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FIRST
CHOICE MEDICAL STAFFING, INC.
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.
Uses and Disclosures: We will use and disclose elements of your protected
health information (PHI) in the following ways:
Without your signed authorization
Treatment: The provision, coordination or management of health
care and related services by one or more health care providers, including
the coordination or management with a third party; consultation between
health care providers relating to a patient; or the referral of a patient
for health care from one health care provider to another.
Payment: The activity undertaken by a health care provider to
obtain reimbursement for health care provided. They include, but are
not limited to: Determinations of eligibility or coverage, including
coordination of benefits or the determination of cost-sharing amounts,
and settlements or submission of health benefit claims. Billing, claims,
management, collection activities, obtaining payment under a contract
for reinsurance, including stop-loss insurance and excess of loss insurance,
and related health care data processing. Review of health care services
with respect to medical necessity, coverage under a health plan, appropriateness
of care or justification of charges. Utilization review activities,
including recertification and preauthorization of services.
Disclosure
to consumer reporting agencies of any of the following information relating
to collection of premiums or reimbursement: name, address, date of birth,
social security number, payment history, account number, name and address
of health care provider and/ or health plan.
When release is required by law, including in judicial settings
and to health oversight regulatory agencies and law enforcement.
In emergency situations or to avert serious health /safety situations:
To medical examiners, coroners or funeral directors to aid in
identifying you or to help them in performing their duties.
Special cases:
- To contact you about appointment reminders, treatment alternatives
and other health related benefits and services.
- In fundraising for ourselves.
- To the sponsor of your health plan.
Other
All other uses and disclosures by us will require us to obtain
from you written authorization in addition to any other permission you
will provide us.
Your
rights: You have the following rights concerning your PHI:
Restrictions: To request access to all or part of your PHI. You
must do so in writing. We are not required to grant your request.
Confidential communications: To received correspondence of confidential
information by alternative means or location. To do this you must submit
the request in writing.
Access: To inspect or receive copies of your protected health
information you must submit your request in writing.
Amendments: To request changes be made to your PHI. You must
do so in writing. We are not required to grant your request.
Accounting: To receive an accounting of the disclosures by us
of your PHI in the six years prior to your request. This request must
be made in writing.
This notice: To get updates or reissue of this notice.
Complaints: To complain to us or the U.S. Dept. of Health &
Human services if you feel your privacy rights have been violated. To
register a complaint with us please call 1-800-568-6216 asks for the
HIPAA Compliance Officer. The law forbids us from taking retaliatory
action against you if you register a complaint.
Our
Duties: We are required by law to maintain the privacy of your PHI.
We must abide by the terms of this notice or any update of this notice.
Privacy
contact: For more information about our privacy practices, please
contact:
o
1457 West 117th Street
Cleveland, OH 44107
800-568-6216
Effective
date: This notice is effective January 1. 2003 |
