Understanding Your Health Record and Medical Information
Each time you visit Valir, a record of your visit is made. Typically, this record documents your symptoms, examination and test results, diagnoses, treatment and a plan for future care or treatment. This information, often referred to as your health or medical record, serves a number of purposes:
- Basis for planning your care and treatment
- Means of communication among the many health professionals who contribute to your care.
- Legal document describing the care you received.
- Means by which you or a third-party payer can verify that services billed were actually provided.
- Tool for educating healthcare professionals.
- Source of data for medical research.
- Source of information for public-health officials who oversee the delivery of healthcare in the United States.
- Source of data for Valir’s planning and marketing.
- Tool with which Valir can assess and continually work to improve the care rendered and the outcomes achieved.
Understanding what is in your record and how your health information is used helps you to ensure its accuracy; to better understand who, what, when, where, and why others may access your health information; and make more informed decisions when authorizing disclosure to others.
- Maintain the privacy of your health information.
- Provide you with a notice as to our legal duties and privacy practices with respect to information Valir collects and maintains about you.
- Abide by the terms of this notice.
- Notify you if Valir is unable to agree to a requested restriction.
- Accommodate reasonable requests you may have to communicate health information by alternative means at alternative locations.
- Reserve the right to change our practices and to make the new provisions effective for all protected health information Valir maintains. Should Valir’s information practices change, a revised notice will be mailed to you.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW CAREFULLY.
It is important to read and understand this Notice of Privacy Practices before signing any Acknowledgment of Receipt of the Notice of Privacy Practices.
If you have any questions about this Notice or would like further information concerning your privacy rights, please contact Valir’s privacy officer at 700 N.W. 7th Street, Oklahoma City, Ok. 405-609-3651.
This Notice of Privacy Practices (the Notice) is meant to inform you of the uses and disclosures of protected health information that we may make. It also describes your rights to access and control your protected health information and certain obligations we have regarding the use and disclosure of your protected health information.
Your protected health information is information that you created and received by us, including demographic information, that may reasonably identity you and that relates to your past, present or future physical or mental health or condition, or payment for the provision of your health care.
We are required by law to maintain the privacy of your protected health information. We are also required by law to provide you with this Notice of our legal duties and privacy practices with respect to your protected health information and to abide by the terms of the Notice that is currently in effect. However, we may change our notice at any time. The new revised Notice will apply to all of your protected health information maintained by us. You will not automatically receive a revised Notice. If you would like to receive a copy of any revised Notice you should access our web site at www.Valir.com, contact Valir or ask at your next appointment.
How We Will Use or Disclose Your Health Information
Valir will ask you to sign a consent form that allows Valir to use and disclose your protected health information for treatment, payment and health care operations. You will also be asked to acknowledge receipt of this Notice.
The following categories describe some of the different ways that we may use or disclose your protected health information. Even if not specifically listed below, Valir may use and disclose your protected health information as permitted or required by law or as authorized by you. We will make reasonable efforts to limit access to your protected health information to those persons or classes of persons, as appropriate, in our workforce, those who need access, to carry out their duties. In addition, if required, we will make reasonable efforts to limit the protected health information to the minimum amount necessary to accomplish the intended purpose of any use or disclosure and to the extent such use or disclosure is limited by law.
(1) Treatment. We may use and disclose your protected health information to provide you with medical treatment and related services. Different hospital departments may share your protected health information in order to coordinate services, such as prescriptions, lab work, and other services. For example, your physician may need to tell the dietitian if you have diabetes so we can arrange for appropriate meals. With a valid consent, Valir may disclose your protected health information to individuals or facilities that will be involved with your care after you leave Valir and for other treatment reasons. We may also use or disclose your protected health information in an emergency situation.
(2) Payment. We may use and disclose your protected health information for payment of the services you received. For example, a bill may be sent to you your payment source including an insurance or managed care company, or a third-party payer, including Medicare or Medicaid. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used for your treatment.
(3) Health care operations. We may use and disclose your protected health information as necessary for operations, such as risk and quality improvement activities, reviewing the competence and qualifications of health care professionals, medical review, legal services, auditing functions and general administrative activities of Valir. For example, members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the health care and service we provide.
