This notice describes how medical information about patients may be used and disclosed, and how to get access to this information.
If you have any questions regarding this notice, you may contact our Administrative Assistant at:
Paragon Behavioral Health
Attention: Community Relations Coordinator
I. YOUR PROTECTED HEALTH INFORMATION
Paragon Behavioral Health is required by the federal privacy rule to maintain the privacy of your health information that is protected by the rule and to provide you with notice of our legal duties and privacy practices with respect to your protected health care information. We are required to abide by the terms of the notice currently in effect.
Generally speaking, your protected health information is any information that relates to your past, present or future physical or mental health or condition, the provision of health care to you, or payment for health care provided to you, and individually identifies you or reasonably can be used to identify you.
Your medical, psychiatric, counseling, and billing records at Paragon Behavioral Health are examples of information that usually will be regarded as your protected health information.
II. USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATI
A. Treatment, payment, and health care operations.
This section describes how we may use and disclose your protected health information for the purposes of treatment, payment, and health care operations. The descriptions include examples. Not every possible use or disclosure for treatment, payment, and health care operations purposes will be listed.
We may use and disclose your protected health information for our treatment purposes as well as the treatment purposes of other health care providers. Treatment includes the provision, coordination, or management of health care services to you by one or more health care providers. Some examples of treatment uses and disclosures include:
While receiving services, Preventative Aftercare social workers, counselors, regional supervisors, directors, and other treatment and support staff involved in your care may review your medical, mental and behavioral health records and share and discuss this information with each other.
We may share and discuss your past, present and future medical, mental and behavioral health information with outside entities to include juvenile probation, children and youth services, human services agencies, medical and mental health providers, and school personnel.
We may share and discuss your progress within the program with family members and other concerned persons.
While receiving services, Preventative Aftercare staff will be meeting with you at school, home and in public community settings.
While receiving services, your name may appear on our business checking system after earning an allowance or stipend check.
While receiving services, Preventative Aftercare staff may escort you to medical or mental health appointments to assist in the assessment and treatment process.
We may use and disclose your protected health information for our payment purposes as well as the payment purposes of other health care providers and health plans. Payment uses and disclosures include activities conducted to obtain payment for the care provided to you or so that you can obtain reimbursement for that care, for example, from your health insurer. Some examples of payment uses and disclosures include:
Sharing information with your health insurer to determine whether you are eligible for coverage or whether proposed treatment is a covered service.
Submission of a claim form to your health insurer.
Providing supplemental information to your health insurer so that your health insurer can obtain reimbursement from another health plan under a coordination of benefits clause in your subscriber agreement.
Sharing your demographic information (for example, your address) with other health care providers who seek this information to obtain payment for health care services provided to you.
Mailing statements in envelopes with Paragon Behavioral Health as the return address.
Provision of a bill to a family member or other person designated as responsible for payment for services rendered to you.
Providing medical records and other documentation to your health insurer to support the medical necessity of a health service.
Allowing your health insurer access to your medical records for a medical necessity or quality review audit.
Providing consumer-reporting agencies with credit information (your name and address, date of birth, social security number, payment history, account number, and our name and address).
Providing information to a collection agency for purposes of securing payment of a delinquent account.
Providing information in a legal action for purposes of securing payment of a delinquent account.
Providing insurance information with an outside physician, laboratory, pharmacy or other provider for purposes of securing payment.
3. Health care operations
We may use and disclose your protected health information for our health care operation purposes as well as certain health care operation purposes of other health care providers and health plans. Some examples of health care operation purposes include:
Quality assessment and improvement activities.
Population based activities relating to improving health or reducing health care costs.
Reviewing the competence, qualifications, or performance of health care professionals.
Conducting training programs for medical and other students.
Accreditation, certification, licensing, and credentialing activities.
Health care fraud and abuse detection and compliance programs.
Conducting other medical review, legal services, and auditing functions.
Business planning and development activities, such as conducting cost management and planning related analyses.
Other business management and general administrative activities, such as compliance with the federal privacy rule and resolution of client grievances.
B. Uses and disclosures for other purposes.
We may use and disclose your protected health information for other purposes. This section generally describes those purposes by category. Each category includes one or more examples. Not every use or disclosure in a category will be listed. Some examples fall into more than one category – not just the category under which they are listed.
1. Individuals involved in care for payment for care.
We may disclose your protected health information to someone involved in your care or payment for your care, such as probation officer, caseworker, attorney or a family member. For example, if you are injured, we may discuss your injury with a family member.
I. Notification purposes
We may use and disclose your protected health information to notify, or to assist in the notification of, a family member, a personal representative, or another person responsible for your care, regarding your location, general condition, or death. For example, if you are hospitalized, we may notify a family member of the hospital and your general condition. In addition, we may disclose your protected health information to your probation officer involved in your care.
II. Required by law
We may use and disclose protected health information when required by federal, state, or local law. For example, we may disclose protected health information to comply with mandatory reporting requirements involving child abuse, disease prevention and control, vaccine-related injuries, medical device-related injuries, gunshot and other injuries by a deadly weapon or criminal act, driving impairments and blood alcohol testing.
III. Other public health activities
We may use and disclose protected health information for public health activities, including:
Public health reporting.
Child abuse and neglect reports.
FDA-related reports and disclosures, for example, adverse event reports.
Public health warnings to third parties at risk of a communicable disease of condition.
Child Welfare reportable incidents.
IV. Victims of abuse, neglect or domestic violence
We may use and disclose protected health information for purposes of reporting abuse, neglect or domestic violence in addition to child abuse to the Child Protective Services Agency.
