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Wellness Life Systems, LLC
Notice of Privacy Practices
Effective October 22, 2004
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.
PROTECTING MEDICAL INFORMATION
This “Notice” explains how we will use and disclose your protected health information while maintaining your privacy, explains your rights with respect to your protected health information and explains our duty to abide by terms of this Notice and any revisions to this Notice that we may make in the future. The Health Insurance Portability & Accountability Act of 1996 (HIPAA) requires us, to maintain the privacy of your protected health information. We are also required to give you this Notice about our privacy practices, our legal duties and your rights concerning your protected health information. Protected Health Information (PHI) is information about you, regardless of form (oral, written, electronic), that may identify you and that relates to your past, present or future physical or mental health or condition.
We must follow the privacy practices that are described in this Notice. We reserve the right to change our privacy practices and the terms of this Notice at any time, as permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all health information we maintain, including health information we created or received before we made the changes. Before we make any significant changes to our privacy practices, we will change this Notice and make the new Notice available upon request.
You may obtain a paper copy of this Notice at any time upon request. For more information about our privacy practices, or for additional copies of this Notice, please contact our Privacy Officer at the address listed at the end of this Notice.
OUR USE OF YOUR INFORMATION
Under HIPAA, we are permitted to use and disclose your PHI without your authorization for the purposes of Treatment, Payment and Health Care Operations.
Treatment: We may use or disclose your health information to a physician or other health care providers to provide you with medical treatment and service. For example, your medical information may be used to provide health-related products and services to you and to coordinate with your doctor to ensure that you receive the products that your doctor has prescribed to you.
Payment: We may use or disclose your health information in order to receive payment for the supplies and or services that have been provided to you as, for example, billing Medicare.
Health Care Operations: We may use or disclose your health information to improve the quality of our internal health care operations. An example of such use for health care operations includes conducting quality assessments, planning, financial analysis and other similar functions.
OTHER USES AND DISCLOSURES NOT REQUIRING YOUR AUTHORIZATION
Business Associates
Business Associates are organizations or individuals that carry out certain functions for us such as utilization review and claims administration. The federal privacy laws allow us to share your PHI with our Business Associates to assist us with these functions. For example, in preparing our annual financial statement, auditors may need to review samples of the medical services provided. We may disclose your health information to the accounting firm to prepare this material. However, before we disclose your health information under these circumstances, we require the Business Associate to whom we make such disclosure to provide assurance that the privacy of your health information will be protected.
Communication with Family
Using our best judgment, we may disclose to a family member, other relative, close personal friend, or any other person you identify, PHI relevant to that person's involvement in your care or in the payment for such care if you do not object or in an emergency. You may restrict or prohibit us from doing so if you are able to do so before we make such disclosure.
Research
We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your PHI.
Disaster Relief
We may use and disclose your PHI to assist in disaster relief efforts.
Funeral Directors/Coroners
We may disclose your PHI to funeral directors or coroners consistent with applicable law to allow them to carry out their duties.
Contacting You
We may contact you to provide you with reminders to reorder supplies and new product and service information. Unless you advise us otherwise, we may leave this information at your home with whoever answers the telephone or on an answering machine.
Food and Drug Administration (FDA)
We may disclose to the FDA your PHI relating to adverse events with respect to products, product defects, or to enable product recalls, repairs, or replacements of products.
Workers Compensation
We may disclose your PHI to the extent necessary to comply with laws relating to Workers Compensation.
Public Health
As required by law, we may disclose your PHI to public health or legal authorities charges with preventing or controlling disease, injury, or disability.
Abuse & Neglect
We may disclose your PHI to public authorities as allowed by law to report abuse or neglect.
Correctional Institutions
If you are an inmate of a correctional institution, we may disclose to the institution or agents there of your PHI necessary for your health and the health and safety of other individuals.
Law Enforcement
We may disclose your PHI for law enforcement purposes as required by law, such as when required by a court order, or in cases involving felony prosecutions, or to the extent an individual is in the custody of law enforcement.
Health Oversight
Federal law allows us to release your PHI to appropriate health oversight agencies or for health oversight activities.
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.
Judicial/Administrative Proceedings
We may disclose your PHI in the course of any judicial or administrative proceeding as allowed or required by law, with your consent, or as directed by a proper court order.
To avert a serious threat to health or safety, we may disclose your PHI consistent with applicable law to prevent or lessen a serious, imminent threat to the health or safety of a person or the public.
For Specialized Governmental Functions
We may disclose your PHI for specialized governmental functions as authorized by law such as to Armed Forces personnel, for national security purposes, or to public assistance program personnel.
Other Uses
Other uses and disclosures besides those identified in this Notice will be made only as otherwise authorized by law or with your written authorization and you may revoke the authorization as previously provided.
YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU
You have the following rights regarding your PHI, which you can exercise through a written request to our Privacy Officer:
- The right to request restrictions on certain uses and disclosures, including any group of persons or person identified by you. However, we are not required to agree to such requested restrictions.
- The right to reasonable requests to receive confidential communications from us by alternative means or alternative locations.
- The right to inspect and copy your PHI. We reserve the right to schedule this activity and charge a reasonable fee to gather the information and for copy expenses.
- The right to amend your PHI, if you believe that the health information we have is incorrect or incomplete. Your request must be in writing and must explain why the information should be amended. We may deny your request under certain circumstances.
- The right to receive a list of disclosures of your PHI after October 22, 2004, other than for treatment, payment, or health cares operations. The right to receive this information is subject to certain limitations.
Some state laws may be more stringent than HIPAA in several areas. State law is more stringent when an individual is entitled to greater access to records than under HIPAA, and when under state law, the records are more protected from disclosure than under HIPAA. Wellness Life Systems, LLC will continue to abide by more stringent state laws when applicable.
COMPLAINT PROCESS
If you believe that your privacy rights have been violated, you have the right to file a formal, written complaint with us at the address below, or with the Secretary of the U.S. Department of Health & Human Services, Office for Civil Rights. We cannot and will not retaliate against you for filing a complaint. To file a complaint with us or to receive further information about our privacy practices or the content of this Notice, please write to:
Privacy Officer
Wellness Life Systems, LLC
1003 Walnut Street, Suite 400
Kansas City, MO 64106
Hotline Number: 1-800-909-6078
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