HIPAA NOTICE OF
PRIVACY PRACTICES
EMPLOYEE BUSINESS SOLUTIONS, INC.
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 describes how we may use and disclose your
protected health information (PHI) to carry out treatment,
payment or health care operations (TPO) and for other
purposes that are permitted or required by law. It also
describes your rights to access and control your protected
health information. “Protected health information” is
information about you, including demographic information,
that may identify you and that relates to your past, present
or future physical or mental health or condition and related
health care services.
Note: The EAP does not release information to insurance
companies, nor do we collect medical information on you; we
are a separate individual service provided to you by your
company. All information obtained by the EAP remains in our
offices.
Uses
and Disclosures of Protected Health Information
Your protected health
information may be used and disclosed by your therapist, our
office staff and others outside of our office that are
involved in your care and treatment for the purpose of
providing health care services to you, to pay for your EAP
sessions, to support the operation of the EAP, and any other
use required by law.
Treatment:
We will use and disclose your protected health information
to provide, coordinate, or manage your counseling and any
related services. This includes the coordination or
management of your health care with a third party. For
example, we may disclose information about your current
therapy to a drug and alcohol treatment center if you are
referred to them for more extended care under the case
management of the EAP.
Payment:
Your protected health information will be used, as needed,
to obtain payment for your EAP sessions. For example, your
demographics information may be released to the EAP by your
therapist to prove use of the EAP.
EAP
Operations:
We may use or disclose, as-needed, your protected health
information in order to support the business activities of
your EAP. These activities include, but are not limited to,
quality assessment activities, EAP review activities,
training of staff, and conducting or arranging for other
business activities. For example, your protected health
information may be disclosed to the EAP by the EAP therapist
in order to receive payment. We may use or disclose your
protected health information, as necessary, to contact the
therapist to confirm the EAP referral and to receive your
appointment dates.
We may use or disclose
your protected health information in the following
situations without your authorization. These situations
include: as Required By Law, Public Health issues as
required by law, Communicable Diseases: Health Oversight:
Abuse or Neglect: Food and Drug Administration requirements:
Legal Proceedings: Law Enforcement: Coroners, Funeral
Directors, and Organ Donation: Research: Criminal Activity:
Military Activity and National Security: Workers’
Compensation: Inmates: Required Uses and Disclosures: Under
the law, we must make disclosures to you and when required
by the Secretary of the Department of Health and Human
Services to investigate or determine our compliance with the
requirements of Section 164.500. (Note that some of the
above do not apply to EAP services)
Other Permitted and Required Uses and Disclosures
Will Be Made Only with Your Consent, Authorization or Opportunity to Object unless required by law. For example,
in the case of a supervisor referral we will ask that you
sign an authorization form that will allow the therapist to
disclose recommendations, progress in treatment and
attendance to the EAP; this release will then allow the EAP
to report attendance and compliance with recommendations to
your supervisor.
You
may revoke this authorization,
at any time, in
writing, except to the extent that your EAP or therapist has
taken an action in reliance on the use or disclosure
indicated in the authorization.
You’re Rights
Following is a statement of your rights with respect to your
protected health information.
You
have the right to inspect and copy your protected health
information.
Under federal law, however, you may not inspect or copy 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.
You
have the right to request a restriction of your protected
health information.
This means you may ask us not to use or disclose any part
of your protected health information for the purposes of
treatment, payment or healthcare operations. You may also
request that any part of your protected health information
not be disclosed to family members or friends who may be
involved in your care or for notification purposes as
described in this Notice of Privacy Practices. Your request
must state the specific restriction requested and to whom
you want the restriction to apply. Under normal practice of
the EAP we only discuss protected health information with
the therapist and you, the client, unless an authorization
has been signed.
Your EAP is not required to agree to a restriction that you
may request. If the EAP believes it is in your best interest
to permit use and disclosure of your protected health
information, your protected health information will not be
restricted. You then have the right to not use the EAP.
You
have the right to request to receive confidential
communications from us by alternative means or at an
alternative location. You have the right to obtain a paper
copy of this notice from us,
upon request, even if you have agreed to accept this notice
alternatively i.e. electronically.
You
may have the right to have your EAP amend your protected
health information. If
we deny your request for amendment, you have the right to
file a statement of disagreement with us and we may prepare
a rebuttal to your statement and will provide you with a
copy of any such rebuttal
You
have the right to receive an accounting of certain
disclosures we have made, if any, of your protected health
information.
We reserve the right to
change the terms of this notice and will inform you by mail
of any changes. You then have the right to object or
withdraw as provided in this notice.
Complaints
You may complain to us or to the Secretary of Health and
Human Services if you believe your privacy rights have been
violated by us. You may file a complaint with us by
notifying our privacy contact of your complaint.
We
will not retaliate against you for filing a complaint.
This notice was published and becomes effective on/or before
September
14, 2003.
We are required by law to maintain the
privacy of, and provide individuals with, this notice of our
legal duties and privacy practices with respect to protected
health information. If you have any objections to this form,
please ask to speak with our HIPAA Compliance Officer in
person or by phone at our Main Phone Number.
.For more
information contact Employee Business Solutions, Inc. at:
info@ebs-eap.com