V. Health oversight activities
We may use and disclose protected health information disclosures for purposes of health oversight activities authorized by law. These activities could include audits, inspections, investigations, licensure actions, and legal proceedings.
VI. Judicial and administrative proceedings
We may use and disclose protected health information disclosures in judicial and administrative proceedings in response to a court order or subpoena discovery request of other lawful process. For example, we may comply with a court order to testify in a case at which your medical condition is at issue.
VII. Law enforcement purposes
We may use and disclose protected health information for certain law enforcement purposes including to:
Comply with legal process, for example, a search warrant.
Comply with a legal requirement.
Respond to a request for information for identification/location purposes.
Respond to a request for information about a crime victim.
Report a death suspected to have resulted from criminal activity.
Provide information regarding a crime on the premises.
Report a crime in an emergency.
Report an injury/health condition in an emergency.
VIII. Coroners and medical examiners
We may use and disclose protected health information for purposes of providing information to a coroner or medical examiner for the purpose of identifying a deceased client, determining a cause of death, of facilitating their performance of other duties required by law.
IX. Funeral directors
We may use and disclose protected health information for purposes of providing information to funeral directors as necessary to carry out their duties.
X. Organ and tissue donation
For purposes of facilitating organ, eye and tissue donation and transplantation, we may use protected health information and disclose protected health information to entities engaged in the procurement, banking, or transplantation of cadaver organs, eyes, or tissue.
XI. Threat to public safety
We may use and disclose protected health information for purposes involving a threat to public safety, including protection of a third party from harm and identification and apprehension of a criminal. For example, in certain circumstances, we are required by law to disclose information to protect someone from imminent serious harm.
XII. Specialized government functions.
We may use and disclosure protected health information for purposes involving specialized government functions including:
Military and veterans activities
National security and intelligence.
Protective services for the President and others.
Medical suitability determinations for the Department of State.
Correctional institutions and other law enforcement custodial situations.
XIII. Business associates
Certain functions of Paragon Behavioral Health are performed by a business associate such as a billing company, an accountant firm, or a law firm. We may disclose protected health information to our business associates and allow them to create and receive protected health information on our behalf. For example, we may share with our billing company information regarding your care and payment for your care so that the company can file health insurance claims and bill the responsible party.
XVI. Creation of de-identified information
We may use protected health information about you in the process of de-identifying the information.
XV. Incidental disclosure
We may disclose protected health information as by-product of an otherwise permitted use of disclosure. For example, while visiting you at school, other students or staff may overhear your name being mentioned as you are asked to report to the office.
C. Use and disclosures with authorization
For all other purposes which do not fall under a category listed under sections II.A and II.B, we will obtain your written authorization to use or disclose your protected health information. Your authorization can be revoked at any time except to the extent that we have relied on the authorization.
III. PATIENT PRIVACY RIGHTS
A. Further restriction on use or disclosure
You have a right to request that we further restrict use and disclosure of your protected health information to carry out treatment, payment, or health care operations, to someone who is involved in your care or the payment for your care, or for notification purposes. We are not required to agree to a request for further restriction.
To request a further restriction, you must submit a written request to our privacy officer. The request must tell use: (a) what information you want restricted; (b) how you want the information restricted; and (c) to whom you want the restriction to apply.
B. Confidential communication
You have a right to request that we communicate your protected health information to you by a certain means or at a certain location. For example, you might request that we only contact you by mail. We are not required to agree to requests for confidential communications that are unreasonable.
To make a request for confidential communications, you must submit a written request to our privacy officer. The request must tell us how and where you want to be contacted. In addition, if another individual or entity is responsible for payment, the request must explain how payment will be handled.
C. Accounting of disclosures
You have a right to obtain, upon request, an “accounting” of certain disclosures of your protected health information by us (or a business associate for us). This right is limited to disclosures within six years of the request and other limitations. Also, in limited circumstances we may charge you for providing the accounting. To request an accounting, you must submit a written request to our privacy officer. The request should designate the applicable time period.
D. Inspection and copying
You have a right to inspect and obtain a copy of your protected health information that we maintain in a designated record set. Under federal law, however, you may not inspect or copy psychotherapy notes. Information compiled in a reasonable anticipation of, or use in, a civil, or criminal, or administration action or proceeding and protected health information that is subject to law and prohibits accesses.
To exercise your right to access, you must submit a written request to our privacy officer. The request must: (a) describe the health information to which access is requested, (b) state how you want to access the information, such as inspection, pick-up of copy, mailing of copy, (c) specify any requested form or format, such as paper copy or an electronic means, and (d) include the mailing address, if applicable.
E. Right to amendment
You have a right to request that we amend protected health information that we maintain about you in a designated record set if the information is incorrect or incomplete. This right is subject to limitations. To request an amendment, you must submit a written request to our privacy officer. The request must specify each change that you want and provide a reason to support each requested change.
IV. CHANGES TO THIS NOTICE
We reserve the right to change this notice at any time. We further reserve that right to make any change effective for all protected health information that we maintain at the time of the change – including information that we created or received prior to the effective date of the change.
We will make available a copy of our current notice with the program social worker. At any time, clients may review the current notice by requesting a copy from the Preventative Aftercare social worker.
If you believe that we have violated your privacy rights, you may submit a complaint to Paragon Behavioral Health or to the Secretary of Health and Human Services. To file a complaint with Paragon Behavioral Health, submit the complaint in writing to our privacy officer. We will not retaliate against you for filing a complaint
VI. LEGAL EFFECT OF THIS NOTICE
This notice is not intended to create contractual or other rights independent of those created in the federal privacy rule.