FIRSTCHOICE MEDICAL STAFFING, INC.
FIRSTCHOICE HOME HEALTH OF OHIO, INC.
NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Uses and Disclosures: We will use and disclose elements of your protected health information (PHI) in the following ways:
Without your signed authorization
Treatment: The provision, coordination or management of health care and related services by one or more health care providers, including the coordination or management with a third party; consultation between health care providers relating to a patient; or the referral of a patient for health care from one health care provider to another.
Payment: The activity undertaken by a health care provider to obtain reimbursement for health care provided. They include, but are not limited to: Determinations of eligibility or coverage, including coordination of benefits or the determination of cost-sharing amounts, and settlements or submission of health benefit claims. Billing, claims, management, collection activities, obtaining payment under a contract for reinsurance, including stop-loss insurance and excess of loss insurance, and related health care data processing. Review of health care services with respect to medical necessity, coverage under a health plan, appropriateness of care or justification of charges. Utilization review activities, including recertification and preauthorization of services.
Disclosure to consumer reporting agencies of any of the following information relating to collection of premiums or reimbursement: Name, address, date of birth, social security number, payment history, account number, name and address of health care provider and/ or health plan.
When release is required by law, including in judicial settings and to health oversight regulatory agencies and law enforcement.
In emergency situations or to avert serious health /safety situations: To medical examiners, coroners or funeral directors to aid in identifying you or to help them in performing their duties.
- To contact you about appointment reminders, treatment alternatives and other health related benefits and services.
- In fundraising for ourselves.
- To the sponsor of your health plan.
All other uses and disclosures by us will require us to obtain from you written authorization in addition to any other permission you will provide us.
Your rights: You have the following rights concerning your PHI:
Restrictions: To request access to all or part of your PHI. You must do so in writing. We are not required to grant your request.
Confidential communications: To received correspondence of confidential information by alternative means or location. To do this you must submit the request in writing.
Access: To inspect or receive copies of your protected health information you must submit your request in writing.
Amendments: To request changes be made to your PHI. You must do so in writing. We are not required to grant your request.
Accounting: To receive an accounting of the disclosures by us of your PHI in the six years prior to your request. This request must be made in writing.
This notice: To get updates or reissue of this notice.
Complaints: To complain to us or the U.S. Dept. of Health & Human services if you feel your privacy rights have been violated. To register a complaint with us please call 1-800-568-6216 asks for the HIPAA Compliance Officer. The law forbids us from taking retaliatory action against you if you register a complaint.
Our Duties: We are required by law to maintain the privacy of your PHI. We must abide by the terms of this notice or any update of this notice.
Privacy contact: For more information about our privacy practices, please contact:
1457 West 117th Street
Effective date: This notice is effective January 1. 2003
Cleveland, OH 44107