NOTICE OF PRIVACY PRACTICES
This notice describes how medical information about you may be used and disclosed and how you may have access to this information.
This notice applies to all of your records of care generated by the practice, whether made by Brij Health or a Brij business associate.
This notice describes our practice’s policies, which extend to:
Any health care professional authorized to enter information into your chart (including physicians, NPs, PAs, RNs, Dentists, Dental Assistants, Psychologist, psychiatrist, Case Managers, Outreach Workers, etc. All areas of Brij Health (front desk, administration, billing and collection, etc. All employees, staff and other personnel that work for or with our practice; Our business associates (including a billing service, or facilities to which we refer patients), on-call physicians, and so on.
Protecting Your Private Health Information:
We understand that medical information about you and your health is personal and private and we are committed to protecting and safeguarding your medical information. Individually identifiable information about your past, present, or future health or condition, the provision of health care to you, or payment for your health care is considered “Protected Health Information” (“PHI”). We are required by law to make sure that your PHI is kept private and to make available this Notice about our legal duties and privacy practices, that explains how, when and why we may use or disclose your PHI. Except in specified circumstances, we must use or disclose only the minimum necessary PHI to accomplish the purpose of the use or disclosure. If we discover a breach (as defined in 42 U.S.C. 201 et seq.) of the privacy or security of your PHI, we are required to notify you of the breach. We are also required by law to abide by the terms of our current Notice of Privacy Practices.
The Practice provides this Notice to comply with the Privacy Regulations issued by the Department of Health and Human Services in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
HOW WE MAY USE AND DISCLOSE
MEDICAL INFORMATION ABOUT YOU
We use and disclose Protected Health Information ( PHI) for a variety of reasons. For certain uses or disclosures we must get your written authorization. However, the law does permit some uses/disclosures of your PHI without your authorization. Disclosures and restrictions of PHI include but are not limited to the uses listed in this Notice. Other uses may apply as permitted by law.
Uses and Disclosures Not Requiring Your Authorization: The law provides that we may use/disclose your PHI without your authorization in the following circumstances:
Medical Treatment. Information obtained by a provider, a nurse, or other member of your health care team will be recorded in your medical record and used to determine the course of treatment, care and services. Health care team members will communicate with one another personally and through the health record to coordinate care provided. We will also provide your physician or subsequent health care provider with copies of various reports that should assist him or her in treating you in the future.
Payment. We may use and disclose medical information about you for services and procedures provided at Brij Health for billing to you, your health plan or any other third party payor. Your health care information may be used to obtain prior authorization of payment for treatment and care.
Operational Uses. Members of the medical staff, the risk and quality improvement staff may use information in your health record to assess the care, treatment and services you have received. This information will then be used in an effort to continually improve the quality and effectiveness of health care we provide. In some cases, we will furnish your health information to other qualified parties for their health care operations such as your health plan and/or our business associates.
Business Associates Brij Health may use and disclose certain medical information about you to our business associates. A business associate is an individual or entity under contract with Brij Health to perform or assist us in a function or activity that necessitates the use or disclosure of your medical information. Examples of business associates, include, but are not limited to, a copy service used by Brij Health to copy medical records, consultants, accountants, lawyers, medical transcriptionists, and third-party billing companies. Brij Health requires the business associate to protect the confidentiality of your medical information.
Teaching Programs; Brij Health facilitates the training of graduates and students from medical, dentistry, nursing, pharmacy, and other allied health programs and they may be assisting with your care under the supervision of a licensed health care provider as a part of their professional health care training program.
Appointment and Patient Recall Reminders. Unless you provide us with alternative instructions, we may use and disclose only minimally necessary medical information to contact you as a reminder that you have an appointment for medical care with Brij Health or that you are due to receive periodic care from the Practice. This contact may be by phone, in writing, e-mail, or otherwise and may involve the leaving an e-mail, a message on an answering machines, or otherwise which could (potentially) be picked up by others.
Others Involved in Your Care In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
Research. Research at Brij Health is conducted under strict Institutional Review Board (IRB) guidelines designed to safeguard and protect you and health information used for research. We would obtain your specific authorization prior to using your health information if the disclosure of that information directly identifies you. The only exception would be granted under rare circumstances when the IRB is permitted by federal regulations to grant a waiver of authorization.
Required By Law. We will disclose medical information about you when required to do so by federal, state or local law.
To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary to prevent a serious threat either to your specific health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
Organ and Tissue Donation. If you are an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
Workers’ Compensation. We may release medical information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. This is particularly true if you make your health an issue. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute. We shall attempt in these cases to tell you about the request so that you may obtain an order protecting the information requested if you so desire. We may also use such information to defend ourselves or any member of our practice in any actual or threatened action.
