Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HI-TECH), your PHI is protected and confidential.
PHI is the term used to refer to any information that is maintained by Crossnore that can be used to identify you such as your name, address, Social Security number, ID numbers, or other unique identifiers. Your PHI also includes symptoms, test results, diagnosis, treatment, other related medical information, payments, billing and insurance information.
HOW WE USE YOUR PROTECTED HEALTH INFORMATION
The following are ways that Crossnore will use or disclose your PHI:
Treatment: We will use and disclose your health information to other staff within the agency providing you with care to coordinate medical/clinical treatment or services. For example, therapists or other members of your treatment team will record information in your record and use it to determine the most appropriate course of care. We may also disclose health information to other health care providers to assist you in a medical emergency.
Payment: We will use and disclose your health information for payment purposes. For example, we will submit bills and maintain records of payments from your health plan. We may need to give your insurance company or a third party, medical information about treatment you received so that the insurance company or third party can make a payment.
Health Care Operations: We will use and disclose your health information to conduct our standard internal operations, including proper administration of records, evaluation of quality treatment, and to assess the care and outcomes of your case and others like it.
As part of our operations, we may disclose your information to qualified personnel for audit and program evaluation. We may allow our agency attorney to use your health information when representing this agency in legal matters. For example, we use your PHI in measuring and evaluating how many of our consumers have received certain services (such as therapy, a combination of therapy and community supports), we may send you a member satisfaction survey to determine how we can improve our services, or we may use your PHI in the course of an accreditation survey, or for fraud and abuse prevention activities.
Individuals Involved in Your Care: We may release limited information about you to a person including a family member actively involved in your care and treatment or supervision as allowed under State law and in accordance with Crossnore policies and procedures. For example, we may release the type and dose of medication you are receiving to your parent, legal guardian, spouse or caregiver if that person is actively involved with your care and treatment.
Information Regarding Deceased Individuals: Your death may increase the accessibility to your records. Besides your health care decision maker, your records may be disclosed to your personal representative or administrator of your estate, if there is not one then your spouse unless you were legally separated, then the trustee of a trust created by you where you were the trust beneficiary, then an adult child, then an adult sibling, then a guardian at the time of death.
Substance Abuse/HIV Health Information: The confidentiality/privacy of alcohol and drug abuse client records related to the diagnosis, treatment, referral for treatment or prevention, is protected by federal law and regulations (42 U.S.C.290dd-3 and 42 U.S.C.290ee-3) and regulations (42 CFR Part 2). Generally, a substance abuse program may not disclose to anyone outside the program that a client attends the program or disclose any information identifying a client as an alcohol or drug abuser, unless the client authorizes in writing. A general authorization for the release of medical or other information is not sufficient for this purpose; the disclosure is allowed by a court order; the disclosure is made to medical personnel in a medical emergency; the disclosure is made to qualified personnel for research or to oversight agencies, funders, and other authorized auditors for audit or program evaluation; the client commits or threatens to commit a crime either at the program or against any person who works for the program and the disclosure is made to report suspected child abuse or neglect.
Communicable Disease Related Information: Communicable disease related information, including HIV-related information, is kept strictly confidential and released only in conformance with the requirements of state law. A general authorization for the release of medical or other communicable disease related information is not sufficient to release HIV-related information. A written authorization must specifically indicate that it is for the release of confidential HIV-related information.
Business Associates: We provide some services through contracts with business associates such as a psychiatrist. When we use such services, we may disclose your health information to the business associate so they can perform the function(s) we have contracted with them to do and bill your third party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.
As required by law: We may disclose medical information about you when required to do so by federal, state, or local law, and or as required for national security or protective services.
Law Enforcement or Court Appearances: We may disclose information about you for law enforcement purposes unless otherwise prohibited by state or federal law. We may release information for court proceedings such as court orders. We may release information to correctional institutions or other law enforcement officials when you are in their custody.
In cases of abuse or neglect: We may disclose your medical information if a government agency or social services agency contacted us concerning a case of abuse, neglect, or domestic violence and asked us for records or information; we would comply with the request.
Coroners, Medical Examiners and Funeral Directors: We may release information to a coroner or medical examiner. This may be necessary to identify a deceased person or determine the cause of death. We may also release medical information about members to funeral directors as necessary to carry out their duties.
Any and all uses or disclosures of your PHI other than described above require your prior written authorization. Crossnore will honor the specific requirements of your authorizations—including any revocation of an authorization that you have previously given us.
If we need to obtain your authorization for any use or disclosure beyond those needed for treatment, payment, or operations, we will contact you to request your written authorization.