(4) Business associates. We may disclose your protected health information to business associates with whom we contract to provide services on our behalf. Some of our services, such as laboratory tests, are provided through contracts with business associates. We will only make these disclosures if we have received satisfactory assurance that the business associate will properly safeguard your protected health information. We require the business associates to receive satisfactory assurances from its subcontractors that they will also properly safeguard your protected health information.
(5) Directory. Unless you notify us that you object, we may use limited information about you in our facility directory while you are a patient at the facility. This information may be provided to people who ask for you by name. You may opt out of the directory and request that we not disclose any information to anyone who asks for you by name.
(6) Notification of Individuals Involved in Your Care or Payment of Care. We may use or disclose your protected health information with persons involved in your medical care or payment for your care such as family member, personal representative, or friend. If you are unable to agree or object to such a disclosure, we may disclose such information if we determine that it is in your best interest based on our professional judgment or if we reasonable infer that you would not object. We may disclose your protected health information to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
(7) Appointment Reminders. We may use and disclose protected health information to contact you as a reminder that you have an appointment at Valir. This may be done by letter, email, or by other methods of communications.
(8) Research. We may use or disclose your protected health information to researchers when their research has been approved by an Institutional Review Board hat has reviewed the research proposal and established protocols to ensure the privacy of your health information.
(9) Fundraising. We may use your protected health information to contact you about fundraising programs. You may receive mailings related to specific programs. We may disclose this information to a business associate or foundation to assist us in fundraising efforts. We will include a clear and conspicuous statement allowing you the opportunity to opt-out of any further fundraising communications.
(10) Funeral Directors, Medical Examiners, Organ procurement organizations. We may disclose your protected health information to funeral directors, medical examiners, or if you are an organ donor, to an organization involved in the donation of organs and tissue to carry out their duties consistent with applicable law.
(11) To Avert a Serious Threat to Health or Safety. We may use and disclose your protected health information when necessary to prevent a serious threat to your health or safety or health or safety of the public or another person. Any disclosure, however, would be to someone able to help prevent the threat.
(12) Food and Drug Administration (FDA). We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.
(13) Public Health. As required by law, we may disclose your protected health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability; reporting births, deaths or other vital statistics; reporting child abuse or neglect; notifying individuals of recalls of products they may be using; notifying a person who may have been exposed to a disease or may be at risk of contracting or spreading a disease or condition.
(14) Health Oversight Activities. We may disclose your protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections, accreditation, licensure and disciplinary actions.
(15) Workers compensation. We may use or disclose your protected health information to the extent authorized and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.
(16) Law Enforcement. We may use or disclose your protected health information for law enforcement purposes as required by law or in response to a valid subpoena.
(17) Judicial and Administrative Proceedings. If you are involved in a lawsuit or a dispute, we may disclose your protected health information in response to your authorization or a court or administrative order. We may also disclose your protected health information in response to a subpoena, discovery request or other lawful process if such disclosure is permitted by law.
(18) Correctional Institution. Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof the institution necessary for you health and the health and safety of other individuals.
(19) Special Rules Regarding Disclosure of Psychiatric, Substance Abuse and HIV-Related Information. For disclosures concerning protected health information relating to care for psychiatric conditions, substance abuse or HIV-related testing and treatment, special restrictions may apply. For example, we generally may not disclose this information in response to a subpoena, warrant or other legal process unless you sign a special Authorization or a court orders the disclosure.
- Mental Health and Substance Abuse information. Certain mental health and substance abuse information is protected by State law as stated in 43A O.S. sec. 1-109.
When We May Use or Disclose Your Protected Health Information
Except as described in this Notice, or a permitted by State or Federal law, we will not use or disclose your protected heath information without your written authorization.
Your written authorization will specify particular uses or disclosures that you choose to allow. Under certain limited circumstances, Valir may condition treatment on the provisions of an authorization, such as for research related to treatment. If you do authorize us to use or disclose your protected health information for reasons other than treatment, payment or heath care operations, you may revoke your authorization in writing at any time by contacting Valir’s Privacy Officer. If you revoke your authorization, we will no longer use or disclose your protected health information for the purposes covered by the authorization, except where we have already relied on the authorization.
