OHS Health and Safety Services,
Inc/Health Tests Direct /Effective Date: April
14, 2003
NOTICE OF PRIVACY
PRACTICES PLEASE REVIEW IT CAREFULLY!
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. We are required to provide you with this Notice of Privacy Practices and to explain our legal duties under the federal Health Insurance Portability and Accountability Act ( HIPAA ).
We are required by law to maintain the privacy of medical information about you. We call this information "protected health information" or "PHI". We are required to give you notice of our privacy practices about your protected health information and required to follow the terms of the notice currently in effect. This Notice of Privacy Practices will tell you how we may use or disclose information about you. Not all situations will be described.
In the future we may change the Notice of Privacy Practices. Any changes will apply to only any information we receive in the future. A copy of the new notice will be posted at our HTD website and facility and provided to individuals as required by law.
Ways We Might Use or Disclose PHI about You without Your Authorization
- Appointments and Other Health Information. We may send you reminders for medical care or checkups. We may send you information about health services that may be of interest to you.
- As Required By Law and For Law Enforcement. We will use and disclose PHI about you when required or permitted by federal or state law or by a court order.
- For Abuse Reports and Investigations. We are required by law to report any allegations of child abuse or neglect.
- To Avoid Harm. We may disclose PHI about you to law enforcement in order to avoid a serious threat to the health and safety of a person or the public.
- For Research. We may use PHI about you for studies and to develop reports. These reports do not identify specific people.
Other Uses and Disclosures Require Your Written Authorization
- For All Other Situations. We will ask for your written authorization before using or disclosing PHI about you. You may cancel this authorization at any time in writing, or by other appropriate means of communication if necessary. We cannot take back any uses or disclosures already made with your authorization.
- Other Laws Protect PHI. Many of our programs have other laws for the use and disclosure of PHI about you. For example, you must give your written authorization to us before we can use and disclose chemical dependency treatment records.
Your PHI Privacy Rights
- Right to See and Get Copies of Your PHI. In most cases, you have the right to look at or get copies of your PHI. You must make the request in writing. You may be charged a fee for the cost of copying and mailing the PHI to you.
- Right to Request to Correct or Update Your PHI. You may ask us to change or add missing PHI if you think there is a mistake. You must make the request in writing and provide a reason for your request. However, there are conditions under which we may deny this request.
- Right to Get a List of Disclosures. You have the right to ask us for a list of disclosures made after April 14, 2003 and up to six years prior to the date you made the request. You must make the request in writing. This list will not include the times that PHI about you was disclosed for treatment, payment, or health care operations. This list will not include PHI about you provided directly to you or your family, or PHI that you authorized.
- Right to Request Limits on Uses or Disclosures of Your PHI. You have the right to ask us to limit how PHI about you is used or disclosed. You must make the request in writing and tell us what PHI you want to limit and to whom you want the limits to apply. We are not required to agree to the restriction. You can request restrictions be terminated in writing or verbally.
- Right to Revoke Permission. If you are asked to sign an authorization to use or disclose PHI about you, you can cancel that authorization at any time. You must make the request in writing. This will not affect PHI that has already been shared.
- Right To Choose How We Communicate With You. You have the right to ask us to share your PHI with you in a certain way or in a certain place. For example, you may ask us to send PHI about you to your work address instead of your home address. You must make this request in writing. You do not have to explain the basis for your request.
- Right to File a Complaint. You have the right to file a complaint if you do not agree with how we have used or disclosed PHI about you.
- Right to Get a Paper Copy of this Notice. You have the right to ask for a paper copy of this notice at any time.
Contact Us to Review, Correct, or Limit Your PHI, you may want to:
- Ask to look at or copy your PHI.
- Ask to limit how PHI about you is used or disclosed.
- Ask to cancel your authorization.
- Ask to correct or change PHI about you.
- Ask for a list of disclosures of your PHI.
We may deny your request to look at, copy or change your PHI. If we do deny your request, we will send you a letter that tells you why your request is being denied, how you can ask for a review of the denial, and also information about how to file a complaint.
Questions and Complaints: You may contact us (info below) to file a complaint or to report a problem with how we have used or disclosed your PHI. Your services will not be affected by any complaints you make. We cannot retaliate against you for filing a complaint or refusing to agree to something that you believe to be unlawful. You may also file a complaint with the California or U.S. Department of Health and Human Services.
OHS Health and Safety Services, Inc/
Operations Dept. Phone: (949) 764-9301 Fax: (714)
862-1165
3303 Harbor Blvd., Suite G-2, Costa Mesa, CA 92626
Email:
operations@ohsinc.com
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