Notice

Notice of Health Information Practices

A. INTRODUCTION

To effectively administer the claims processing of our client's health benefit plans, Health Design Plus must collect and disclose Protected Health Information (PHI) of the plan participants.

Under federal law, your patient health information is protected and confidential. 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.

We reserve the right to change the terms of this notice and make the provisions of the new notice effective for all PHI we maintain. Updates to this notice will be posted to http://www.hdplus.com when applicable.

B. OUR PRIVACY OBLIGATIONS

We are required by law to maintain the privacy of your health information (Protected Health Information or PHI) and to provide you with this notice of our legal duties and privacy practices with respect to your Protected Health Information. When we use or disclose your Protected Health Information, we are required to abide by the terms of this Notice (or other notice in effect at the time of the use or disclosure).

C. PERMISSIBLE USES AND DISCLOSURES WITHOUT WRITTEN AUTHORIZATION

In certain situations, which we will describe in Section D below, we must obtain your written authorization in order to use and/or disclose your PHI. However, we do not need any type of authorization from you for the following uses and disclosures:

  1. Uses and Disclosures For Treatment, Payment and Healthcare Operations - We may use and disclose PHI, but not your Highly Confidential Information (defined in Section D below), in order to process payment for services provided to you and conduct our Healthcare Operations as detailed below:
    • Treatment - We disclose PHI to healthcare providers involved in your treatment. We may also disclose PHI for claims processing purposes, utilization review and management, medical necessity review, coordination of benefits, subrogation and reimbursement procedures, administration of reinsurance and excess or stop loss insurance policies, and other activities.
    • Payment - We may use and disclose your PHI to process payment for services provided to you.
    • Healthcare Operations - We may use and disclose your PHI for our healthcare operations, which include internal administration and planning and various activities that may include business management, quality improvement and assurance, peer review, data and information systems management, credentialing of participating network/preferred providers, accreditation, eligibility enrollment, compliance, auditing, and other business functions that may be related to your employer's group health plan. We may use PHI in quality assessment and improvement activities, such as credentialing of participating network/preferred providers, accreditation by the National Committee for Quality Assurance, American Accreditation HealthCare Commission (URAC), and other independent oversight organizations, where applicable.
  2. Disclosures to Relatives and Close Personal Friends - We may disclose your PHI related to payment of your healthcare to a family member, other relative, a close personal friend or any other person identified by you. We would disclose only information that we believe is relevant to the person's involvement with payment related to your healthcare.
  3. Public Health Activities - We may disclose your PHI for the following public health activities: (1) to report health information to public health authorities for the purpose of preventing or controlling disease, injury or disability; (2) to report information about products and services under the jurisdiction of the U.S. Food and Drug Administration.
  4. Health Oversight Activities - We may disclose your PHI to a health oversight agency that oversees the healthcare system and is charged with responsibility for ensuring compliance with the rules of government health programs such as Medicaid or Medicare.
  5. Judicial and Administrative Proceedings - We may disclose your PHI in the course of a judicial or administrative proceeding in response to a legal order or other lawful process.
  6. Law Enforcement Officials - We may disclose your PHI to the police or other law enforcement officials as required or permitted by law or in compliance with a court order or a grand jury or administrative subpoena.
  7. Decedents - We may disclose your PHI to a coroner or medical examiner as authorized by law.
  8. Health or Safety - We may use or disclose your PHI to prevent or lessen a serious and imminent threat to a person's or the public's health or safety.
  9. Workers' Compensation - We may disclose your PHI as authorized by and to the extent necessary to comply with state law relating to workers' compensation or other similar programs.
  10. As Required By Law - We may use and disclose your PHI when required to do so by any other law not already referred to in the preceding categories.

D. USES AND DISCLOSURES REQUIRING WRITTEN AUTHORIZATION

  • Use or Disclosure with Your Authorization - For any purpose other than the ones described above in Section C, we may only disclose your PHI when you grant us your written authorization on our authorization form.
  • Uses and Disclosures of Your Highly Confidential Information - In addition, federal and state law requires special privacy protections for certain highly confidential information about you including the subset of your PHI that is about HIV/AIDS testing, diagnosis or treatment.

E. YOUR RIGHTS REGARDING YOUR PROTECTED INFORMATION

  • Complaints - If you desire further information about your privacy rights, are concerned that we have violated your privacy rights or disagree with a decision that we made about access to your PHI, you may contact our Director of Compliance at (330) 656-1072. You may also file written complaints with the Director, Office for Civil Rights of the U.S. Department of Health and Human Services. Upon request, the Privacy Office will provide you with the correct address for the Director. We will not retaliate against you if you file a complaint with us or the Office of Civil Rights.
  • Right to Request Additional Restrictions - You may request restrictions on our use and disclosure of your PHI (1) for treatment, payment and healthcare operations, or (2) to individuals (such as a family member, other relative, close personal friend or any other person identified by you) involved with payment related to your care. While we will consider all requests for additional restrictions carefully, we are not required to agree to a requested restriction.
  • Right to Receive Confidential Communications - You may request, and we will accommodate, any reasonable written request for you to receive your PHI by alternative means of communication or at alternative locations.
  • Right to Revoke Your Authorization - You may revoke Your Authorization, or any written authorization obtained in connection with your Highly Confidential Information, except to the extent that we have taken action in reliance upon it, by delivering a written revocation statement.
  • Right to Inspect and Copy Your Health Information - You may request access to medical and billing records maintained by us in order to inspect and request copies of the records. Under limited circumstances, we may deny you access to a portion of your records, but will allow you to choose a person to access your records on your behalf. If you request additional copies, we may charge you $0.10 (10 cents) for each page. We may also charge you for our postage costs, if you request that we mail the copies to you.
  • Right to Amend Your Records - If you believe that information in your medical record is incorrect, or if important information is missing, you have the right to request that we correct the existing information or add the missing information.
  • Right to Receive An Accounting of Disclosures - You may request a list of instances where we have disclosed health information about you for reasons other than treatment, payment or healthcare operations.
  • Right to Receive Paper Copy of This Notice - Upon request, you may obtain a paper copy of this Notice.

F. CONTACT INFORMATION

If you have any questions, requests or complaints, please contact:

Compliance Officer
Health Design Plus
1755 Georgetown Road
Hudson, OH 44236
P: (330) 656-1072

Effective Date of This Notice: April 14, 2003

Amended: July 11, 2007

* Information we collect through our Internet website is subject to our Web Privacy Statement, which is also available on our website.