NOTICE OF PRIVACY PRACTICES FOR MY DIABETES TUTOR, INC.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW CAREFULLY. If you have questions, you may call (559) 530-3396 or (844) 623-0999.
My Diabetes Tutor, Inc. (hereinafter the “Group”) respects the privacy of each and every person and is committed to protecting all of your personal and Protected Health Information (PHI). This Notice will serve as a summary of your privacy rights and our obligations.
Group is engaged in the business of providing virtual and in-person diabetes education, medical nutrition therapy education, remote patient monitoring services and virtual and in person endocrinology consultations.
II. PATIENT RIGHTS AND RESPONSIBILITIES.
Your Rights. You have the right to:
1. Get a copy of your medical record. This section explains your rights, and some of our responsibilities, to help you get a 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 us how to do this.
● We will provide a copy or a summary of your health information, usually within thirty (30) days of your request. We may charge a reasonable, cost-based fee.
2. Ask us to correct medical records. You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. Under limited circumstances, we may decline your request, but we’ll tell you why in writing within sixty (60) days.
3. Request confidential communications. You can ask us to contact you in a specific way (for example, home or office phone or email) or to send mail to a different address. We will agree to all reasonable requests.
4. Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment, or our operations. In specific circumstances, we may not be able to agree to your request, such as if such a disclosure would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will agree to such restriction, unless a law requires us to share that information.
5. Ask for an accounting of disclosures. You can ask for a list of the times we have shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within twelve (12) months.
6. Request a copy of this Notice. You can ask for a paper copy of this privacy notice at any time, even if you have agreed to receive the notice electronically. Upon request, we will provide you with a paper copy promptly.
7. 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.
8. File a complaint if you feel your rights are violated. You can complain if you feel we have violated your rights by contacting us at email@example.com or at the following address: Group, 880 W. 7th Street, Suite 303, Hanford, CA 93230, Attn: Legal, Privacy and Security Officer. You can also 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.
Information Sharing Preferences. For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
You have the right to tell us your preferences regarding how to share information with your family, close friends, or others involved in your care.
In other cases, we never share your information unless you give us written permission, including:
● Marketing purposes
● Sale of your information
● Most sharing of psychotherapy notes.
III. MEDICAL GROUP ACTIONS AND OBLIGATIONS.
Our Uses and Disclosures. We typically use or share your health information in the following ways:
1. Treat you. We can use your health information and share it with other professionals who are treating you. Example: A doctor treating you for an injury asks another doctor about your overall health condition
2. Run our organization. We can use and share your health information to run our practice, improve your care, and to contact you when necessary. Example: We use health information about you to manage your treatment and services.
3. Bill for your services. We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your services.
Other Ways That We May Use or Share Your Health Information. We are allowed to or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.
For more information see:
1. Public Safety Issues. We may use or share your health information in certain situations such as: helping state or federal officials with public health and safety issues for the purpose of preventing disease; helping with product recalls; reporting adverse reactions to medications; reporting suspected abuse, neglect, or domestic violence; or preventing or reducing a serious threat to anyone’s health or safety.
2. Do research. We can use or share your information for health research.
3. Comply with the law. We 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 we’re complying with federal privacy law.
4. For workers’ compensation claims. We can share information about you for worker’s compensation claims.
5. For law enforcement purposes. We may share information about you with a law enforcement official or with health oversight agencies for activities authorized by law or for special government functions such as military, national security, and presidential protective services.
6. Respond to lawsuits and legal actions. We can share health information about you in response to a court or administrative order, or in response to a subpoena.
7. Respond to organ and tissue donation requests. We can share health information about you with organ procurement organizations.
8. Work with a medical examiner or funeral director. We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
IV. MAINTAINING PRIVACY AND SECURITY.
We are required by law to maintain the privacy and security of your protected health information. We must follow the duties and privacy practices described in this notice and give you a copy of it.
Breach Notification. You may have the right to be notified in the event of unpermitted access or use of unsecured PHI. If the law requires us to notify you of this type of access or use, then we will notify you promptly.
Personal Information and PHI Protection. We never sell identifiable personal information. We will not use or share your information other than as described here unless you tell us we can in writing; which you can change or update at any time. Updated instructions will apply to any future requests for information that we receive.
Additional Protections. Federal and state laws may place additional limitations on the disclosure of your health information related to sensitive information, including drug or alcohol abuse treatment programs, sexually transmitted diseases, genetic information, or mental health treatment programs. When permitted or required by law, we will obtain your authorization before releasing this type of information.
V. BUSINESS ASSOCIATES. Group may contract with outside businesses to provide some services. For example, Group may use the services of transcription, laboratories or collection agencies. Each contracted party may enter into a Business Associate agreement with Group, which requires the contracted party to protect PHI that is shared with them in accordance with the restrictions outlined in this Notice. Furthermore, PHI will only be provided to third party businesses for the limited scope of performing required services to help facilitate treatment, payment, and health care operations to you.
VI. DE-IDENTIFIED INFORMATION. Group may use, disclose, and request PHI that has been de-identified pursuant to the procedures set forth in 45 CFR 145.514(a)-(c).
VII. REVISIONS TO THIS NOTICE. Group is constantly innovating and implementing new features as part of its Services. As a result, our privacy practices may change. We may revise this Notice to reflect any changes in our privacy practices. We reserve the right to make the revised Notice effective for PHI we already have about you. It also will be effective for any information we receive in the future. We will post a current version of the Notice on this Site prior to the change becoming effective, as well as in the places where you receive the Services. The effective date of this Notice is on the top of this page, left-hand corner, under the title.
For more information see:
VIII. COMPLAINTS. If you think your privacy rights have been violated, you may file a complaint with firstname.lastname@example.org or in writing at the address listed below. You may also file a complaint with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint. You may also contact us for further information about your privacy rights by emailing us at email@example.com as well as by post mail:
My Diabetes Totor, Inc.
515 W Grangeville Blvd.
Hanford, CA 93230
Attn: Legal, Privacy and Security Officer