New Hope is dedicated to maintaining the privacy of your individually identifiable Protected Health Information (PHI). We are required by applicable federal and state law to protect your privacy and to give this Notice about our privacy practices, our legal duties, and your rights concerning your PHI. New Hope will follow the privacy practices described in the Notice while it is in effect.
New Hope reserves the right to change our privacy practices and the terms of this Notice at any time, provided such changes are 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 PHI that we maintain, including PHI we created or received before we make the changes. Before making any significant change in our privacy practices, we will change this Notice and make the new Notice available upon written request.
You may request a copy of our Notice at any time. For more information about our privacy practices or additional copies of this Notice, please contact us using the information listed at the end.
The following categories describe the different ways we use and disclose your PHI in connection with our business operations: “us” or “our” entities of New Hope (hereinafter designated as “New Hope”) for all dimensions and activities.
We may use or disclose your PHI for treatment purposes, including for the activities of a physician or other healthcare provider or professional treating you. For example, your PHI may be provided to a physician treating you to assist with referral or diagnosis.
We may use and disclose your PHI to obtain payment for services we provide to you. For example, obtaining approval for third-party payer, Medicare, or passport waivers may require that your PHI be disclosed to obtain approval for our services.
We may use and disclose your PHI to operate our business. These operating activities may include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating provider performance, conducting training programs, accreditation, certification, or licensing activities. For example, New Hope may contact you to remind you of your scheduled visit by our New Hope office staff.
In addition to our use of your PHI for care, payment, or healthcare operations, you may give us written Authorization to use your PHI or to disclose it to anyone for any purpose. If you authorize us, you may revoke it in writing at any time. Your revocation will not affect any use or disclosure permitted by our Authorization while it is in effect. Unless you give us written Authorization, we cannot use or disclose your PHI for any reason except those described in this Notice. Release of psychotherapy notes will always require your prior Authorization.
We must disclose your PHI to you, as described in the Patient Rights section of this Notice. We may disclose your PHI to a family member, friend, or other person involved in your care who assists in taking care of you and paying for your healthcare, but only if you agree that we may do so.
We may use or disclose PHI, including identifying or locating, to notify or assist in the notification of a family member, your personal representative, or another person responsible for your care, your location, your general condition, or death. If you are present, we will provide you with an opportunity to object to such use or disclosures before using or disclosing your PHI. In the event of your incapacity or emergency circumstances, we will disclose PHI based on a determination using our professional and reasonable judgment, and we will only disclose PHI that is directly relevant to the person’s involvement in your healthcare. We will also use our professional judgment and experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up supplies and other similar forms of PHI.
We may disclose your PHI to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes. This information may be disclosed to the extent necessary to avert a serious threat to your health, safety, or others.
We may use and disclose your PHI to contact you and remind you of an appointment via phone or voicemail messages.
We may use and disclose your PHI to public health authorities or other authorized persons to carry out certain activities related to public health.
We will only sell or use your PHI for marketing communication with your written Authorization.
Required by Law, Lawsuits, and Legal Proceedings: We may use or disclose your PHI when we are required to do so by law, required by a court, in response to subpoenas, discovery requests, or another legal process.
We may use or disclose your PHI if you are or have been a member of the U.S. or foreign military forces and if required by the appropriate authorities. We may also disclose this information to federal officials for intelligence and national security activities authorized by law and correctional institution officials in case an inmate or an individual is taken into custody.
Coroners, Medical Examiners, Funeral Directors: We may use or disclose your PHI to a coroner or medical examiner to identify a deceased person and determine the cause of death, as authorized by law, and to funeral directors so that they may carry out their jobs.
We may disclose PHI to organ and tissue donation and transplant organizations.
Your protected health information may be disclosed as authorized to comply with Worker’s Compensation laws and similar legally-established programs.
You have the right to look at or obtain electronic or paper copies of your PHI, with limited exceptions. You must request in writing to inspect and obtain access to your PHI. You may request access by sending us a letter using the contact information listed at the end of this Notice. We will charge you a reasonable cost-based fee for expenses such as copies and staff time.
You have the right to receive notification of breaches of your unsecured PHI.
You may request that we not use or disclose your PHI for a particular reason related to treatment, payment, general health care operations, and to a particular family member, other relative, or close personal friend. Although we will consider your request, please be aware that we are under no obligation to accept it or abide by it unless it is a request to prohibit disclosures to your health care plan relating to a service for which you have already paid in full out of pocket. If we agree to a restriction, we will abide by our agreement, except in an emergency.
You have the right to request, in writing, that we amend your PHI. It must explain why the information should be amended. We may deny your request under certain circumstances.
You can request that we communicate with you in a certain way or location. For example, you can ask that we only contact you at home or by postal mail.
To request a confidential communication of your PHI, you must submit a written request to our Privacy Officer (using the contact information at the end of this Notice) stating how or when you would like to be contacted. We will not require you to provide an explanation for your request. We will accommodate all reasonable requests.
You are entitled to receive a paper copy of our Notice of Privacy Practices. You can give us a copy of this Notice anytime by contacting your local area administrator or printing this page.
If you believe your privacy rights have been violated, you may file a complaint with our New Hope Privacy Officer or the U.S. Department of Health and Human Services Office for Civil Rights using the contact information at the end of this Notice.
Please contact us if you want more information about our privacy practices or have questions or concerns.
If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made about access to your PHI or in response to a request you made to amend or restrict the use or disclosure of your PHI, you may discuss it with us using the contact information listed at the end of this Notice.
You also may submit a written complaint to Office for Civil Rights: Centralized Case Management Operations, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Room 509F HHH Bldg., Washington, D.C. 20201 or OCRComplaint2hhs.gov. We support your right to privacy regarding your PHI. We will not retaliate if you file a complaint with us or the U.S. Department of Health and Human Services Office for Civil Rights.
Privacy Officer: Andrea Sheley
Address: 1630 South Jefferson Ave., Cookeville, TN 38506
Email: contact@newhopehc.com
