities. We are not needed to consent to your solicitation, and we might say “no” assuming that it would influence your consideration.

• Assuming you pay for assistance or medical care things cash-based in full, you can ask us not to share that data with the end goal of installment or our activities with your wellbeing safety net provider. We will say “OK” except if a law expects us to share that data.

Get a list of those with whom we’ve shared information.

• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice.                            

 You can request a paper copy of this policy. Even if your earlier request is an electronic copy, you can request again for a paper copy, and we will promptly provide you with a paper copy.

You can file a complaint if you feel your rights are violated

• You hold the right to file a complaint against us if you feel we have violated your rights.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.
• We will not retaliate against you for filing a complaint.

 

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation
• Include your information in a hospital directory

If you are not able to tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases, we never share your information unless you give us written permission:

• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes

In the case of fundraising:

• We may contact you for fundraising efforts, but you can tell us not to contact you again.

Our Uses and Disclosures

How do we typically use or share your health information?

We typically use or share your health information in the following ways.

Treat you

We can use your health information and share it with other professionals who are treating you.                                            Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your health insurance plan to pay for your services.

How else can we use or share your health information?

We are allowed or required to share our information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before sharing your information for these purposes.

For more information, see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues.

 We can share health information about you for certain situations such as:

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

Do research

 We can use or share your information for health research.

Comply with the law

 We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

 We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director.

 We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

 We can use or share health information about you:

• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

 

Respond to lawsuits and legal actions

 We can share your health information in response to a court or administrative order.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can get in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.

Other Instructions for Notice

• If you have concerns, contact the Privacy Officer with AKA CHI at 646-643-6665 or info@akachipsychiatry.com

• We never market or sell personal information