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Notice of Privacy Practice

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.

Effective Date: OCTOBER 1, 2023

This notice summarizes the privacy practices of your ArchWell Health® medical practice (“we”, “our”, “us), and any healthcare components of any current or future hybrid entity under common ownership or control with your medical practice.

The terms “information” or “health information” in this notice include any information we maintain that reasonably can be used to identify you and that relates to your physical or mental health condition, the provision of health care to you, or the payment for such health care.

WE ARE REQUIRED BY LAW

We will comply with the requirements of applicable privacy laws, which require us to:

  • Protect the privacy of your health information;
  • Provide you this notice, which explains our duties and
  • how we may use information about you and when we can give out or "disclose" that information to others;
  • Follow the terms of this notice that are currently in effect;
  • Notify you in the event of a breach of your health information; and,
  • Whenever applicable, follow more stringent privacy laws regarding the use or disclosure of your health information.

WHO WILL FOLLOW THIS NOTICE?

This notice applies to your medical practice, which includes:

  • All colleagues, health care professionals, trainees, externs, students, and other agents of the medical practice;
  • All other entities, sites, and locations where the health care professionals' practice. In addition, these entities, sites, and locations may share medical information with each other for treatment, payment or operations purposes as described in this notice.

HOW WE TYPICALLY USE OR DISCLOSE INFORMATION

The following sections describe different ways we may use and disclose your medical information. We abide by all applicable laws related to the protection of this information. Not every use or disclosure will be listed. All the ways we are permitted to use and disclose information, however, will fall within one of the following categories: Treatment: We may use or disclose health information to aid in your treatment or the coordination of your care. For example, we may share medical information about you with other ArchWell Health colleagues or non-ArchWell Health care providers, agencies or facilities in order to provide or coordinate the different things you need, such as prescriptions, X-rays, lab work or transportation.

Payment: We may use or disclose health information to obtain payment for health care services. For example, we may disclose your health information to your health plan to obtain payment for the medical services we provide to you.

Health Care Operations: We may use or disclose health information as necessary to operate and manage our business activities related to providing and managing your health care. For example, we might analyze data to determine how we can improve our services. Some other business reasons we may use and share your health information include to follow laws and regulations, to train and educate, or for licensure.

Health Information Exchanges (HIEs) and Data Exchange Networks: Exchange of health information can provide your care teams with faster access to important information about your health, better coordination of care, and assist providers in making more informed decisions.

We participate in national data exchange networks, that offer participating healthcare providers access to past and present medical information to make better decisions and better coordinate care across your care teams. We also participate in some state level HIEs. A list of the data exchange networks and HIEs we participate in is available at the medical practice where you receive care. We may share information about you with other health care providers or other health care entities, such as your other doctors, providers, and your health plan, as permitted by law, through data exchange networks and state HIEs for treatment, payment, or health care operations purposes. For example, information about your past medical care and current medical conditions and medications can be available to us or to your non-ArchWell Health providers or hospital, if they also participate in the data exchange networks and HIEs.

You may opt in or out of allowing ArchWell Health to share, receive, or both share and receive your health information through data exchange networks and the state HIEs we participate in by completing and submitting an Opt IN/Out form. Even if you opt-out of allowing ArchWell Health to share, receive, or both share and receive your health information, public health reporting and Controlled Dangerous Substances information, as part of the State Prescription Drug Monitoring Program (PDMP), and other information may still be available to your health care providers through data exchange networks or state HIEs as permitted by law. You may obtain opt in/out information and forms at your medical practice.

Organized Health Care Arrangements: ArchWell Health may participate in one or more organized health care arrangements (OHCA) with other health care providers. We do this to engage in joint activities that support the delivery and management of high quality, innovative, and cost-effective care.

HOW ELSE CAN WE USE OR SHARE YOUR HEALTH INFORMATION?

We may use or disclose your health information for the following purposes under limited circumstances:

Required by Law: We may disclose information when required to do so by federal, state, and local laws.

