As Required by the Privacy Regulations Created as a Result of the Health Insurance Portability and Accountability Act of 1996 (IIlPAA)
This notice describes how health information about you (as a client of Good Shepherd Catholic School) may be used and disclosed and how you can get access to this information.
Please review this notice carefully.
Good Shepherd Catholic School at Mercy is dedicated to maintaining the privacy of your individually identifiable health information (IIHI). In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We also are required by law to provide you with this notice of our legal duties and the privacy practices that we maintain concerning your IIHI. By federal and state law, we must follow the terms of the notice of privacy and practices that we have in effect at this time.
We realize that these laws are complicated, but we must provide you with the following important information:
- How we may use and disclose your IIHI
- Your privacy rights in your IIHI
- Our obligations concerning the use and disclosure of your IIHI
The terms of this notice apply to all records containing your IIIIl that are created or retained by Good Shepherd Catholic School. We reserve the right to revise or amend this Notice of Privacy Practices. Any revision or amendment to this notice will be effective for all your records that our organization has created or maintained in the past, and for any of your records that we may create or maintained in the future. Good Shepherd will post a copy of our current Notice on our web site (www.goodshepherdcs.org) at all times, and you may request a copy of our most current Notice at any time.
If you have any questions about this notice, please contact: Patricia Filer, Director of Good Shepherd Catholic School at Mercy
13404 N. Meridian, Oklahoma City, OK 73120
- Uses and Disclosures of Consent of Therapy
Uses and Disclosures of Protected Health Information Based Upon Your Written Consent
Your protected health information may be used and disclosed by your therapist, our staff, and others outside Good Shepherd that are involved in your care and treatment for the purposes of providing health care services to you.
Your protected health information may also be used and disclosed to pay your health care bills and to support the operations of Good Shepherd Catholic School at Mercy .
Following are examples of the types of uses and disclosures of your protected health care information that Good Shepherd is permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office once you have provided consent.
Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party that has already obtained your permission to have access to your protected health information. For example,
we would disclose your protected health information, as necessary, to a home health agency that provides care to you. We will also disclose protected health information to other therapist who may be treating you when we have the necessary permission from you to disclose your protected health information. For example, your protected health information may be provided to a therapist to whom you have been referred to ensure that the therapist has the necessary information to diagnose or treat you.
Inaddition, we may disclose your protected health information from time-to time to another therapist or health care provider (e.g., a specialist or laboratory) who, at the request of your therapist, becomes involved in your care by providing assistance with your health care diagnosis or treatment to your therapist.
Payment: Your protected health information will be used, as needed, to obtain payment for your health care services. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we recommend for you such as; making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities. For example, obtaining approval for a hospital stay may require that your relevant protected health information be disclosed to the health plan to obtain approval for the hospital admission.
Health Care Operations: We may use or disclose, as needed, your protected health information in order to support the business activities of your therapist's practice. These activities include, but are not limited to, quality assessment activities, employee review activities, training of therapy students, licensing, marketing and fundraising activities, and conducting or arranging for other business activities.
We may share your protected health information with third party "business associates" that perform various activities (e.g. billing, transcription services) for Good Shepherd Catholic School. Whenever an arrangement between Good Shepherd Catholic School and a business associate involves the use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy of your protected health information.
We may use or disclose your protected health information, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may also use and disclose your protected health information for other marketing activities. For example, your name and address may be used to send you a newsletter about Good Shepherd and the services we offer. We may also send you information about products or services that we believe may be beneficial to you. You may contact our Privacy Contact to request these materials not be sent to you.
We may use or disclose your demographic information and the dates that you received treatment from your therapist, as necessary, in order to contact you for fundraising activities supported by Good Shepherd Catholic School. If you do not want to receive these materials, please contact our Privacy Contact and request that these fundraising materials not be sent to you.
Use and Disclosures of Protected Health Information Based upon Your Written Authorization
Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke this authorization, at any time, in writing, except to the extent that your therapist or Good Shepherd Catholic School has taken an action in reliance on the use or disclosure indicated in the authorization.
