HIPAA Compliance

HIPAA NOTIFICATION BY REACHOUT HEALTHCARE AMERICA AND THE DENTAL PROVIDERS
Health Insurance Portability and Accountability Act of 1996 (HIPAA)

Notice of Privacy Practices

This notice describes how health information about you may be used and disclosed and how you can get access to your individually identifiable health information.

Please review it carefully. The privacy of your health information is important to us.

Our legal duty

We are required by applicable federal and state law to maintain the privacy of your health information as a Business Associate of a covered entity of various Dental Providers. We are also required to give you this notice about our privacy practices, our legal duties and your rights concerning your health information. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect April 14, 2003, and will remain in effect until we replace it.

We reserve the right to change our privacy practices and the terms of this Notice any time, provided such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all health information that we maintain, including health information we created or received before we made the changes. Before we make a significant change in our privacy practices, we will change this Notice and make the new Notice available upon request.

You may request a copy of our Notice at anytime for more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this notice.

USES AND DISCLOSURES OF HEALTH INFORMATION

The Dental Providers may use and disclose health information about you for treatment, payment, and healthcare operations. We will assist in this process if requested by the Dental Provider.  For example:

Treatment

We may use or disclose your health information to a physician or other healthcare provider providing treatment to you if requested by the Dental Provider.

Payment

We may use and disclose your health information to obtain payment for services that the Dental Provider has provided to you if requested by the Dental Provider.

Healthcare Operations

We may use and disclose your health information in connection with our healthcare operations if requested by the Dental Provider. Healthcare operations include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities.

Your Authorization

Unless you or your responsible party give the Dental Provider a written authorization and we are requested by the Dental Provider, we cannot use or disclose your health information for any reason except those described in this Notice.

To Your Family and Friends

We must disclose your health information to you, as described in the Patients Rights section of this Notice if requested by the Dental Provider. We may disclose your health information to family member, friend, or other person to the extent necessary to help with your healthcare or with payment for your healthcare, but only if the Dental Provider, you or your responsible party agrees that we may do so.
Persons Involved in Care: We may use or disclose health information to notify, or assist in the notification of (including identifying or locating) a family member, your personal representative, your responsible party or other person responsible for your care, of your location, your general condition, or death if requested by the Dental Provider. We will leave copies of your dental chart and need for future orders pertaining to your dental care with the Nursing Home and school nurse if requested by the Dental Provider. If you are present or the responsible party is present, then prior to use or disclosure of your health information, we will provide you or the responsible party with an opportunity to object to such uses or disclosures if requested by the Dental Provider. In the event of your incapacity or emergency circumstances, we will disclose health information based on a determination made by the Dental Provider’s and then only disclosing only health information that is directly relevant to the person’s involvement in your health care as directed by the Dental Provider. We will also follow the directions of the Dental Provider in his or her professional judgment to make reasonable inferences of your best interest in allowing a person to pick up filled prescriptions, medical supplies, x-rays, making decision about the need for extractions, new dentures and other dental care for you or other similar forms of health information.

Marketing Health-Related Services

We will not use your health information for marketing communication without your written consent. We will, however, communicate with you, your responsible party and assigned members of your nursing home or school nurse or assigned agency as it specifically relates to your dental care and coverage if requested by the Dental Provider.

Required by Law

We may use or disclose your health information when we are required to do so by law.
Abuse or Neglect: We may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes. We may disclose your health information to the extent necessary to avert a serious threat to your health or safety or the health or safety of others.

National Security

We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence, and other national security activities. We may disclose to correctional institutions or law enforcement officials having lawful custody of protected health information of inmate or patient under certain circumstances.Appointment Reminders: We will disclose your dental conditions to the assigned persons at your nursing home and school order to arrange an appropriate time for a dental visit, adjustments of medications and the like so that the dentist and his or her support staff can see you at the nursing home for your dental needs if requested by the Dental Provider.

PATIENT RIGHTS

Access: You have the right to look at or get copies of your health information, with limited exceptions from the Dental Provider and we will assist if requested by the Dental Provider. You may request that we provide copies in a format other than photocopies. We will use the format you request unless we cannot practicably do so. (You must make a request in writing to obtain access to your health information. You may obtain a form to request access by using the contact information listed at the end of this Notice. We will charge you a reasonable cost-based fee for expenses such as copies and staff time. You may also request access by sending us a letter to the address at the end of this Notice. If you request copies, we will charge you 25 cents for each page, $15.00 per hour for staff time to locate and copy your health information, and postage if you want the copies mailed to you. If you request an alternative format, we will charge a cost-based fee for providing your health information in that format. If you prefer, we will prepare a summary or an explanation of your health information for a fee. Contact us using the information listed at the end of this Notice for a full explanation of our fee structure.)

Disclosure Accounting

You have the right to receive a list of instances in which we or your Dental Provider disclosed your health information for purposes, other than treatment, payment healthcare operations and certain other activities, for the last 6 years, but not before April 14, 2003. If you request this accounting more than once in a 12 month period, we may charge you a reasonable, cost-based fee for responding to these additional requests.

Restriction

You have the right to request that the Dental Provider place additional restrictions on our use or disclosure of your health information. We are not required to agree to these additional restrictions as it is up to the direction of the Dental Provider, but if we do, we will abide by our agreement (except in an emergency).

Alternative Communication

You have the right to request that the Dental Provider communicate with you about your health information by alternative means or to alternative locations and we will assist the Dental Provider if requested by the Dental Provider. (You must make your request in writing.) Your request must specify the alternative means or location, and provide satisfactory explanation how payments will be handled under the alternative means or location you request.

Amendment

You have the right to request that the Dental Provider amend your health information. (Your request must be in writing, and it must explain why the information should be amended.). The Dental Provider may deny your request under certain circumstances but that is his or her decision.

Contact Person

If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made about access to your health information or in response to a request made to amend or restrict the use or disclosure of your health information or to have us communicate with you by alternative means or at alternative locations, you may complain to us using the contact information listed at the end of this Notice. You also may submit a written complaint to the U.S. Department of Health and Human Services upon request.

We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.

If you want more information about our privacy practices or have any questions or concerns or wish your patient information as listed above, please contact Ralph Green at 1904 W. Parkside Ln, Suite 201 Phoenix, AZ 85027 Tel: (623) 434-9343 Ext. 116 or your Dental Provider directly.

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