HIPAA Privacy Statement
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. It is the policy of the MedWise Urgent Care to keep all of your medical and personal information confidential. We will only use or disclose your information for the following reasons:
Treatment: We will share your medical information with other medical providers who are involved in your care (including hospitals and clinics), to refer you for treatment, and to coordinate your care with others. For example, we may contact you for appointment reminders or treatment options information. Members of the medical staff, the risk or quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the health care and service we provide.
We also participate in Electronic Health Information Exchanges, which may make your Protected Health Information available statewide and nationwide. We will only authorize this information to be shared for your treatment purposes. For example, if you are in another city or state, it may be possible to share treatment information with a doctor who needs that information. We will also provide your subsequent health care providers with copies of various reports that should assist him/her in treating you. Such reports may be oral, written, or electronic.
Payment: We may use and disclose Protected Health Information when it is needed to receive payment for services provided to you. For example, if you have Medicaid benefits or private insurance, we will release the minimum information necessary for the Medicaid program to pay us.
Health Care Operations: We will use and disclose Protected Health Information when it is needed to make sure we are providing you with good service. For instance, we may review your records in order to make certain quality service was given. We may also share Protected Health Information to a health plan for the plan’s Health Plan Employer Data and Information Set (HEDIS). For example, your insurance company may want to know if you have had immunizations in an effort to make improvements in their service and quality of care.
Other uses or disclosures of your Protected Health Information that may occur include:
- If you have given us permission in writing to release part of your information;
- When ordered to do so by a valid court order or in response to a subpoena;
- When cases of child abuse or neglect are investigated;
- Immunization information is shared with schools and childcare centers;
- When business associates of MedWise Urgent Care, such as community clinics, sign agreements to protect your privacy;
- When required by state law or to respond to a governmental request. For instance, when reporting injuries and disease as required by the Public Health codes or to prevent the spread of diseases such as tuberculosis (TB), providing information related to a workers’ compensation claim, for special governmental functions like military, national security, or presidential protective services, or when reporting suspected child abuse or neglect to the Department of Human Services.
- We can share your information with anyone as necessary, consistent with applicable law and the MedWise Urgent Care policies and procedures, if we feel there is imminent danger. For example, we will release the minimum information necessary if we believe it will prevent or lessen a serious and imminent threat to the health and safety of a person or the public.
Emergency Coordination: We will share your medical information with other medical providers who are involved in your care to coordinate your care with others (such as emergency relief workers or others who can help in finding you appropriate health services). We can share your information as necessary to identify, locate and notify family members, guardians, or anyone else responsible for your care of your location, general condition, or death. For example, if it is necessary, we may notify the police, the press, or the public at large to the extent necessary to help locate, identify or otherwise notify family members and others as to your location and general condition.
Any Other Use or Disclosure of Your Protected Health Information Requires Your Written Authorization: Under any circumstances other than those listed above, MedWise Urgent Care will ask for your written authorization before we use or disclose your Protected Health Information. Specifically, MedWise Urgent Care must obtain your written authorization for the use and disclosure of psychotherapy notes, marketing, and the sale of Protected Health Information. MedWise Urgent Care will not sell Protected Health Information without your written authorization. You can later cancel your authorization in writing, and we will not disclose your Protected Health Information after we receive your cancellation, except for disclosures which were processed before we received your cancellation.
You have the right to:
- Receive a list of persons or organizations, other than those listed above, to whom we released your information.
- Request limits on how your information is used or disclosed; however, we are not required to agree to those limits unless you pay out of pocket in full for a service. If you pay out of pocket in full for a service and you request we not share information for that service with your insurance company, we will honor your request.
- Ask that we not contact you at home.
- Inspect and copy your medical records except in cases involving certain psychotherapy notes.
- Amend incorrect information in your medical record.
- Revoke your written permission for release of information.
- Receive notification if your unsecured health information is breached.
- Receive a paper copy of this privacy notice.
Federal law requires MedWise Urgent Care to:
- Maintain the confidentiality of your protected health information.
- Provide you with a copy of this notice.
- Abide by the terms of this notice.
- Only change this notice as permitted by federal rules.
- Provide you with a way to file complaints regarding privacy issues.
For further information regarding this notice and your rights, or to report any complaints regarding privacy issues, contact:
HIPAA Privacy Officer
You may also report complaints directly to the Secretary of Health and Human Services at the following address:
The U.S. Department of Health and Human Services, the Office of Civil Rights
1301 Young Street, Suite 1169, Dallas, TX 75202
Telephone: 214.767.4056, 214.767.8940 (TDD)