Public Health Risks. Law or public policy may require us to disclose medical information about you for public health activities. These activities generally include the following: to prevent or control disease, injury or disability, to report births and deaths, to report child abuse or neglect, to report reactions to medications or problems with products, to notify people of recalls of products they may be using and to notify persons of possible exposure to a disease or may be at risk for contracting or spreading a disease or condition, to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
Investigation and Government Activities We may disclose medical information to a local, state or federal agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the payor, the government and other regulatory agencies to monitor the health care system, government programs, and compliance with civil rights laws.
Military and Veterans If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.
Law Enforcement We may release medical information if asked to do so by a law enforcement official: In response to a court order, subpoena, warrant, summons or similar process; To identify or locate a suspect, fugitive, material witness, or missing person; About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement; About a death we believe may be the result of criminal conduct; About criminal conduct at the Practice; and In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
Coroners, Medical Examiners and Funeral Directors We may release medical information to a coroner or medical examiner and funeral directors as necessary by law or to perform and carry out their duties.
Inmates Medical information can be released about inmates in correctional institutions or under the custody of a law enforcement official, This release would help facilitate (1) the institution in providing you with health care; (2) protecting your health and safety or the health and safety of others and (3) the overall safety and security of the correctional institution.
Other Uses of Medical Information Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. We are required to retain records of the care we provided to you for a minimum period specified by law.
Your Rights Regarding Your Protected Health Information (PHI):
This section describes your rights and the obligations of Brij Health regarding the use and disclosure of your PHI. You have the following rights regarding medical information we maintain about you:
Right to Inspect and Copy. You have the right to inspect and copy medical information that may be used to make decisions about your care. This includes your own medical and billing records, but does not include psychotherapy notes. Upon proof of an appropriate legal relationship, records of others related to you or under your care (guardian or custodial) may also be disclosed. Medical information protected under the Minnesota Minor Consent Law is excluded from your right to access, inspect, amend or copy medical information regardless of legal or guardianship status without the written permission of the minor. To inspect and copy your medical record, you must submit your request in writing to our HIPAA Compliance Officer. Ask the front desk person for the name of the HIPAA Compliance Officer. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies (tapes, disks, etc.) associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that our Compliance Committee review the denial. Another licensed health care professional chosen by Brij Health will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome and recommendations from that review.
Right to Amend. If you feel that the medical information we have about you in your record is incorrect or incomplete, then you may ask us to amend the information, following the procedure below. You have the right to request an amendment for as long as Brij Health maintains your medical record. To request an amendment, your request must be submitted in writing, along with your intended amendment and a reason that supports your request to amend. The amendment must be dated and signed by you and notarized. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that: Was not created by us, unless the person or entity that created the information is no longer available to make the amendment; Is not part of the medical information kept by or for the Practice; Is not part of the inaccurate and incomplete medical information in your record.
Right to Revoke Disclosure. You may at any time in writing, revoke your permission to use or disclose your medical information that requires your written authorization. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission.
Right to an Accounting of Disclosures. You may request an accounting of certain disclosures of your health information showing with whom your health information has been shared (does not apply to disclosures to you, with your authorization, for treatment, payment or health care operations, and in certain other cases). To request an accounting of disclosures, you must send a written request to the Medical Records Department. Your request must state a time period that may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically). The first list you request within a twelve (12) month period will be free. For additional lists, there may be charge for the costs of providing the list. You will be notified in advance of any costs and you may choose to withdraw or modify your request at that time.
Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care (a family member or friend). For example, you could ask that we not use or disclose information about treatment you received. We are not required to agree to your request and we may not be able to comply with your request. If we do agree, we will comply with your request except that we shall not comply, even with a written request, if the information is needed to provide emergency treatment to you. We cannot agree to limit uses or disclosures that are required by law. To request restrictions, you must make your request in writing and state what information you want to limit; whether you want to limit our use, disclosure or both; and to whom you want the limits to apply, (e.g., disclosures to your children, parents, spouse, etc.)
Right to Request 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 ask that we only contact you at work or by mail, that we not leave voice mail or e-mail, or the like. To request confidential communications, you must make your request in writing. We will not ask you the reason for your request. We will attempt to accommodate all reasonable requests. Your request must specify how or where you wish us to contact you.
Right to a Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
CHANGES TO THIS NOTICE
We reserve the right to change this notice at any time. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we may receive from you in the future. We will post a copy of the current notice in the Practice. The notice will contain on the first page, in the lower left corner, the date of last revision and effective date. In addition, each time you visit Brij Health for treatment or health care services you may request a copy of the current notice in effect.
If you believe your privacy rights have been violated, you may file a complaint with Brij Health. To file a complaint with the Practice, contact our office manager, who will direct you on how to file an office complaint. All complaints must be submitted in writing, and all complaints shall be investigated, without repercussion to you. There will be no retaliation for filing a complaint.
For more information or to file a compliant please call the Director of Health Information at 952-479-0814. or write to:
Director of Health Information
10800 Lyndale Avenue South
Bloomington, MN 55420
Effective Date: April 1, 2015
Revised July 28, 2019