Patriot
Health Florida, Inc. (the "Company"), and any and all organizations
providing services, care about your privacy, and are providing you with
this Privacy Notice ("Notice") to inform you that the Company
understands that your Personal Health Information ("PHI") is
confidential. This Notice describes generally how the Company may use
and disclose your PHI to provide Eligible Services to you and other
purposes that are permitted or required by law. We may not use or
disclose any more of your PHI than is necessary, with some exceptions.
If state law is more protective of your privacy, we will follow state
law.
We reserve the right to change
the terms of this notice and our privacy policies. Any changes will
apply to your past, current, or future PHI. When we make an important
change to our policies, we will change this notice and post a new
notice on our Web site. You can also request a copy of our current
notice at any time from the Company.
This
Notice also explains your rights regarding PHI. This Notice is in
compliance with the Health Insurance Portability & Accountability
Act of 1996, which became effective on April 14, 2003. PHI is protected
health information that individually identifies you or your dependents
and relates to past, present, and future health care and/or payment for
such health care services. Please review this Notice carefully.
The
Company is required to keep Personal Health Information about you
private; give you this Notice of our legal duties and privacy practices
with respect to your Personal Health Information and follow the terms
of this Notice.
In providing
Eligible Services, the Company may use and disclose your Personal
Health Information ("PHI") in various ways. The most common disclosures
include, but are not limited to the following: (a) determining Eligible
Services available to you through your membership in a plan or program
offered by the Company ("Membership"), (b) verifying that your
Membership is active, (c) coordinating with your medical providers to
obtain information regarding received or planned procedures in order to
provide Eligible Services, or to investigate or process a claim
pursuant to this Membership Agreement, (d) providing an explanation of
benefits to you or your dependents, (e) we may use your PHI to provide
appointment reminders or give you information about treatment
alternatives or other health care services, (f) disclosing PHI to
government agencies and law enforcement personnel when the law requires
it; and (g) providing PHI to a family member, friend, physician,
facility or hospital, or other persons involved in your care to the
extent necessary to help with your care or payment for your care.
Additionally, the Company may use and disclose PHI about you for
certain operational, administrative, research and quality assurance
activities. The Company may provide, pursuant to law, PHI to
governmental regulatory bodies, including, but not limited to a state
insurance department, the Office of Civil Rights, or the Department of
Health and Human Services. PHI may also be provided to those business
associates of the Company, including, but not limited to various
insurance companies and/or provider networks, who are also required to
protect your Personal Health Information. You have the following rights
regarding your PHI: (a) the right to inspect & copy, (b) the right
to amend, (c) the right to an accounting of disclosures, (d) the right
to request restrictions, (e) the right to request confidential
communications, and (f) the right to a paper copy. The Company may only
use and disclose PHI as generally described in this Notice or according
to laws that apply to the Company. Other uses or disclosure of your PHI
will be made only with your written permission, identified as an
"Authorization". If you revoke your Authorization, the Company will no
longer use or disclose your PHI for the reasons stated in your
authorization, except to the extent that the Company may have already
taken action. You may request information or revoke your authorization
at any time by sending a written request to: Patriot Health Florida
Inc. 160 Eileen Way, Syosset, NY 11791 |