Effective date: May 1, 2018
HIPAA NOTICE OF PRIVACY PRACTICES FOR FACE IT TOGETHER, INC.
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW CAREFULLY.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides standards for how health or medical information should be used and disclosed by healthcare providers, health plans, and other covered entities. We provide each of our clients with this information and ask each of our clients to acknowledge receipt of our HIPAA Notice of Privacy Practices for Face It TOGETHER, Inc., which discloses our practices for personal information gathering and dissemination. Please note that by using the website (the “Site”), our mobile app (the “App”), or the services provided by Face It TOGETHER, Inc., together with any independent contracted affiliates (together “FIT”, “we”, “our” or “us”), you accept the practices described in this Notice of Privacy Practices. If you do not agree to this Notice, please do not use the Site, App, or FIT services. IF YOU ARE UNDER 13 YEARS OF AGE, PLEASE DO NOT USE OR ACCESS OUR SITE OR APP.
What Information do we collect from clients and how is it used?
Forms and Assessments. To fully use our services, you may need to fill out forms or assessments that ask for or contain personal information such as your name, contact information, health, and other personal information. By providing us with your phone number, you consent to receiving calls from us that may include protected health information. We will only communicate by text or voicemail when you opt-in to those communications methods.
Medical Information. In order for us to provide the best care, we may ask you to provide us with certain medical information, for which we will obtain a signed authorization from you. In order to support your care, we may also ask you for a description of symptoms, a medical history, life-style descriptions and information on the progress of your care from us or treatment from your provider(s) over the phone, by email, through our Site, or App.
Correspondence. If you correspond with us via email or text, we may gather in a file specific to you the information that you transmit. We may keep this information indefinitely, however, you always have the right to have your information returned to your and/or deleted.
Recordings. If you contact our addiction management team by phone, email, text, chat, or by video we may record and retain copies of the interaction for, among other things, quality assurance purposes. If you access our App or other services we offer, we may record your interactions with our software. We will inform you if we are recording audio or video of your interactions with our addiction management team or affiliated providers and, if you do not wish to be recorded, you can let the addiction management team or provider know at that time.
How does Face It TOGETHER use and disclose protected health information about you that we collect?
Face It TOGETHER will collect protected health information (“PHI”), which includes your name, age, gender, contact information, problems you are seeking help for, and progress and outcomes of your care, from you and will use or share it for the following purposes:
Treatment. In limited circumstances, can use your PHI and share it with other professionals or programs that are treating you, such as when you are referred to another addiction or mental health professional for further treatment. When you enroll in services, you will be asked to explicitly consent to our services that may require the sharing of information like your name, age, gender, problems you are seeking help for, including addiction related issues, care preferences, health plan coverage, and progress of your treatment with current and potential therapists to promote good outcomes. To comply with other federal and state regulations, we will seek consent for explicit release of information.
Business Operations. We can use and share your PHI to run our practice, improve our offerings to clients, improve your care and the coordination of your care, and contact you when necessary, such as using your PHI to manage your care and services.
Billing and Payment. We may use and share your PHI to confirm eligibility for services and to ensure proper payment to providers. For example, we may request your PHI from your health plan or employer in order to confirm eligibility for services.
Face It TOGETHER is also permitted and/or required to use and disclose your PHI for: public health and safety issues; health research; mandatory reporting requirements; compliance with law enforcement; responses to lawsuits and legal actions or legal requests; organ and tissue donation requests; work with medical examiners or funeral directors; statistical analysis (Face It TOGETHER will de-identify and/or aggregate your PHI for statistical analysis, and in these situations, we do not disclose any information that can personally identify you); and when we use third-party contractors in order to provide certain services or to complete or confirm a transaction that may you conduct with us.
You have the right to tell us to share your PHI with your family, close friends, or others involved in your care; and share your PHI in a disaster relief situation, If you are not able to tell us your preference, we may share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
We will never share your identifiable PHI for marketing purposes. We will also never sell any of your information for any purpose. You may revoke or restrict any release or sharing authorization to disclose your PHI or any information at any time.
Face It TOGETHER reserves the right to release collected information to law enforcement or other government officials, as we, in our sole and absolute discretion, deem necessary or appropriate. If you use our Site or App outside of the United States, you consent to the transfer and processing of your information out of your locale, to servers inside the United States and maintained indefinitely.
What are your rights regarding your protected health information?
You have certain rights regarding protected health information that we maintain about you, including:
- Get or review a complete electronic or paper copy of your record and other health information we have about you. Contact us at the information below to ask how to do this. We will provide a copy or a summary of your health information, within 30 days of your request, unless expressly notified. We will never charge you to get or review or information.
- Ask us to correct your record or other health information. You can ask us to correct health or other information about you that you think is incorrect or incomplete. Contact us at the information below to ask us how to do this. We may say “no” to your request, but we will tell you why in writing within 30 days.
- Request confidential communications. You can ask us to contact you in a specific way (for example, at home or office phone) or to send mail or email to a different address. We will follow all reasonable requests.
- Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment, or our operations. We will honor your request unless doing so would affect your care.
- Get a list of those with whom we’ve shared information. You can ask for a list of the times we’ve shared your health information, who we shared it with, and why. We will include all disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make).
- Get a copy of this privacy notice. You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
- Choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
- File a complaint if you feel your rights are violated. You can complain if you feel we have violated your rights by contacting us using the information below. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.
What are Face It TOGETHER’s responsibilities with your information?
We are required by law to maintain the privacy and security of your protected health information. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your protected health information or any information we retain of yours. We must follow the duties and privacy practices described in this notice and give you a copy of it. We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
How will you know about changes in the Notice of Privacy Practices?
Face It TOGETHER reserves the right to update this Notice of Privacy Practices from time to time. Please visit this page periodically so that you will be apprised of any changes. We will obtain acknowledgement of this Notice on an annual basis. The policies indicated in this Notice will remain effective, even if you are no longer using our Site or services.
How to contact us?
If you have questions, or need to reach us for any other reason, you may contact the Chief Innovation Officer at (605) 496-9139 or at firstname.lastname@example.org.