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HIPPA Notice of Privacy Practices
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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.
Under the Health Insurance Portability and Accountability Act
of 1996 (HIPAA), we are required to maintain the privacy of
your Protected Health Information (PHI)and post a notice of
our legal duties and privacy practices with respect to such
protected health information.
We are required to abide by the terms of the notice currently
in effect. We reserve the right to change the terms of our notice
at any time and to make the new notice provisions effective
for all protected health information that we maintain. In the
event that we make a material revision to the terms of our notice,
we will post a revised notice within 60 days of such revision.
If you should have any questions or require further information,
please contact our Privacy Officer at (304) 257-1414.
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HOW WE MAY USE
OR DISCLOSE YOUR HEALTH INFORMATION
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Treatment: We may use and share your personal information
with health care providers for coordination and management of
your care. Providers include physicians, hospitals, and other
caregivers who provide services to you.
Payment: We may use and share your personal information
to determine your eligibility, coordinate care, review medical
necessity, pay claims, obtain external review, and respond to
complaints. We may also use and share your personal information
to obtain payment from others that may be responsible for such
costs.
Health Care Operations: We may use and share your personal
information as part of our operations in servicing your benefits.
Operations include quality improvement activities; responses
to your questions, grievance or external review programs; and
disease management. We may also use and share information for
our general administrative activities such as detection and
investigation of fraud and auditing.
Business Associates: There may be instances where services
are provided to our organization through contracts with third-party
“business associates.” Whenever a business associate arrangement
involves the use or disclosure of your health information, we
will have a written contract that requires the business associate
to maintain the same high standards of safeguarding your privacy
that we require of our own employees and affiliates.
Required by Law: We will disclose medical information
about you when required to do so by federal, state, or local
law.
Communication with Family or Friends: Our service professionals,
using their best judgment, may disclose to a family member,
other relative, close personal friend, or any other person you
identify, health information relevant to that person’s involvement
in your care or payment related to your care.
Public Health: As required by law, we may disclose your
health information to public health or legal authorities charged
with preventing or controlling disease, injury, or disability.
Workers’ Compensation: We may disclose health information
to the extent authorized by, and to the extent necessary, to
comply with laws relating to Workers’ Compensation or other
similar programs established by law.
To Avert a Serious Threat to Health or Safety: Consistent
with applicable federal and state laws, we may use and disclose
health information when necessary to prevent a serious threat
to your health and safety or the health and safety of the public
or another person.
Health Oversight Activities: We may disclose health information
to a health oversight agency for activities authorized by law,
including audits, investigations, inspections, and licensure.
Law Enforcement: We may disclose health information when
requested by a law enforcement official as part of law enforcement
activities; investigations of criminal conduct; in response
to court orders; in emergency circumstance; or when required
to do so by law.
Lawsuits and Disputes: We may disclose health information
about you in response to a subpoena, discovery request, or other
lawful order from a court.
Plan Sponsors: We may disclose health information about
you to your plan sponsor to carry out plan administration functions
that the plan sponsor performs upon certification by the plan
sponsor that the plan documents have been amended as set forth
under HIPAA regulations.
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YOUR RIGHTS
REGARDING YOUR HEALTH INFORMATION
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The following describes your rights regarding the health information
we maintained about you. To exercise your rights, you must submit
your request in writing to our Privacy Officer at Post Office
Box 278, Petersburg, WV 26847.
Right to Request Restrictions: You have a right to request
that we restrict uses or disclosures of your health information
to carry out treatment, payment, health care operations, or
communications with family or friends. We are not required to
agree to a restriction.
Right to Receive Confidential Communications: You have
the right to request that we send communications that contain
your health information by alternative means or to alternative
locations. We must accommodate your request if it is reasonable
and you clearly state that the disclosure of all or part of
that information could endanger you.
Right to Inspect and Copy: You have the right to inspect
and copy health information that we maintain about you in a
designated record set. A “designated record set” is a group
of records that we maintain such as enrollment, payment, and
claims adjudication record systems. If copies are requested
or you agree to a summary or explanation of such information,
we may charge a reasonable, cost-based fee for the costs of
copying, including labor and supply cost of copying; postage;
and preparation cost of an explanation or summary, if such is
requested. We may deny your request to inspect and copy in certain
circumstances as defined by law. If you are denied access to
your health information, you may request that the denial be
reviewed.
Right to Amend: You have the right to have us amend your
health information for as long as we maintain such information.
Your written request must include the reason or reasons that
support your request. We may deny your request for an amendment
if we determine that the record that is the subject of the request
was not created by us, is not available for inspection as specified
by law, or is accurate and complete.
Right to Receive an Accounting of Disclosures: You have
the right to receive an accounting of disclosures of your health
information made by us in the six years prior to the date the
accounting is requested (or shorter period as requested). This
does not include disclosures made to carry out treatment, payment,
and health care operations; disclosures made to you; communications
with family and friends; for national security or intelligence
purposes; to correctional institutions or law enforcement officials;
or disclosures made prior to the HIPAA compliance date of April
14, 2002. Your first request for accounting in any 12-month
period shall be provided without charge. A reasonable, cost-based
fee shall be imposed for each subsequent request for accounting
within the same 12-month period.
Right to Obtain a Paper Copy: You have the right to obtain
a paper copy of this Notice of Privacy Practices at any time.
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HOW TO FILE
A COMPLAINT IF YOU BELIEVE YOUR PRIVACY RIGHTS HAVE
BEEN VIOLATED
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If you believe that your privacy rights have been violated,
please submit your complaint in writing to:
Potomac Valley Transit Authority
Attn: Privacy Officer
P.O. Box 278
Petersburg, WV 26847
You may also file a complaint with the Secretary of the
Department of Health and Human Services. You will not be
retaliated against for filing a complaint.
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