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Notice of Privacy Practices

Your Information. Your Rights. Our Responsibilities.
 

 


This notice describes how medical information about you may be used and disclosed by your healthcare Provider and

how you can get access to this information. Please review it carefully.

We are HIPAA Compliant

 

YOUR RIGHTS

 

YOUR CHOICES

 

OUR USES AND DISCLOSURES

OUR RESPONSIBILITIES

 

CHANGES TO THE TERMS OF THIS NOTICE

YOUR RIGHTS

YOUR RIGHTS

 

 

When it comes to your health information, you have certain rights.

 

This section explains your rights and some of our responsibilities to help you.

 

Bloomsbury Health is a software provider and is a Business Associate of your healthcare Provider. We do not access or share your health information unless required by Law.

Get an electronic or paper copy of your medical record

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask your Provider how to do this. They will provide a copy usually within 30 days of your request. They may charge a reasonable, cost-based fee.

 

Ask your to correct your medical record

You can ask your Provider to correct health information about you that you think is incorrect or incomplete. Ask your Provider how to do this.

They may say “no” to your request, but will tell you why in writing within 60 days.

 

Request confidential communications

You can ask your Provider to contact you in a specific way (for example, home or office phone) or to send mail to a different address. They will say “yes” to all reasonable requests.

 

Ask your Provider to limit what we they use or share

You can ask your Provider not to use or share certain health information for treatment, payment, or our operations.

They are not required to agree to your request, and they may say “no” if it would affect your care.

If you pay for a service or health care item out-of-pocket in full, you can ask them not to share that information for the purpose of payment or their operations with your health insurer. They will say “yes” unless a law requires them to share that information.

Get a list of those with whom your Provider has shared information

You can ask for a list (accounting) of the times they’ve shared your health information for six years prior to the date you ask, who they shared it with, and why.

Get a copy of this privacy notice

You will have electronic access to a copy of this notice at any time.

 

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. We will make sure the person has this authority and can act for you before we take any action.

 

File a complaint if you feel your rights are violated

You can complain if you feel Bloomsbury Health have violated your rights by contacting us at help@bloomsburyhealth.org

You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696- 6775, or visiting www.hhs.gov/ocr/privacy/hipaa/ complaints/.

 

We will not retaliate against you for filing a complaint.

YOUR CHOICES

YOUR CHOICES

 

 

For certain health information, you can tell your Provider your choices about what they share. If you have a clear preference for how they share your information in the situations described below, talk to them. Tell them what you want them to do, and they will follow your instructions.

 

In these cases, you have both the right and choice to tell your Provider to

Share information with your family, close friends, or others involved in your care. Share information in a disaster relief situation

If you are not able to tell them your preference, for example if you are unconscious, they may go ahead and share your information if they believe it is in your best interest. They may also share your information when needed to lessen a serious and imminent threat to health or safety.

 

In these cases your Provider never shares your information unless you give them written permission

Marketing purposes.

Sale of your information.

Most sharing of psychotherapy notes

 

In the case of fundraising

They may contact you for fundraising efforts, but you can tell them not to contact you again.

OUR USES AND DISCLOSURES

OUR USES AND DISCLOSURES

 

Bloomsbury Health do not access or share your health information unless required by Law.

How does your Provider typically use or share your health information?

Your Provider typically uses or share your health information in the following ways however please ask them to provide their Privacy Notice which supersedes this one:

Treat you

Your Provider uses your health information and shares it with other professionals who are treating you. Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run their organization

They can use and share your health information to run their practice, improve your care, and contact you when necessary. Example: They use health information about you to manage your treatment and services.

Bill for your services

They can use and share your health information to bill and get payment from health plans or other entities.

Example: They give information about you to your health insurance plan so it will pay for your services.

How else can they use or share your health information?

They are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. They have to meet many conditions in the law before they can share your information for these purposes.

 

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues

They can share health information about you for certain situations such as:

Preventing disease

Helping with product recalls

Reporting adverse reactions to medications 

Reporting suspected abuse, neglect, or domestic violence

Preventing or reducing a serious threat to anyone’s health or safety

Do research

They can use or share your information for health research.

Comply with the law

They will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that they're complying with federal privacy law.

Respond to organ and tissue donation requests

They can share health information about you with organ procurement organizations. Notice of Privacy Practices

Work with a medical examiner or funeral director

They can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

They can use or share health information about you:

For workers’ compensation claims

For law enforcement purposes or with a law enforcement official

With health oversight agencies for activities authorized by law

For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

They can share health information about you in response to a court or administrative order, or in response to a subpoena.

OUR RESPONSIBILITIES

OUR RESPONSIBILITIES

 

 

We are required by law to maintain the privacy and security of your protected health information.

We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

We must follow the duties and privacy practices described in this notice and give you a copy of it.

We will not use or share your information other than as described here.

You may change your mind at any time. Let us know by withdrawing your Consent. 

For more information see: www.hhs.gov/ocr/privacy/hipaa/ understanding/consumers/noticepp.html.

CHANGES TO THE TERMS OF THIS NOTICE

CHANGES TO THE TERMS OF THIS NOTICE

 

 

Changes to the Terms of This Notice

We can change the terms of this notice, and the changes will apply to all information we have about you.

The new notice will be available upon request, in our office, and on our web site.

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