Other Permitted and Required Used and Disclosures That May Be Made With Your Consent, Authorization or Opportunity to Object
We may use and disclose your protected health information in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of your protected health information. If you are not present or able to agree or object to the use or disclosure of protected health information, then your therapist may, using professional judgment, determine whether the disclosure is in your best interest. Inthis case, only the protected health information that is relevant to your health care will be disclosed.
Others Involved in Your Healthcare: Unless you object, we may disclose to a member of your family, a relative,
a close friend or any other person you identify , your protected health information that directly relates to that person's involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We may use or disclose protected health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition or death. Finally, we may
use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.
Emergencies: We may use or disclose your protected health information in an emergency treatment situation. If this happens, your therapist shall try to obtain your consent as soon as reasonably practicable after the delivery of treatment. If your therapist or another therapist for Good Shepherd Catholic School is required by law to treat you and the therapist has attempted to obtain your consent but is unable to obtain your consent, he or she may still use or disclose your protected health information to treat you.
Communication Barriers: We may use and disclose your protected health information if your therapist or another therapist for Good Shepherd Catholic School attempts to obtain consent from you but is unable to do so due to substantial communication barriers and the therapist determines, using professional judgment, that you intend to consent to use or disclosure under the circumstances.
Other Permitted and Requited Uses and Disclosures That May Be Made Without Your Consent, Authorization or Opportunity to Object
We may use or disclose your protected health information in the following situations without your consent or authorization . These situations include:
Required By Law: We may use or disclose your protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures.
Public Health: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose of controlling disease, injury or disability. We may also disclose your protected health information, if directed by the public health authority, to a foreign government agency that is collaborating with the public health authority.
Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.
Health Oversight: We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations , and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs , and other government regulatory programs and civil rights laws.
Abuse or Neglect: We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect. Inaddition, we may disclose your protected health information if we believe that you have been a victim of abuse, neglect, or domestic violence to the governmental
entity or agency authorized to receive such information . Inthis case, the disclosure will be made consistent with the requirement of applicable federal and state laws.
Food and Drug Administration: We may disclose your protected health information to a person or company required by the Food and Drug Administration to report adverse events, products defects or problems, biologic products deviations, track products; to enable product recalls; to make repairs or replacements, or to conducts post marketing surveillance, as required .
Legal Proceedings: We may disclose protected health information in the course of any judicial or administrative proceeding, in the response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), in certain conditions in response to a subpoena, discovery request or other lawful process.
Law Enforcement: We may also disclose protected health information, so long as applicable legal requirements are met, for law enforcement purposes. These law enforcement purposes include (1) legal processes and otherwise required by law, (2) limited information requested for identification and location purposes, (3) pertaining to victim of a crime, (4) suspicion that death has occurred as a result of criminal conduct, (5) in the event that a crime occurs on the premises where services were given, and (6) medical emergency (not on the premises) and it is likely that a crime has occurred.
Research: We may disclose your protected health information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.
Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public . We may also disclose protected health information if it is necessary
for law enforcement authorities to identify or apprehend and individual.
- Consumer 's Rights to Privacy
Consumer's medical information will not be shared and/or disclosed without the permission except as described in this notice or as required by law. Consumers may also retract (in writing) this authorization at any time. We will not request an explanation from you as to the basis for the request. Please make this request in writing to our Primary Contact:
Patricia Filer, Director
Good Shepherd Catholic School at Mercy 13404 N. Meridian
Oklahoma City, OK 73120
You may have the right to have your therapist amend your protected health information. This means you may request an amendment of protected health information about you in a designated record set for as long as we maintain this information. Incertain cases, we may deny your request for an amendment. If we deny your request for an 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. Please contact our Privacy Contact to determine if you have questions about amending your medical record.
You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. This right applies to disclosures for purposes other than treatment, payment or healthcare operations as described in this Notice of Privacy Practices. It excludes disclosures we may have made to you, to family members or friends involved in your care, or for notification purposes. You have the right to receive specific information regarding these disclosures that occurred after April 14, 2003. You may request a shorter timeframe. The right to receive this information is subject to certain exceptions, restrictions and limitations .
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 electronically.
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 complaing.
You may contact our Privacy Contact, Patricia Filer at Good Shepherd Catholic School at Mercy, 13404 N. Meridian , Oklahoma City, OK 73120.