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.
If you have any questions about this Notice of Privacy Practices ("Notice"), please contact: Privacy Officer: Diana Moran Phone Number: (510) 727-3320 Email: compliance@edenemergency.com Address: 20103 Lake Chabot Road, Castro Valley, CA 94546
We are required by law to maintain the privacy of your protected health information ("PHI"), to provide you with notice of our legal duties and privacy practices with respect to your PHI, and to notify you in the event of a breach of your unsecured PHI. This Notice describes your rights and our obligations for using and disclosing your PHI.
Your Rights
You have the right to:
Get a copy of your paper or electronic medical record
Correct your paper or electronic medical record
Request confidential communication
Ask us to limit the information we share
Get a list of those with whom we've shared your information
Get a copy of this Notice
Choose someone to act for you
File a complaint if you believe your privacy rights have been violated
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help ensure your rights are maintained appropriately.
Get an electronic or paper copy of your medical record
You have the right to view, inspect and receive electronic or paper copies of your PHI, including your medical record.
You will not be charged to view and inspect your medical record, but we may charge a reasonable, cost-based fee for copying your medical record. If you would like your record copied, whether in paper or electronic form, you must agree in advance to the copying charge.
In certain circumstances, we may deny access to your medical record. If so, we will notify you of our denial in writing and we will explain to you why your request to view or copy your medical record was denied.
If you wish to inspect your medical records, you must make a written request. A simple letter addressed to our Privacy Officer is all that is needed. We will respond within 30 days of receiving your request in accordance with federal law. However, we are permitted to have one 30-day extension of time to consider your request, as long as we inform you of the need and the reason for the extension.
Ask us to correct your medical record
You can ask us to correct health information about you that you think is incorrect or incomplete. A simple letter addressed to our Privacy Officer is all that is needed.
We may say "no" to your request, but we'll tell you why in writing within 30 days.
Request confidential communications
You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
We will say "yes" to all reasonable requests.
Special Notice on E-Mail: You may find it convenient to communicate with us by email. We may communicate with you by e-mail if you so request or if you initiate email communication with us. However, e-mail communications may not be encrypted and thus not secure. We cannot protect the confidentiality of your PHI while it is being transmitted over the Internet unless proper encryption is used.
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. We are not required to agree to your request, and we may say "no" if it 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 say "yes" unless a law requires us to share that information.
Get a list of those with whom we've shared information
You can ask for a list (accounting) of the times we've 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 12 months of a previous request.
Get a copy of this Notice
You, and any member of the public, can ask for a paper copy of this Notice at any time, even if you have agreed to receive the Notice electronically. We will provide you with a paper copy promptly.
We will use reasonable efforts to obtain your acknowledgment of receipt of the Notice.
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 take appropriate steps to ensure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
Our Privacy Officer is listed at the top of this Notice and serves as the contact person for individuals who have complaints about how Eden Emergency Medical Group has used or disclosed their PHI or who have questions about our Notice. You can complain if you feel we have violated your rights by contacting the Privacy Officer.
You can 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 take any action to retaliate against you for filing a complaint.
Your Choices
You have some choices in the way that we use and share information when we:
Tell family and friends about your condition
Provide disaster relief
Include you in a hospital directory
Provide mental health care
Market our services and sell your information
Raise funds
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.
In these cases, you have both the right and choice to tell us to:
Share information with your family, close friends, or others involved in your care
Share information in a disaster relief situation
Include your information in a hospital directory
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
Unless you give us written permission, we will never:
Use your information for marketing purposes
Sell your information
Disclose psychotherapy notes in most instances
Use your information to respond to organ or tissue donor requests without your authorization
In the case of fundraising:
We may contact you for fundraising efforts, but you can tell us not to contact you again.
Our Uses and Disclosures
We may use and share your information when we:
Treat you
Run our organization
Bill for your services
Help with public health and safety issues
Conduct research
Comply with the law
Respond to organ and tissue donation requests
Work with a medical examiner or funeral director
Address workers' compensation, law enforcement, and other government requests
Respond to lawsuits and legal actions
We typically use or share your health information in the following ways:
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.
Run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.
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.
How else can we use or share your health information?
We are allowed 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: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
We can share health information about you for certain situations such as:
Preventing disease
Helping with product recalls
Reporting adverse reactions to medications
Reporting suspected abuse, neglect, or domestic violence
Preventing or reducing a serious threat to anyone's health or safety
Conduct research
We can use or share your information for health research.
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.
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.
Address workers' compensation, law enforcement, and other government requests
We can use or share health information about you:
For workers' compensation claims
For law enforcement purposes or with a law enforcement official
With health oversight agencies for activities authorized by law
For special government functions, such as military, national security, and presidential protective services
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.
More Restrictive State Law: Certain state laws may have more strict requirements on how we use and disclose your PHI. If there are specific more restrictive requirements, even for some of the purposes listed above, we may not disclose your PHI without your written authorization. To the extent that there are more strict state requirements or restrictions, we will only use and disclose your PHI as permitted by those stricter requirements.
Our Responsibilities
We are required by law to maintain the privacy and security of your protected health information.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this Notice and give you a copy of it.
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
We will adhere to this Notice and will not use or disclose your information in a manner inconsistent with this Notice.
We can change the terms of this Notice, and the changes will apply to all information we have about you.
The Notice will be promptly revised whenever there is a material change to our practices described in the Notice.
Unless required by law, material revisions will not be implemented prior to the effective date of the revised Notice.
The new Notice will be available upon request, in our office, and on our website.
Eden Emergency Medical Group's Notice will be retained for six (6) years from its last effective date.
Eden Emergency Medical Group
20103 Lake Chabot Road, Castro Valley, CA 94546
Phone: (510) 727-3320 | Email: compliance@edenemergency.com Serving the East Bay Community