A signed authorization is required for the use or disclosure of your protected health information for the purpose of marketing, except if it is in the form of, a face to face communications, a promotional gift of nominal value; or falls under an exception recognized by HIPAA. If Valir receives any remuneration for a marketing communication, we must obtain your authorization and inform you that payment is involved. A signed authorization is required for the use or disclosure of you or your story in photograph, video, or print media for purposes of advertising Valir’s services.
Sale of PHI
Valir will not directly or indirectly receive payment in exchange for any protected health information without first obtaining a signed authorization that includes a specification of whether the protected health information can be further exchanged for payment by the entity receiving protected health information of the individual.
Your Health Information Rights
You have the following rights with respect to your protected health information. The following briefly describes how you may exercise these rights.
Right to Request Restrictions of Your Protected Health Information
You have the right to request a restriction or limitation on the health information we use or disclose for treatment , payment, or health care operations. You also have the right to request a limit on the health information we disclose to someone involved in your care or the payment for your care, like a family member or friend. We ask that such requests be made in writing on a form provided by Valir. Although we will consider your request, please be aware that we are under no obligation to accept it or to abide by it, unless you are requesting us to restrict the use and disclosure of your protected health information to a health plan for payment or health care operation purposes and such information you wish to restrict pertains solely to a health care item or service for which you have paid “out of pocket” in full.
If you paid out-of-pocket (or in other words, you have requested that we not bill your health plan) in full for a specific item or service, you have the right to ask that your protected health information with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations, and we will honor your request.
Right to Receive Confidential Communications
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can request that we only contact you by mail at work. You may submit a request in writing by obtaining and filling out a Request for Confidential Communication form from Valir. We will attempt to accommodate all reasonable requests.
Right to Access, Inspect and Copy Your Protected Health Information
You have the right to access, inspect and or obtain copies of health information about you, which will be provided to you in the time frames established by law. You will be required to make your request in writing. Under very limited circumstances, we may deny, in whole or in part, you access to your medical record file. If we deny your request, we will provide you with a written explanation of the reason for the denial. If we deny your request you have the right to have the decision reviewed by an independent health care professional designated by us, or through a court of law at your expense. If you request copies, we will charge you a reasonable fee. You have the right to receive an electronic copy in the form and format requested if readily producible; if not, then in a machine-readable electronic form and format, as agreed upon by the individual and Valir.
Right to Amend Your Protected Health Information
You have the right to request an amendment to your protected health information if you believe that any health information in your record is incorrect or if you believe that important information is missing. Such requests must be made in writing. We may deny your request for an amendment if (1) the request is not in writing or does not include a reason to support the request; (2) the information was not created by us or is not part of the medical record we maintain; (3) the information is not part of the information that you would be permitted to inspect or copy; or (4) the information is accurate and completed. If we deny an amendment we will provide written denial including the reason. For a request form, please contact the staff on duty. If you disagree you may contact the Privacy Officer.
Right to Receive an Accounting of Disclosures of Protected Health Information
You have a right to receive an accounting of your protected health information of certain disclosures other than those made for purposes of treatment, payment and health care operations or for those which you provided written authorization. You may request an accounting for up to six (6) years prior to the date of your request (three years if protected health information is an electronic health record). Request for an accounting must be in on a form provided by Valir. You will not be charged for your first accounting request in any 12-month period.
Right to Get Notice of a Breach
You have the right to be notified upon a breach of any of your unsecured protected health information.
Right to Obtain a Paper Copy of Notice
You have the right to obtain a paper copy of our Notice of Information Practices upon request.
Right to Revoke
You may revoke an authorization to use or disclose health information, except to the extent that action has already been taken. Such a request must be made in writing.
Right to Op-Out
You have the right to opt-out of fund raising solicitations made by Valir.
Right to Complain
If you believe that your privacy rights have been violated, you may file a complaint with us. These complaints must be filed in writing on a form provided by Valir. The complaint form must be obtained from Valir Health, and when completed should be returned to 700 N.W. 7th Street, Oklahoma City, OK 73102. You may also file a complaint with the Secretary of Health and Human Services, 200 Independence Avenue, S.W., Washington, D.C 20201. All complaints must be filed within 180 days of when you knew or should have known that the act complained of occurred. There will be no retaliation for filing a complaint.
If you have questions and would like additional information, you may contact Valir’s Privacy Officer at Valir Health, 700 N.W. 7th Street, Oklahoma City, OK 73102 or 405-609-3651.