ZOOM+CARE NOTICE OF PRIVACY PRACTICES
Effective: September 28, 2017
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.
1. To Whom Does this Notice Apply?
This Notice of Privacy Practices (“Notice”) applies to Protected Health Information of Patients of all ZOOM+Care clinics. A Patient is anyone who receives or has received healthcare from ZOOM+Care.
- This Notice does not apply to you if you are not a Patient and only use the ZOOM+Care website for educational or informational purposes as a Visitor. Please see the ZOOM+Care Website and App Privacy Statementfor information about how we may use or disclose Personal Information about Visitors.
2. What Laws Apply?
At ZOOM+Care, we are committed to protecting the privacy rights of our Patients. You have a variety of rights under the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations (“HIPAA”). Washington and Oregon state laws also grant you similar rights. These rights are described in this Notice.
3. Our Obligations
- We are required by law to maintain the privacy of your Protected Health Information.
- We must provide you with this Notice and abide by the terms of this Notice, as currently in effect.
- We must notify you in the event Protected Health Information is used or disclosed (shared) in an unauthorized manner, resulting in a Breach, as defined by HIPAA.
- We may change this Notice at any time. If we change this Notice, the new Notice will be posted on the ZOOM+Care website. We will also make it available at our ZOOM+Care clinics.
4. What is Protected Health Information?
- Protected Health Information (sometimes referred to as “PHI”) includes more than just information about medical procedures. The term includes all information created or received by or on behalf of ZOOM+Care which can be used to identify you and relates to:
- Your past, present, or future physical or mental health or condition.
- The provision of healthcare to you.
- The past, present, or future payment for the provision of healthcare to you.
- Washington and Oregon also have laws which protect individuals’ health information from unauthorized use or disclosure. Unless we specify otherwise, when used in this Notice, the term “Protected Health Information” refers to information protected by HIPAA and these state laws.
5. Reasons We Typically Use and Share Your Protected Health Information
We may use and disclose (share) your Protected Health Information without asking your permission for the following reasons:
- Treatment. To provide you with health care services and coordinate and manage your care. We may share your Protected Health Information with doctors, nurses, technicians, and others involved in your care, including third parties such as hospitals, pharmacies, and diagnostic laboratories. For example, if your ZOOM+Care physician refers you to a specialist, ZOOM+Care will provide your relevant files to that specialist.
- Bill for Services. To allow us, or others, to bill and be paid by you, your insurance company, or a third party for health care services provided to you. We may also tell your insurance company about a treatment you are going to receive to learn if your plan will pay for the treatment. For example, ZOOM+Care will share necessary information about treatment provided to treat an injury with your insurance company so that it will pay us or reimburse you for those services.
- Run Our Business. To allow us and, in some circumstances, other organizations, to perform administrative, educational, quality assurance and business-related functions. For example, ZOOM+Care may use your Protected Health Information to allow the supervising doctor for a clinic to review the quality of the services you received.
6. Additional Reasons We May Use and Share your Protected Health Information
We may also use and disclose (share) your Protected Health Information without asking your permission to the following individuals or organizations or for the following reasons:
- To public health agencies to protect public health and safety, or to prevent or control diseases, injuries, or conditions.
- To disaster relief organizations such as the Red Cross to assist within disaster relief efforts.
- To report suspected child or vulnerable adult abuse or neglect to authorized governmental agencies.
- To health oversight agencies for activities authorized by law, such as audits and investigations.
- To the U.S. Food and Drug Administration (FDA) to investigate or track problems with prescription drugs and medical devices.
- To law enforcement officials under limited conditions, such as to report a crime at a ZOOM+Care clinic.
- To authorized federal officials as required if you are in the U.S. armed forces or work for certain national security or certain other federal governmental agencies.
- In response to a court order and, in certain cases, a subpoena, discovery request, or other lawful process.
- To employers, insurers, and others to comply with laws related to workers’ compensation and employment safety.
