In accordance with the Health and Accountability Act (HIPAA) of 1996 and Final Regulations set forth by the US Department of Health and Human Services on August 14, 2002, Billing Enterprises is providing this information as required to comply with HIPAA and The Regulations in the use and disclosure of a patient’s health information by which they can be identified. The health information, also known as "PHI" or Protected Health Information, is protected and Billing Enterprises is required to give patients notice of our legal duties and privacy practices as it pertains to their PHI. Billing Enterprises must also inform and provide its patients with information informing them about their rights under HIPAA and The Regulations.
1) Uses And Disclosures of Protected Health Information
Billing Enterprises has two distinct categories of a patient’s PHI: 1) Information about a patient that can be used and disclosed without a patient’s prior consent, and 2) Information that requires a patient’s prior consent or authorization before it can be used or disclosed.
A) Patients’ Prior Consent Not Required - Billing Enterprises is not required to act on prior consent for treatment, payment, healthcare issues, and other permitted uses and disclosures.
Treatment – Billing Enterprises will disclose patients’ PHI concerning their medical treatment in such situations where family members, relatives, or other individuals involved in the patient’s health or care have been tasked to pick up or receive a patient’s prescriptions when such a disclosure is necessary to ensure accurate prescription delivery. Billing Enterprises uses care and professional judgment when determining the disclosure of information to ensure that such disclosure is only performed in the best interests of patients. Past experiences help Billing Enterprises in future situations. Other instances where PHI may be disclosed include but are not limited to a patient’s prescriptions being sent to a doctor or specialist who is currently or in the near future going to treat a patient or when a patient has been hospitalized especially for emergency treatment.
Payment – If Billing Enterprises is providing or receiving payment to or from a patient, working with insurance companies or processing credit cards, Billing Enterprises has the right to send PHI to all entities as required to ensure accurate and timely payment and processing.
Healthcare Operations – A patient’s PHI may be used for reviews by healthcare professionals, reviews and ratings by insurers, legal purposes, business management and planning, etc. Billing Enterprises will also use personnel information to review the quality of its patients’ healthcare and treatment. This information will be used to help improve or change treatment programs and products.
Other Permitted Uses and Disclosures – Billing Enterprises has the right to disclose or use a patient’s PHI for various other reasons. These reasons include, but are not limited to, the following:
Various public health activities or promotions
Legal issues such as abuse, neglect, domestic violence, as mandated by law enforcement agencies, death, organ donation, research studies, research participation, when non-disclosure may lead to serious threats to one’s health, volunteer activities, military or veterans’ activities, reasons of national security, when audits are being conducted, in the event of medical emergencies or hospitalizations, in communications with patients both orally and in written form, when refilling prescriptions, when addressing billing issues or inaccuracies, when auditing the treatment of a patient, for the assessment or implementation of alternative therapies, for changes or modifications to a patient’s treatment, etc.
B) Patient’s Prior Authorization Required
Billing Enterprises will seek permission for a patient’s PHI for all purposes other than those mentioned above. This authorization will be in written form and must be obtained before any use of a patient’s PHI. If Billing Enterprises has requested authorization, the patient has the right to decline or agree without penalty. If a patient has given permission to use his or her PHI and decides against future use, Billing Enterprises must honor these wishes and revoke the use of information immediately. The permission to use a patient’s PHI then becomes null and void.
2) Patient’s Rights
HIPAA and The Regulations have given Billing Enterprises a set of guidelines regarding patient’s rights and the use of their PHI. The patient has the following rights:
A) Patient’s Record
Every Billing Enterprises patient is entitled to receive a copy of his or her PHI record simply by providing Billing Enterprises a written request. Charges may be incurred by fulfilling the request, which will be conveyed and passed along to the patient. These charges can take the form of postage or delivery fees along with other expenses that may be unavoidable in the procurement of the record or summary.
B) Accounting of Disclosures
Every Billing Enterprises patient is entitled to receive an accounting of disclosures of the PHI over the course of the last 3 years. All disclosures must be listed except those made on behalf of treatment, payment or healthcare operations.
Every Billing Enterprises patient has the right to amend or change his or her PHI by requesting such an amendment or change in writing. Billing Enterprises will reserve the right to review the request and make a decision regarding whether it is necessary to make a change to a patient’s PHI.
Upon notification, Billing Enterprises will communicate with patients in a personal and confidential manner about their PHI. This communication can take place through various forms such as telephone, written communication or meetings at an agreed upon place.
E) Special Restrictions
Billing Enterprises allows patients to suggest through certain channels (forms, written, telephone, meeting) to restrict the use and disclosure of certain PHI except in instances that are required by law or emergency. These restrictions will be reviewed by Billing Enterprises and a course of action will be adopted by Billing Enterprises that reflects the best course of action as deemed by Billing Enterprises. HIPAA and The Regulations do not require Billing Enterprises to make changes.
If a patient believes that Billing Enterprises has not abided by the rules and regulations of HIPAA and The Regulations or does not agree with certain actions regarding his or her PHI, the patient has the right to file a complaint and refer it to Billing Enterprises for review and resolution. Billing Enterprises has the obligation and right to review complaints and resolve or make adjustments as are fitting and necessary. If the patient feels that the resolution is not sufficient or in keeping with past resolutions, he or she has the right to correspond with the Department of Health and Human Services.
Billing Enterprises is required by law to protect a patient’s PHI and provide information about the company’s privacy practices. Billing Enterprises from time to time will amend or make changes to its privacy practices. Billing Enterprises will provide notices to patients of any pending change to their privacy practices before such actions are taken.