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    • HIPAA Privacy

    Notice of Privacy
    Notice of Privacy Practices
    Please note that your personal information and private medical records, sometimes referred to as "Protected Health Information" (PHI), may be disclosed to other medical and healthcare professionals who are involved in the treatment of your condition or illness. This section explains how you can get access to this information.

    WHO WILL FOLLOW THIS NOTICE:
    This notice describes our practices and that of:
    Any health care professional treating you at one of our partners.
    All departments, employees, staff and other personnel working with our partners.

    OUR PLEDGE REGARDING MEDICAL INFORMATION:
    This Notice will tell you how we may use and disclose medical health and related personal information about you. We also describe your rights and certain obligations we have regarding the use, disclosure and protection of your PHI.

    We are required by law to:
    Make sure that medical information that identifies you is kept private and used and disclosed only on an "as needed" basis.
    Give you this Notice of our legal duties and privacy practices with respect to medical information about you.
    Follow the terms of the Notice that is currently in effect.

    HOW WE MAY USE AND DISCLOSE MEDICAL AND PERSONAL INFORMATION ABOUT YOU:
    The following categories describe different ways that we use and disclose PHI. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

    For Treatment. We may use medical information about you to provide you with medical treatment or services by our partners, or to determine the nature and extent of medical treatment and services you may need from outside health care providers. We may disclose medical information about you to doctors, nurses, technicians, medical students, or other health care personnel who are involved in taking care of you. Different areas of the Plan also may share medical information about you in order to coordinate the different things you need, such as prescriptions, lab work and x-rays. We also may disclose medical information about you to people outside the Plan who may be involved in your medical care, such as family members, clergy or others we use to provide services that are part of your care.

    For Payment. We may use and disclose medical information about you so that the treatment and services you receive from health care providers may be billed to the Plan and payment made or billed to you, an insurance company or a third party.

    Other Ways We Use or Share Information. We may use and disclose health information about you for other reasons, such as: 1) required by the Federal, State or Local Law, 2) to prevent serious threat to your health and safety, 3) workers' compensation purposes, 4) public health purposes, 5) health oversight purposes, 6) litigation, legal purposes, 7) coroner or medical examiner, 8) for national security purposes, 9) research purposes, and/or 10) organ donation purposes.

    DISCLOSURES YOU MAY REQUEST
    You may instruct us, and give your written authorization, to disclose your PHI to another party for any purpose. We require your authorization to be in writing on our standard form. To obtain the form, contact the Medical Records department at your assigned medical center.

    YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU:
    You have the following rights. To exercise these rights you must make a written request on our standard form. To obtain the form, contact the Medical Records department at your assigned medical center.

    Right to a Notice of Privacy Practices
    You must be given a copy of our Notice of Privacy Practices. We must post it at each service location and on our Website, and provide it to you upon request.

    Right to Access PHI
    You may look at and receive a copy of your protected health information (PHI) that we keep, subject to certain limitations. You may request a copy or a summary of the requested information. We may charge a fee for the costs of the copying, mailing or other supplies associated with the request. If we deny your request for access, we will tell you the basis for the decision and whether you have a right to further review.

    Right to Request Amendment to PHI
    You may ask us to amend the PHI that we keep. You have a right to request an amendment for as long as the information is kept by or for the Plan. If we deny your request, we will provide you a written explanation. If you disagree, you may have a statement of your disagreement placed in our records.

    Right to Request Confidential Communication
    You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. We will accommodate all reasonable request. Your request must specify how or where you wish to be contacted.

    Right to Request Restriction on PHI
    You may ask us to restrict how we use or disclose your PHI for treatment, payment or health care operations. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.

    Right to an Accounting
    You have a right to request an accounting of certain disclosures of your PHI made by us or by our business associates (that is, disclosures not made for treatment, payment, or healthcare operations and where a patient has not specifically authorized release). This accounting requirement applies to disclosures we make beginning on and after April 14, 2003. If you request this accounting more than once in a 12-month period, we may charge you a fee covering the cost of providing the list.

    Right to Complain About our Privacy Practices
    You may make complaints about our privacy practices to our organization and/or to the Secretary of the U.S. Department of Health and Human Services if you believe we're not complying with HIPAA.
    COMPLAINTS
    If you believe your privacy rights have been violated, you may file a complaint with the facility or with the Secretary of the Department of Health and Human Services. To file a complaint with the Secretary of the Department of Health and Human Services, write to:

    Office for Civil Rights
    Department of Health and Human Services
    233 N. Michigan Ave., Ste. 240
    Chicago, IL 60601

    To file a complaint with the facility, contact The Wellness Integrated Network Compliance and Privacy Officer. All complaints must be submitted in writing to:

    The Privacy Officer
    Wellness Integrated Network
    725 Boardman-Canfield Rd Suite N1.
    Boardman, Ohio 44512

    OTHER USES OF MEDICAL INFORMATION:
    Other uses and disclosures of medical information not covered by this Notice or the laws that apply to the Plan will be made only with your written permission in the form of signed authorization. If you provide the Plan permission to use or disclose medical information about you by signing such an authorization, you may revoke that permission, in writing, at any time.