Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU MAY ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
During your treatment at Alivio Medical Center, our caregivers may gather information about your medical history and current health. This Notice of Privacy Practices explains how that information may be used and shared with others. It also explains your privacy rights regarding this information. This Notice is in full compliance with the Health Insurance Portability and Accountability Act, otherwise known as HIPAA. Please review it carefully.
Alivio Medical Center is required by law to abide by the terms of this Notice, to make sure that information that identifies you is kept private and to give you this Notice of our legal duties and practices with respect to medical information about you.
Uses and Disclosures of your Health Information
Below are descriptions of ways that we may use and disclose health information that identifies you. In some cases, examples are included, but not every type of use or disclosure of health information is described.
Alivio Medical Center may use health information to carry out treatment, payment and health care operations.
Treatment is the provision, coordination or management of health care. We may use health information to treat you or provide you with health care services. We may disclose health information to doctors, nurses, technicians or other personnel, including people outside our organization who may be involved in your medical care. For example: to coordinate care, we may use and disclose your information to consult a third party, to refer you to a specialist or to provide your pharmacy with information about the medicines you are prescribed or taking.
Payment includes the activities necessary to obtain reimbursement for the provision of health care. For example, we may need to give your health plan information about treatment you received at Alivio Medical Center so your health plan will pay us or reimburse you for the treatment. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
Health care operations include the activities necessary for Alivio Medical Center to run its business operations. For example, we may use your information to review treatment and services and to evaluate the performance of our staff to make sure all our patients receive quality care and for operation and management purposes.
We may also use or disclose your health information:
To contact you as a reminder that you have an appointment with us.
To tell you about treatment options, alternatives or health-related benefits and services that may be of interest to you.
When required by federal, state or local law.
To support public health activities by reporting as required or authorized by state or federal law. These reports may include the reporting of exposure to a communicable disease or risk of spreading a disease or condition.
To cooperate with law enforcement officials for certain law enforcement purposes as directed by a court order, warrant, criminal subpoena or other lawful process.
To report abuse or neglect.
To support health oversight activities that are authorized by law, such as administrative or criminal investigations, inspections, licensure or disciplinary actions and other similar activities necessary for appropriate oversight of government benefit programs or functions.
When required by a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death or other duties as required by law.
When necessary to prevent or lessen a serious and imminent threat to the health and safety of a person or the public and the disclosure is to a person reasonably able to prevent or lessen the threat, pursuant to applicable law and standards.
For judicial or administrative proceedings, in response to a valid court order, administrative order, a grand jury subpoena or with your written consent.
For research purposes, with your written authorization or as permitted by state law.
To business associates to perform functions or services for or on behalf of Alivio Medical Center, if the business associate has signed an agreement to protect the confidentiality of the information and if the information is necessary for such functions or services.
Alivio Medical Center may disclose your health information to a family member, relative, a friend or any other person you identify who is involved in your medical care or who helps pay for your care. We may also notify such persons about your location or general condition.
State and federal laws may be more stringent and may prohibit certain uses and disclosures identified above. When another law is more stringent than HIPAA, we will follow the more stringent requirements. For example, some state laws require additional protection for records related to mental health treatment, drug and alcohol treatment and HIV-related information.
Except for the purposes described above, we will use and disclose health information only with written permission from you. If you give us permission, you can change your mind at any time. Let us know in writing if you change your mind.
You may request Alivio Medical Center to restrict uses and disclosures of your health information for treatment, payment or our health care operations. However, Alivio Medical Center is not required to agree to the requested restriction, and we may say “no” if it would affect your care. Requests should be made in writing to the Alivio Medical Center Privacy Office.
You have the right to request a limit on the health information we disclose about you to someone who is involved in your care, such as a family member, relative or friend. These requests should be made in writing to the Alivio Medical Center Privacy Office. In your request, you must tell us: (a) what information you want to limit; (b) whether you want to limit Alivio Medical Center’s use, disclosure or both; and © to whom you want the limits to apply, for example, if you want to prohibit disclosures to your spouse. We will comply with your request unless we need to use or disclose the information in certain emergency treatment situations or as required by law
You have the right to request confidential communications by alternative means or at alternative locations. For example, you may request that we communicate with you only by mail. We will accommodate all reasonable requests, but your request must specify how or where you wish to be contacted and we may require you to provide information about how payment will be handled. You must request confidential communications in writing to the Alivio Medical Center Privacy Office.
You have a right to inspect or obtain a copy of your health information that is used to make decisions about your care for as long as Alivio Medical Center maintains the information. This right does not apply to certain health information, including information compiled in reasonable anticipation of or for litigation and other information not subject to the right to access. We will provide a copy or summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee. Requests for access to health information should be made in writing to the Alivio Medical Center Privacy Office. If access is denied, you will be provided with a written explanation that sets forth the basis for the denial, a description of how you may review those rights and a description of how you may complain.
You have the right to request that Alivio Medical Center amend your health information if it is incorrect or incomplete. Requests for amendment of information should be made in writing to the Alivio Medical Center Privacy Office, and you must provide a reason that supports your request to have the information changed. Alivio Medical Center may deny your request if you ask us to amend information that: (a) was not created by Alivio Medical Center (unless the person or entity that created the information is no longer available to make the amendment); (b) is not part of the medical information kept by Alivio Medical Center; © is not part of the information you would be permitted to inspect and copy; or (d) is accurate and complete.
At your request, Alivio Medical Center will provide you with an accounting of disclosures by Alivio Medical Center of your health information during the six years prior to the date of your request. However, such accounting will not include disclosures made: (a) to carry out treatment, payment or health care operations; (b) directly to you or your personal representatives; © prior to the effective date of this Notice; or (d) based on your written authorization. If you request more than one accounting within a 12-month period, Alivio Medical Center will charge a reasonable, cost-based fee for each subsequent accounting. Requests for an accounting of disclosures should be made in writing to the Alivio Medical Center Privacy Office.
To obtain a paper copy of this Notice, contact the Alivio Medical Center Privacy Office.
You may exercise your rights through a personal representative as permitted or required by applicable law. Your personal representative may be required to produce evidence of authority to act on your behalf before that person will be given access to your information or is allowed to take any action for you.
If you believe your privacy rights have been violated, you may complain to the Alivio Medical Center Privacy Office. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services. All complaints should be submitted in writing. You will not be penalized in any way for filing a complaint.
Alivio Medical Center Duties
We are required to maintain the privacy and security of your health information.
We must follow the duties and privacy practices described in this Notice and give you a copy of it.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
This Notice is effective beginning July 1, 2020. However, Alivio Medical Center reserves the right to change its Privacy Practices and this Notice, and to apply the changes to any health information received or maintained by Alivio Medical Center prior to the date of the changes as well as any information received in the future. If the terms of this Notice are changed, a revised version will be available upon request and will be posted in a clear and prominent location at our centers. You may access the Notice by visiting our website at: www.oakstreethealth.com
Complaints, Questions, and Requests
You may direct your questions about this Notice or Alivio Medical Center’s Privacy Practices, requests regarding your information or other privacy or confidentiality concerns to:
Alivio Medical Center LLC
2060 N. Shadeland Ave. Suite 200
Indianapolis, IN 46219