- To coroners, medical examiners, funeral directors, or organ procurement organizations or donation banks if you die.
For research purposes in certain limited circumstances.
7. Sharing your Protected Health Information with Your Family and Friends
We may disclose (share) your Protected Health Information with your family members, close friends, or others involved in your care or the payment for your care, or as necessary to notify, identify, or locate those involved in your care and inform them of your location, general condition, or death in the following circumstances:
- If you are available to agree or object and you either agree or do not object to our disclosing your Protected Health Information, or,
- If you not available or are incapacitated, we determine that disclosing your Protected Health Information is in your best interest.
8. Communications with You
- We may use and disclose your Protected Health Information as necessary to contact you to provide reminders about upcoming appointments for treatment or related services.
- We may use and disclose your Protected Health Information to contact you to tell you about or recommend treatment options, alternatives, or health related products or services offered by Zoom+Care that may be of interest to you.
9. When Your Written Authorization Is Required
- We may not sell your Protected Health Information or disclose it to another entity for third party for that third party’s marketing purposes without your authorization.
- Federal and state laws impose special protections for certain kinds of Protected Health Information and require us to obtain authorization from you before we can share it. For example, notes of psychotherapy sessions, information about specific types of sexually transmitted disease, and mental health issues may be specifically protected. Before disclosing this type of information we will contact you for the necessary authorization.
- If you sign an authorization to disclose your Protected Health Information, you may revoke it at any time by letting us know in writing. However, the revocation does not affect actions taken before we receive it.
10. Your Other Privacy Rights
You have a certain rights with respect to your Protected Health Information that you may choose to exercise. If you want to exercise any of these rights, you must do so in writing by completing a form that you can obtain from the Zoom+Care Privacy Office. In some cases, we may charge you for the costs of providing materials to you. You can receive more information about how to exercise your rights and any charges by contacting the Zoom+Care Privacy Office.
- You may ask us to limit how we use or disclose your Protected Health Information for treatment, payment, or healthcare operations purposes.
- Generally, we are not required to say “yes” to your request, and we may say “no” if it would affect your care.
- If you or someone else, other than your health insurer, pays for treatment received from ZOOM+Care in full, you may ask that we not share information about that treatment with your health insurer for payment or healthcare operations purposes. We will say “yes” to your request, unless the law requires us to share that information.
- In Washington, you may instruct us not to disclose your Protected Health Information to certain healthcare providers or facilities that previously provided you with healthcare.
- In Washington, you may instruct us not to disclose your Protected Health Information as described in Section 7 of this Notice to certain family members.
- You may ask us to communicate with you in a certain way or at a certain location. For example, you may wish to be contacted only at home and not at work. We will consider all reasonable requests, and must say “yes” if you tell us you would be in danger if we do not.
- You may ask to see or receive a copy of information in your ZOOM+Care medical and billing records and certain other records used by either ZOOM+Care to make decisions. Under certain circumstances, we may say “no” to your request. If we do, we will tell you why, and you may ask that the decision be reviewed.
- You may ask us to correct or amend information in your ZOOM+Care medical and billing records and certain other records used by ZOOM+Care to make decisions. Under certain circumstances, we may say “no” to your request. If we do, we will tell you why, and you ask that the decision be reviewed.
- You may ask for a record of certain disclosures of your Protected Health Information made by or on behalf of ZOOM+Care.
- You may ask us for a paper copy of this Notice, even if you have agreed to receive privacy notices electronically.
11. Contact Us
If you have any questions about this Notice or believe your privacy rights have been violated, please contact the ZOOM+Care Privacy Office at: firstname.lastname@example.org
Telephone Number: 503-684-8252
Mail: ZOOM+Care, 1455 NW Irving Street, #600, Portland, OR, 97209
- You may file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights by following the instructions at https://www.hhs.gov/hipaa/filing-a-complaint.
- We will not retaliate against you in any way for filing a complaint.
Copyright © 2017, ZOOM+Care