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.
Our Commitment to Your Privacy
TelewellnessMD is dedicated to maintaining the privacy of your protected health information (‘PHI’). PHI is information about you that may be used to identify you (such as your name, social security number or address), and that relates to (a) your past, present or future physical or mental health or condition, (b) the provision of healthcare to you, or (c) your past, present, or future payment for the provision of healthcare. In conducting its business, TelewellnessMD will receive and create records containing your PHI. TelewellnessMD is required by law to maintain the privacy of your PHI and to provide you with notice of its legal duties and privacy practices with respect to your PHI.
TelewellnessMD must abide by the terms of this Notice while it is in effect. This current Notice takes effect on July 23, 2019, and will remain in effect until TelewellnessMD replaces it. TelewellnessMD reserves the right to change the terms of this Notice at any time, as long as the changes are in compliance with applicable law. If TelewellnessMD changes the terms of this Notice, the new terms will apply to all PHI that it maintains, including PHI that was created or received before such changes were made. If TelewellnessMD changes this Notice, it will post the new Notice on its website and will make the new Notice available upon request.
Our Commitment to Children’s Privacy
Protecting the privacy of the very young is especially important. We do not knowingly collect or maintain PHI from anybody under the age of 18.
Uses and Disclosures of PHI
TelewellnessMD may use and disclose your PHI in the following ways:
Treatment, Payment and Healthcare Operations:
- TelewellnessMD is permitted to use and disclose your PHI for purposes of (a) treatment, (b) payment, and; (c) healthcare operations.
- Treatment: TelewellnessMD may disclose your PHI to another physician or healthcare provider for purposes of a visit or in connection with the provision of follow-up treatment.
- Payment: TelewellnessMD may use and disclose your PHI to your health insurer or health plan in connection with the processing and payment of claims and other charges.
- Healthcare Operations: TelewellnessMD may use and disclose your PHI in connection with its healthcare operations, such as providing customer services and conducting quality review assessments. TelewellnessMD may engage third parties to provide various services for TelewellnessMD. If any such third party must have access to your PHI in order to perform its services, TelewellnessMD will require that third party to enter an agreement that binds the third party to the use and disclosure restrictions outlined in this Notice.
- TelewellnessMD is permitted to use and disclose your PHI upon your written authorization, to the extent such use or disclosure is consistent with your authorization. You may revoke any such authorization at any time.
As Required by Law:
- TelewellnessMD may use and disclose your PHI to the extent required by law.
The following categories describe unique circumstances in which TelewellnessMD may use or disclose your PHI:
Public Health Activities:
- If required by law, TelewellnessMD may disclose your PHI to public health authorities or other governmental authorities for purposes including preventing and controlling disease, reporting child abuse or neglect, reporting domestic violence and reporting to the Food and Drug Administration regarding the quality, safety and effectiveness of a regulated product or activity.
Health Oversight Activities:
- If required by law, TelewellnessMD may disclose your PHI to a health oversight agency for authorized activities such as audits, investigations, inspections, licensing and disciplinary actions relating to the healthcare system or government benefit programs.
Judicial and Administrative Proceedings:
- If required by law, TelewellnessMD may disclose your PHI, in certain circumstances, as permitted by applicable law, in response to an order from a court or administrative agency, or in response to a subpoena or discovery request.
- If required by law, TelewellnessMD may, under certain circumstances, disclose your PHI to a law enforcement official, such as for purposes of identifying or locating a suspect, fugitive, material witness or missing person.
Threat to Health or Safety:
- If required by law, TelewellnessMD may, under certain circumstances, use or disclose PHI if necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
Your Rights Regarding Your PHI
You have the following rights regarding the PHI maintained by TelewellnessMD:
- You have the right to receive confidential communications of your PHI. You may request that TelewellnessMD communicate with you through alternate means or at an alternate location, and TelewellnessMD will accommodate your reasonable requests. You must submit your request in writing to TelewellnessMD.
- You have the right to request restrictions on certain uses and disclosures of PHI for treatment, payment or healthcare operations. You also have the right to request that TelewellnessMD restrict its disclosures of PHI to only certain individuals involved in your care or the payment of your care. You must submit your request in writing to TelewellnessMD and it will be bound by such agreement, except when otherwise required by law or in the event of an emergency.
Inspection and Copies:
- You have the right to inspect and copy your PHI. You must submit your request in writing to TelewellnessMD. TelewellnessMD may impose a fee for the costs of copying, mailing, labor and supplies associated with your request.
- You have a right to request that TelewellnessMD amend your PHI if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is maintained by TelewellnessMD. You must submit your request in writing to TelewellnessMD.
- You have the right to be notified in the event that TelewellnessMD (or a TelewellnessMD Business Associate) discovers a breach of unsecured PHI.
- You have the right to obtain a paper copy of this Notice from TelewellnessMD at any time upon written request to email@example.com.
- You may complain to TelewellnessMD and to the Secretary of the Department of Health and Human Services if you believe that your privacy rights have been violated. To file a complaint with TelewellnessMD, you must submit a statement in writing to TelewellnessMD: Attn: Security Officer, 2744 Summerdale Drive, Clearwater, FL TelewellnessMD will not retaliate against you for filing a complaint.
- If you would like more information about your privacy rights, please contact TelewellnessMD at firstname.lastname@example.org. To the extent you are required to send a written request to TelewellnessMD to exercise any right described in this Notice, you must submit your request to TelewellnessMD LLC, Attn: Security Officer, 2744 Summerdale Drive, Clearwater, FL