To Persons Involved With Your Care: Unless you say no, we may use or disclose your health information to a person involved in your care, or who has a legal right to act for you, or who helps pay for your care, such as a family member, if these people need to know this information to help you, and then only to the extent permitted by this notice or law. If you are unavailable or unable to object, we will use our best judgment to decide if the disclosure is in your best interests (e.g., emergency, deceased).

Public Health Activities: We may disclose your health information to public health authorities as required by law and for purposes such as reporting or preventing disease outbreaks or for other public health purposes.

Reporting Victims of Abuse, Neglect or Domestic Violence: We may disclose your health information to government authorities that are authorized by law to receive such information, including a social service or protective service agency.

Health Oversight Activities: We may disclose your health information to a health oversight agency for activities authorized by law, such as licensure, governmental audits, and fraud and abuse investigations.

Judicial or Administrative Proceedings: We may disclose your health information for judicial, administrative, or other legal proceedings, such as in response to a court order, search warrant or subpoena.

Law Enforcement Purposes: We may disclose your health information to a law enforcement official for purposes such as providing limited information to locate a missing person or report a crime.

To Avoid a Serious Threat to Health or Safety: We may disclose your health information to avoid a serious threat to the health and safety towards you, another person, or the public, by, for example, disclosing information to public health agencies or law enforcement authorities, or in the event of an emergency or natural disaster.

Specialized Government Functions: We may disclose your health information for specialized government functions, such as military and veteran activities, national security and intelligence activities, and the protective services for the President and others.

Workers’ Compensation: We may disclose your health information to your employer and public health authorities as authorized by, or to the extent necessary to comply with, state workers’ compensation laws that govern job-related injuries or illness.

Research Purposes: We may disclose your health information to researchers for purposes such as conducting research related to the evaluation of certain treatments or the prevention of disease or disability if the research study meets federal privacy law requirements.

To Provide Information Regarding Decedents: We may disclose information to a coroner or medical examiner to identify a deceased person, determine a cause of death, or as authorized by law. We may also disclose information to funeral directors as necessary to carry out their duties.

Organ Procurement Purposes: We may use or disclose information to entities that handle procurement, banking or transplantation of organs, eyes, or tissue to facilitate donation and transplantation.

To Law Enforcement Officials: We may disclose your health information to correctional institutions and law enforcement officials if you are an inmate of a correctional institution or under the custody of a law enforcement official, but only if the disclosure is necessary for the institution to provide you with health care, to protect your health and safety or the health and safety of others, or for the safety and security of the correctional institution.

To Business Associates: We may disclose your health information to business associates such as vendors that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. Our business associates are required, under contract with us and pursuant to federal law, to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract and permitted by law.

Fundraising Purposes: We may use or disclose your demographic information and other limited information, such as dates and where health care was provided, to certain organizations for the purpose of contacting you to raise funds for our organization. If we contact you for fundraising purposes, we will provide you with a clear opportunity to elect not to receive any further fundraising communications.

Appointment Reminders: We may use or disclose health information to send you reminders about your care, such as appointment reminders with providers who provide medical care to you, or reminders related to medicines prescribed for you.

De-Identification: We may also de-identify health information in accordance with applicable laws. After that information is de-identified, it is no longer subject to this notice, and we may use it for any lawful purpose.

Prescription Refill Reminders and Health-Related Products and Services: We may use or disclose your health information for prescription refill reminders, to tell you about health-related benefits, products, or services we may provide, or to recommend possible treatment alternatives that may be of interest to you.

USE AND DISCLOSURES WITH YOUR AUTHORIZATION

Other uses and disclosures of health information not covered by this Notice will be made only with your written authorization. Most uses and disclosures of psychotherapy notes and most uses and disclosures for marketing purposes fall within this category and require your authorization before we may use your medical information for these purposes. Additionally, with certain limited exceptions, we are not allowed to sell or receive anything of value in exchange for your medical information without your written authorization. If you provide us with authorization to use or disclose medical information about you, you may revoke (withdraw) that authorization, in writing, at any time. However, uses and disclosures made before your withdrawal are not affected by your action and we cannot take back any disclosures we may have already made with your authorization.

