Notice of Privacy Practices

This Notice is effective January 11, 2016

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.

We Are Required by Law to Protect Medical Information about You

We are required by law to protect the privacy of medical information about you and that identifies you.

We are also required by law to provide you with this Notice of Privacy Practices explaining our legal duties and privacy practices with respect to medical information. We are legally required to follow the terms of this Notice.

We may change the terms of this Notice in the future. We reserve the right to make changes and to make the new Notice effective for all medical information that we maintain. If we make changes to the Notice, we will have copies of the new Notice available upon request (you may always contact our Privacy Officer at 1-877-366-7483 to obtain a copy of the current Notice). In addition, if, at any time, you have questions about information in this Notice or about our privacy policies, procedures, or practices, you can contact our Privacy Officer at 1-877-366-7483.

We May Use and Disclose Medical Information about You under the following Circumstances

1. Healthcare Operations
We may use and disclose medical information about you in performing a variety of business activities that we call “health care operations.” These “health care operations” activities allow us to, for example, improve the quality of service we provide and reduce health care costs. For example, we may use or disclose medical information about you in performing the following activities:

  • Reviewing and evaluating the skills or training of Onsite Health Diagnostics employees who are bound by a confidentiality agreement or Business Associate Agreement, as it pertains to not disclosing your information.
  • Cooperating with outside organizations, including government agencies or private organizations that evaluate, certify, or license clinical laboratories.
  • Sending a copy of your results to physicians you designate
  • Providing Wellness & Disease Management companies and Healthcare Providers assigned to you the ability to append your information to information they already have about you.

2. Required by Law or Court Order
We will use and disclose medical information about you whenever we are required by law or court order to do so.

3. Authorizations
Other than the uses and disclosures described above (#1-2), we will not use or disclose medical information about you without the “authorization” – or signed permission – of you or your personal representative. In some instances, we may wish to use or disclose medical information about you and we may contact you to ask you to sign an authorization form. In other instances, you may contact us to ask us to disclose medical information and we will ask you to sign an authorization form.

If you sign a written authorization allowing us to disclose medical information about you, you may later revoke (or cancel) your authorization in writing. If you revoke your authorization, we will follow your instructions except to the extent that we have already relied upon your authorization and taken some action.

You Have Rights with Respect to Medical Information about You

You have several rights with respect to medical information about you. If you would like to know more about your rights, please contact our Privacy Officer at 1-877-366-7483.

1. Right to a Copy of This Notice
You have a right to have a paper copy of our Notice of Privacy Practices at any time. If you would like to have a copy of our Notice, contact our Privacy Officer at 1-877-366-7483.

2. Right of Access to Inspect and Copy
You have the right to inspect (which means see or review) and have access to medical information about you that we maintain in our Electronic Health Record (EHR) system. You may obtain an electronic copy of your medical records. You may also instruct us to send an electronic copy of your medical records to a third party.

We may deny your request in certain circumstances. If we deny your request, we will explain our reason for doing so in writing. We will also inform you in writing if you have the right to have our decision reviewed by another person. If you would like a copy of the medical information about you, we may charge you a fee to cover the costs of the copy.

3. Right to Have Medical Information Amended
You have the right to have us amend (which means correct or supplement) medical information about you that we maintain in certain groups of records. If you would like us to amend information, you must provide us with a request in writing and explain why you would like us to amend the information.

We may deny your request in certain circumstances. If we deny your request, we will explain our reason for doing so in writing. You will have the opportunity to send us a statement explaining why you disagree with our decision to deny your amendment request and we will share your statement whenever we disclose the information in the future.

4. Right to an Accounting of Disclosures We Have Made Specific to Your Records
You have the right to receive an accounting (which means a detailed listing) of disclosures that we have made for the previous six (6) years. If you would like to receive an accounting, you may contact our Privacy Officer.

The accounting will not include different types of disclosures, including health care operations. The accounting also will not include disclosures made more than six (6) years prior to the date of your request. If you request an accounting more than once every twelve (12) months, we may charge you a fee to cover the costs of preparing the accounting.

5. Right to Request Restrictions on Uses and Disclosures
You have the right to request that we limit the use and disclosure of medical information about you for treatment, payment, and health care operations. Under federal law, we must agree to your request and comply with your requested restriction(s) if:

  1. Except as otherwise required by law, the disclosure is to a health plan for the purpose of carrying out payment of health care operations (and is not for purposes of carrying out treatment); and,
  2. The medical information pertains solely to a health care item or service for which the health care provided involved has been paid out-of-pocket in full.

Once we agree to your request, we must follow your restrictions (except if the information is necessary for emergency treatment). You may cancel the restrictions at any time. In addition, we may cancel a restriction at any time as long as we notify you of the cancellation and continue to apply the restriction to information collected before the cancellation.

6. Right to Request an Alternative Method of Contact
You have the right to request to be contacted at a different location or by a different method. For example, you may prefer to have all written information mailed to your work address rather than to your home address. We will agree to any reasonable request for alternative methods of contact. If you would like to request an alternative method of contact, you must provide us with a request in writing.

You May File a Complaint about Our Privacy Practices

If you believe that your privacy rights have been violated, you may file a written complaint either with us or with the federal government. We will not take any action against you or change our treatment of you in any way if you file a complaint.

To file a written complaint with us or with the federal government, use the contact information below:

Onsite Health Diagnostics
Attn: Privacy Officer
1199 S. Beltline Rd, Suite 120
Coppell, TX 75019

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independent Avenue, S.W., Room 509F, HHH Building
Washington, D.C. 20201
Toll-Free Phone: (800) 368-1019
TDD Toll-Free: (800) 537-7697
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/index.html
Email: OCRMail@hhs.gov