Heart & Hands on-Deck Care Support: Notice of Privacy Practices
Effective Date: [Date]
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Heart & Hands on-Deck Care Support (“we,” “us,” or “our”) respects your privacy and is committed to protecting your personal health information. This Notice of Privacy Practices describes how we may use, disclose, and safeguard your health information, as well as your rights regarding your health information.
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1. Our Responsibilities
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Privacy of Health Information: We are required by law to maintain the privacy of your health information and to provide you with this Notice of our legal duties and privacy practices.
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Compliance: We must follow the terms of this Notice currently in effect.
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2. Uses and Disclosures of Health Information
We may use and disclose your health information for various purposes. Here are some examples of how we may use your information:
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A. Treatment, Payment, and Healthcare Operations
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Treatment: We may use your health information to provide, coordinate, or manage your healthcare and related services. For example, a healthcare provider might share your information with another provider if needed for your care.
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Payment: We may use your information to bill and collect payment for the services provided to you. For example, we may share information with your insurance company to obtain payment for services.
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Healthcare Operations: We may use and disclose your health information for operations necessary to run our business, such as quality improvement and staff training.
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B. Other Permitted Uses and Disclosures
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Public Health and Safety: We may disclose your health information to prevent a serious threat to health and safety or report on public health risks.
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Legal Obligations: We may share information as required by law, such as reporting abuse, neglect, or domestic violence, or in response to legal proceedings.
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Research: We may use and share your information for research purposes under specific circumstances and with appropriate safeguards in place.
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C. Uses and Disclosures That Require Your Written Authorization
For certain uses and disclosures, we need your written permission, including:
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Marketing and Fundraising: Using your information for marketing purposes or fundraising activities.
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Sale of Health Information: We will not sell your health information without your explicit consent.
You have the right to revoke any authorization given at any time by contacting us in writing.
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3. Your Rights Regarding Health Information
You have the following rights concerning your health information:
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Right to Access: You can request to see or get a copy of your health information, with limited exceptions. You may be charged a fee for the cost of copying, mailing, or other supplies associated with your request.
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Right to Amend: You may request corrections to your health information if you believe it is incorrect or incomplete.
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Right to an Accounting of Disclosures: You can ask for a list (an “accounting”) of certain disclosures we have made of your health information over a specific period.
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Right to Request Restrictions: You may request additional restrictions on our use or disclosure of your health information. While we will consider your request, we are not required to agree to it.
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Right to Confidential Communications: You have the right to request that we communicate with you in a certain way or at a certain location.
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Right to a Paper Copy: You may request a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
To exercise any of these rights, please contact us using the information provided below.
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4. Changes to This Notice
We reserve the right to change this Notice and our privacy practices at any time. Any changes will apply to all health information we have on file. The updated Notice will be posted on our website and available upon request.
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5. Questions and Complaints
If you believe your privacy rights have been violated, or if you have questions about this Notice or our privacy practices, you may contact us directly. Additionally, you may file a complaint with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.
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Heart & Hands on-Deck Care Support
2515 E. Semoran Blvd, Apopka, FL, 32703
info@hearthandson-deckcaresupport.com
(321) 212-7536