Revoking Authorization: If you provide us with written authorization to use or disclose health information about you, you may revoke that authorization, in writing at any time. Your revocation of authorization must include the date of the revocation and a signature. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written authorization, except to the extent we have already relied on your authorization. Please note that the revocation will not apply to any authorized use or disclosure of your health information that took place before we received your revocation.

YOUR RIGHTS

The following are your rights with respect to your health information:

Your Right to Receive Confidential Communications: You have the right to ask to receive confidential communications of information in a different manner or at a different place; for example, by sending information to a P.O. Box instead of your home address. We will accommodate reasonable requests. 

In certain circumstances, we will accept your verbal request to receive confidential communications; however, we may also require you confirm your request in writing. In addition, any request to modify or cancel a previous confidential communication request must be made in writing.

Your Right to Access: You have the right to see and obtain a copy of certain health information we maintain about you such as medical records and billing records. If we maintain a copy of your health information electronically, you will have the right to request that we provide a copy of your health information in an electronic format to you. You can also request that we provide a copy of your information to a third party that you identify. In some cases, you may receive a summary of this health information.

You must make a written request to inspect or obtain a copy of your health information or have your information sent to a third party. In certain limited circumstances, we may deny your request to inspect and copy your health information. If we deny your request, you may have the right to have the denial reviewed. We may charge a reasonable cost-based fee for any copies.

Your Right to Request Amendments: You have the right to ask to amend certain health information we maintain about you such as medical records and billing records if you believe the information is wrong or incomplete.

Your request must be in writing and provide the reasons for the requested amendment. We may say “no” to your request, but we will tell you why in writing. If we deny your request, you may have a statement of your disagreement added to your health information.

Your Right to Receive an Accounting of Disclosures of Health Information: You have the right to receive an accounting of certain disclosures of your information made by us during the six years prior to your request. This accounting will not include disclosures of information made:

  1. For treatment, payment, and health care operations purposes;
  2. To you or pursuant to your authorization;
  3. To correctional institutions or law enforcement officials; and
  4. Other disclosures for which federal law does not require us to provide an accounting.

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.

Your Right to Restrict Uses and Disclosures: You have the right to ask to restrict uses or disclosures of your information for treatment, payment, or health care operations. We are not required to agree to your request and may say “no” if it would affect your care.

You also have the right to ask to restrict disclosures to family members or to others who are involved in your health care or payment for your health care.

If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

For requests to restrict your health information for payment or health care operations purposes, please request the restriction prior to receiving services at the medical office where you receive your care.

Your Right to Receive a Paper Copy of This Notice: You may ask for 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 also obtain a copy of this notice through the following website: www.archwellhealth.com, or asking for one at the medical office where you receive care.

QUESTIONS, COMPLAINTS AND CONTACTS

Contacting Your Provider: If you have any questions about this notice or want information about exercising any of your rights, we ask that you contact the manager at the medical office where you receive care or Contact us through ArchWell Health at the following address and/or telephone number:

ArchWell Health

Attn: Privacy Office

102 Woodmont Blvd., Suite600

Nashville, TN 37205

1-888-987-1151

Submitting a Written Request: You can mail your written requests to exercise any of your rights, including modifying or cancelling a confidential communication, requesting copies of your records, or requesting amendments to your record, by contacting us through ArchWell Health at the following address:

ArchWell Health

Attn: Privacy Office

102 Woodmont Blvd., Suite600

Nashville, TN 37205

Filing a Complaint: If you believe your privacy rights have been violated, you may file a complaint with us. We ask that all complaints be submitted in writing through ArchWell Health at the following address:

ArchWell Health

Attn: Privacy Office

102 Woodmont Blvd., Suite600

Nashville, TN 37205

You may also notify the Secretary of the U.S. Department of Health and Human Services of your complaint by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not take any action against you for filing a complaint.

CHANGES TO THIS NOTICE

We reserve the right to change our privacy practices and notice. We reserve the right to make the revised or changed notice effective for all health information we already have about you as well as any information we receive in the future.

If we make a material change to our privacy practices and this notice, we will post a copy of the revised notice: