Notice of Privacy Practices – California Patients

Effective Date: May 20, 2021

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.

Remedy Medical of California, P.C. (Provider) is committed to protecting your protected health information when providing in home and telehealth services. Protected Health Information (PHI) includes information that we have created or received regarding your health, your health care, and payment for your health care. We are required by law to maintain the privacy of PHI.

You have the right to:

• Get a copy of your medical record
• Correct your medical record
• Ask us to limit the information we share
• Get a list of those with whom we have shared your information
• Get a copy of this notice in paper or electronic form
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated

OUR TYPICAL USES AND DISCLOSURES OF PHI

We use and disclose PHI for the purposes of treatment, payment, and health care operations; in most cases without your written permission. Examples of our use and disclosure of your PHI without your written permission:

• For Treatment – This includes such things as obtaining verbal and written information about your medical condition and treatment from you as well as from others, such as doctors and nurses or other professionals who are treating you or providing orders for us to treat you. We may give your PHI to other health care providers involved in your treatment and care.
• For Payment – This includes any activities we must undertake in order to get reimbursed for services we provide to you, including such things as submitting bills to insurance companies, making medical necessity determinations, and collecting outstanding accounts.
• For Health Care Operations – This includes quality assurance activities, licensing and training programs to ensure that our personnel meet our standards of care and follow established policies and procedures, developing treatment and care coordination protocols, as well as certain other management and administrative functions.

OTHER USES AND DISCLOSURES OF PHI

We are allowed or required to use and share your PHI in other ways; we use and/or disclose your PHI without your written authorization or opportunity to object, in certain situations and unless prohibited by a more stringent state law where CareHive provides services, for the following:

• The treatment, payment, or health care operation activities of another health care provider who treats you.
• To share with a business associate for the purpose of assisting with our business and health care operations, such as, without limitation: scheduling, telehealth delivery, billing, development of treatments and protocols, care coordination, etc.
• Health care and legal compliance activities.
• To share your health care information with a family member, other relative, or close personal friend or other individual involved in your care or payment for your treatment.
• To de-identify your PHI. Once your PHI has been de-identified, it is no longer considered PHI and we can use and disclose it like non-personal information.
• To aggregate your PHI with that of other covered entities (and we also may use a business associate to do so for us) in order to conduct activities related to our health care operations, for example, data analyses or quality assurance.
• To create a limited data set of your PHI, from which certain direct identifiers have been removed; we may use such limited data set for research, health care operations, or public health purposes.
• To a public health authority in certain situations as required by law (such as to report abuse, neglect, or domestic violence, or to report an adverse reaction to a medication, or for disease prevention).
• For health oversight activities including audits or government investigations, inspections, disciplinary proceedings, and other administrative or judicial actions undertaken by the government (or their contractors) by law to oversee the health care systems.
• In the event of or in anticipation of a corporate change such as sale to or merger with another entity, or in the event of a sale of assets or bankruptcy, we may disclose or transfer your PHI to the new party in control or the entity acquiring assets.
• For judicial and administrative proceedings as required by a court or administrative order, or in some cases, in response to a subpoena or other legal process.
• For law enforcement activities in limited situations, such as when responding to a warrant.
• For military, national defense and security and other special government functions.
• To avert a serious threat to the health and safety of a person or the public at large.
• For workers’ compensation purposes and in compliance with workers’ compensation laws.
• To coroners, medical examiners, and funeral directors for identifying a deceased person, determining cause of death, or carrying on their duties as authorized by law.
• If you are an organ donor, we may release health information to organizations that handle organ procurement or organ, eye, or tissue transplantation nor to an organ donation bank, as necessary to facilitate organ donation and transplantation.
• For health research if certain conditions are met.

Our uses and disclosures of PHI include electronic disclosure of PHI.

We will obtain your written authorization to disclose your PHI:

• for marketing purposes
• for employment or insurance underwriting purposes
• sale of your PHI
• any other reason not described in this Notice.

You may revoke your authorization at any time, in writing, except to the extent that we have already used or disclosed medical information in reliance on that authorization.

PATIENT RIGHTS

As a patient, you have a number of rights with respect to your PHI, including:

• The Right to Access, Copy, or Inspect Your PHI –
  This means you may inspect and copy most of the medical information about you that we maintain. We will normally provide you with access to this information within thirty (30) days of your request. We may also charge you a reasonable fee, as state law permits, to provide a copy of any medical information you have the right to access. In limited circumstances, we may deny your access to your medical information, and you may appeal certain types of denials. We have forms available to request access to your PHI and we will provide a written response if we deny you access and let you know your appeal rights. If you wish to inspect or obtain a copy of your medical information, you should contact our Privacy Officer.
• The Right to Amend Your PHI –
  You have the right to ask us to amend written medical information that we may have about you. We will generally amend your information within 60 days of your request and will notify you when we have amended the information. We are permitted by law to deny your request to amend your medical information only in certain circumstances, like when we believe the information you have asked to amend is correct. If you wish to request an amendment of the medical information we have about you, please contact our Privacy Officer to obtain an amendment request form.
• The Right to Request An Accounting of Your PHI –
  You may request an accounting from us of certain disclosures of your health information we have made in the six (6) years prior to the date of your request. We are not required to give you an accounting of information we have used or disclosed for purposes of treatment, payment, or health care operations or when we share your health information with our business associates, such as our billing company or a vendor from/to which we have contracted with to help us provide services to you. We are also not required to give you an accounting of our uses of PHI for which you have already given us written authorization. If you wish to request an accounting, please contact our Privacy Officer.
• The Right to Request That We Restrict The Uses and Disclosures of Your PHI –
  You have the right to request that we restrict how we use and disclose your health information we have about you. We are not required to agree to any restrictions you request, but any restrictions agreed to by us in writing are binding on us.
• The Right to Request How We Provide Confidential Communications To You –
  You may ask us to share information with you in a certain way or in a certain place. For example, you may ask us to email or text information to a specific email address or mobile phone number, or you may ask us to call you at work instead of at home. You do not have to explain the reason for your request and we will say “yes” to any reasonable requests.

Your Legal Rights and Complaints
You also have the right to complain to us, or to the Secretary of the U.S. Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against in any way for filing a complaint with us or to the Government. If you have any questions, comments, or complaints, you may direct all inquiries to our Privacy Officer.

Our Legal Duties and Rights
We will not use or share your information other than as described here unless you tell us we can 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. The law requires us to protect the privacy of your health information and to provide this Notice of our practices. You can request a paper copy of this Notice by contacting our Privacy Officer.

We reserve the right to change our health information practices and the terms of this Notice. We reserve the right to make the changed notice effective for health information we already have about you and for new information. The Notice will be placed on our website.

Other Uses and Disclosures Require Your Written Authorization

Uses and disclosures not described in this Notice will be made only as allowed by law or with your written authorization. You may revoke your authorization to use or disclose PHI at any time and the revocation must be in writing. The revocation will not affect uses or disclosures that have already been made.

For more information, please contact us at:

If you believe your privacy rights have been violated, you may file a complaint by contacting our Privacy Officer. You may also send a complaint to the Secretary of the U.S. Department of Health and Human services at the address below. You will not be retaliated against for filing a complaint.

State-Specific Rights

Texas Residents:

• Electronic Disclosures of PHI: We will obtain your written authorization for electronically disclosing your PHI when required to comply with Texas law, but not in situations where Texas law allows for electronic disclosure without your authorization.
• Right to Access, Copy or Inspect Records: We will provide you with access or a copy of your medical information within fifteen (15) business days after receiving your request.

California Residents:

• Right to Access, Copy or Inspect Records: We will provide you with access within five (5) business days or a copy within fifteen (15) days after receiving your request.