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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.

CarePro Health Services is required by law to maintain the privacy of Protected Health Information (“PHI”) and to provide individuals with notice of our legal duties and privacy practices with respect to PHI. PHI is 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. This Notice of Privacy Practices (“Notice”) describes how we may use and disclose PHI to carry out treatment, payment or health care operations and for other specified purposes that are permitted or required by law. The Notice also describes your rights with respect to PHI about you.

  • CarePro Health Services is required to follow the terms of this Notice. We will not use or disclose PHI about you without your written authorization, except as described in this Notice. We reserve the right to change our practices and this Notice and to make this new Notice effective for all PHI we maintain. Upon request, we will provide any revised Notice to you. In addition, we are required to inform you of any unauthorized access, use or disclosure of your unencrypted confidential information in the event its security or privacy is compromised (i.e., in the event that a reportable breach occurs as provided by the HIPAA Omnibus Final Rule.)  We will provide such notice to you without unreasonable delay but in no case later than sixty days after we discover the breach.
  •  We reserve the right to revise or amend our Notice of Privacy Practices without additional Notice to you. Any revision or amendment to this Notice will be effective for all of your records our practice has created or maintained in the past, and for any of your records, we may create or maintain in the future. CarePro Health Services will post a copy of our current Notice and any amended Notice in our offices in a prominent place and will post any such Notice on our web site. In addition, you have a right to request a paper copy of the current Notice.
  • Unless you object, CarePro may disclose to a member of your family, a relative, a close friend or any other person you identify, your PHI that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such a disclosure, CarePro may disclose such information as necessary if CarePro, based on its professional judgement, determines it is in your best interest. CarePro may use or disclose PHI 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.

Your Health Information Rights

You have the following rights with respect to PHI about you:

  • Obtain a paper copy of the Notice upon request. You may request a copy of the Notice at any time. Even if you have agreed to receive the Notice electronically, you are still entitled to a paper copy. Paper copies of the Notice are available at CarePro Health Services.
  • Request a restriction on certain uses and disclosures of PHI. You have the right to request additional restrictions on our use or disclosure of PHI about you by sending a written request to the Privacy Officer, at CarePro Health Services, 1014 5th Avenue, SE Cedar Rapids, IA  52403. We are not required to agree to those restrictions unless the requested restrictions are for services that are paid in full in advance and only disclosures to your health plan, Medicare, Medicaid, insurance company or any entity that pays for your health care.
  • Inspect and obtain a copy of PHI. You have the right to access and copy PHI about you contained in a designated record set for as long as CarePro Health Services maintains the PHI. The designated record set usually will include prescription and billing records. To inspect or copy PHI about you, you must send written request to the Privacy Officer, at CarePro Health Services, 1014 5th Avenue, SE  Cedar Rapids, IA  52403. You may ask to see or get an electronic or paper copy of your medical record and other health information we have about you. You may ask to have an electronic or paper copy sent to another individual or entity. We may charge a fee for the costs of copying, mailing and supplies that are necessary to fill your request. We may deny your request to inspect and copy in certain limited circumstances. If you are denied access to PHI about you, you may request that denial be reviewed. We will generally respond to a request to access and copy PHI within 30 days unless an extension of an additional 30 days is required.
  • Choose someone to act for you: If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • Request an amendment of PHI. If you feel that PHI we maintain about you is incomplete or incorrect, you may request that we amend it. You may request an amendment for a long as we maintain the PHI. To request an amendment, you must send a written request to the Privacy Officer, at CarePro Health Services, 1014 5th Avenue, SE Cedar Rapids, IA  52403. You must include a reason that supports your request. In certain cases, we may deny your request for amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with the decision and we may give a rebuttal to your statement.
  • Receive an accounting of disclosures of PHI. You have the right to receive an accounting of the disclosures we have made of PHI about you. If the information is kept in paper form, you are entitled to an accounting of disclosures that go back six years for most purposes other than treatment, payment, or health care operations. If the information is kept in your electronic medical record, you may receive an accounting that includes disclosures for treatment, payment and health care operations that goes back three years. Any accounting will exclude certain disclosures, such as disclosures made directly to you, disclosures you authorize, disclosures to friends or family members involved in your care, and disclosures for notification purposes. The right to receive an accounting is subject to certain other exceptions, restrictions, and limitations. To request an accounting, you must submit a request in writing to the Privacy Officer, at CarePro Health Services, 1014 5th Avenue, SE Cedar Rapids, IA  52403. The first accounting you request within a 12 month period will be provided free of charge, but you may be charged for the cost of providing additional accountings. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time.
  • Request communications of PHI by alternative means or at alternative locations. For instance, you may request that we contact you about medical matters only in writing or at a different residence or post office box. To request confidential information of PHI about you, you must submit a request in writing to the Privacy Officer, at CarePro Health Services, 1014 5th Avenue, SE Cedar Rapids, IA  52403. Your request must state how or where you would like to be contacted. We will accommodate all reasonable requests.

Examples of How We May Use and Disclose PHI

The following are descriptions and examples of ways we use and disclose PHI:

  • We will use PHI for treatment. Example: Information obtained by CarePro Health Services will be used to dispense prescription medication to you. We will document in your record information related to the medications dispensed to you and services provided to you.
  • We will use PHI for payment. Example: We will contact your insurer or pharmacy benefit manager to determine whether it will pay for your prescription and the amount of your copayment. We will bill you or a third-party payer for the cost of prescription medications dispensed to you. The information on or accompanying the bill may include information that identifies you, as well as the prescriptions you are taking.
  • We will use PHI for health care operations. Example: The Pharmacy may use information in your health record to monitor the performance of pharmacists providing treatment to you. This information will be used in an effort to continually improve the quality and effectiveness of the health care and service we provide.
  • We may also use or disclose PHI for the following purposes:
  • Business Associates: There are some services provided by us through contracts with business associates. Examples include (disposal of paper including PHI). When these services are contracted for, we may disclose PHI about you to our business associate so they can perform the job we have asked them to do and bill you or your third-party payer for services rendered. To protect PHI about you, we require the business associate to appropriately safeguard the PHI.
  • Communication with individuals involved in your care or payment for your care: Health professionals such as pharmacists, using their professional judgement, may disclose to a family member, other relatives, close personal friends or any person you identify, PHI relevant to that person’s involvement in your care or related to your care.
  • Health-related communications: We may contact you to provide refill reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
  • Food and Drug Administration (FDA): We may disclose to the FDA, or persons under the jurisdiction of the FDA, PHI relative to adverse events with respect to drugs, foods, supplements, products and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.
  • Worker’s Compensation: We may disclose PHI about you as authorized by and as necessary to comply with laws relating to worker’s compensation or similar programs established by law.
  • Public Health: As required by law, we may disclose PHI about you to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
  • Law enforcement: We may disclose PHI about you for law enforcement purposes as required by law or in response to a valid subpoena or other legal processes.
  • As required by law: We must disclose PHI about you when required to do so by law, including providing PHI to the Secretary so that our compliance with HIPAA may be determined.
  • Health oversight activities: We may disclose PHI about you to an oversight agency for activities authorized by law. These oversight activities include audits, investigations, and inspections, as necessary for our licensure and for the government to monitor the healthcare system, government programs, and compliance with civil rights laws.
  • Judicial and administrative proceedings: If you are involved in a lawsuit or a dispute, we may disclose PHI about you in a response to a court or administrative order. We may also disclose PHI about you in response to a subpoena, discovery request, or other lawful processes by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the requested PHI. We are permitted to use or disclose the PHI about you for the following purposes:
  • Coroners, medical examiners, and funeral directors: We may release PHI about you to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person to determine the cause of death. We may also disclose PHI to funeral directors consistent with applicable law to carry out their duties.
  • Organ or tissue procurement organizations: Consistent with applicable law, we may disclose PHI about you to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
  • Notification: We may use or disclose PHI about you to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and your general condition.
  • Correctional institution: If you are or become an inmate of a correctional institution, we may disclose PHI to the institution of its agents with necessary for your health or the health and safety of others.
  • To avert a serious threat to health or safety: We may use and disclose PHI about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
  • Military and veterans: If you are a member of the armed forces, we may release PHI about you as required by the military command authorities. We may also release PHI about foreign military personnel to the appropriate military authority.
  • National security and intelligence activities: We may release PHI about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
  • Protective services for the President and others: We may disclose PHI about you to the authorized federal official so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
  • Victims of abuse, neglect, or domestic violence: We may disclose about you to a government authority, such as a social service or protective services agency, if we reasonably believe you are a victim of child or dependent adult abuse or neglect. We will only disclose this type of information to the extent required by law, if you agree to the disclosure, or if the disclosure is allowed by law and we believe it is necessary to prevent serious harm to you or someone else or the law enforcement or public official that is to receive the report represents that it is necessary and will not be used against you.
  • HIV/AIDS information: We will not disclose any HIV/AIDS-related information, except in situations where the subject of the information has provided us with a written authorization allowing the release or where we are authorized or required by state or federal law to make the disclosure.
  • Corporate Wellness Programs: We may disclose PHI about you as authorized by you, to your employer, if you are enrolled in such a program.
  • Patient Prescription Bottles Brought in for Refill:  We will return any old prescription bottles brought in by the patient, for the purpose of prescription refills, in the sack with the new prescription.
  • Research purposes: CarePro may disclose your PHI for research purposes.

OTHER USES AND DISCLOSURES OF PHI

CarePro Health Services will obtain your written authorization before using or disclosing PHI about you for the purposes other than those provided for above (or as otherwise permitted or required by law). You may revoke an authorization in writing at any time. Upon receipt of the written revocation, we will stop using or disclosing PHI about you, except to the extent that we have already taken action in reliance on the authorization.

FOR MORE INFORMATION OR TO MAKE A COMPLAINT

  • If you have questions or would like additional information about CarePro Health Services privacy practices, send a written request to the Privacy Officer, at CarePro Health Services 1014 5th Avenue, SE Cedar Rapids, IA 52403.
  • If you believe your privacy rights have been violated, you can file a complaint with the Privacy Officer, in writing, or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.

EFFECTIVE DATE

Revised Date 3/6/2017 | Effective Date 9/23/2013.