THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW TO GET ACCESS TO THIS INFORMATION.
Where this applies
This notice applies to all AppleCare Immediate Care sites (collectively referred to as “AppleCare”)
By law, AppleCare must keep protected health information (aka PHI) private. The federal government defines PHI as any information whether oral, electronic or paper, which is created or received by AppleCare and relates to a patient’s physical or mental health or condition, or payment for the provision of medical services. This includes not only the results of tests and notes written by doctors, nurses and other clinical personnel, but also certain demographic information (such as name, address and telephone number) that is related to your health records.
AppleCare is required by law to give you this notice and to follow the terms and conditions of the notice that is currently in effect. AppleCare will report breaches of your unsecured protected health information as required by law.
How AppleCare Fulfills These Duties
- AppleCare considers patient privacy as part of its mission to serve the needs of the patient first
- AppleCare takes necessary precautions against inappropriate use or disclosure of PHI
- AppleCare employees are expected to access protected health information only as necessary to perform their jobs
- AppleCare employees who violate these rules and policies are subject to sanctions, including discipline and termination
Health Care Providers Covered by This Notice
This notice covers AppleCare and AppleCare personnel, volunteers, students and trainees.
A Word About Federal and State Law
Federal and state laws require AppleCare to protect your medical information and federal law requires AppleCare to describe to you how we handle that information. When federal and state privacy laws differ, and the state law is more protective of your information or provides you with greater access to your information, then state law will override federal law. For example, where we have specifically identified additional applicable state law requirements in this notice, the referenced AppleCare entities will follow the more stringent state law requirements.
I. Most Common Uses and Disclosures
This section describes the most common circumstances in which AppleCare may use or disclose PHI.
AppleCare will use or disclose PHI to provide, coordinate or manage your care. This includes communication and consultation between all health care providers. This applies to disclosures for treatment purposes to health care providers within and outside of AppleCare.
AppleCare will use and disclose protected health information to create bills and collect payments from insurance companies, Medicare and other payers. This may include providing information such as dates of service, symptoms and diagnosis to your insurance company. AppleCare may also disclose PHI to another health care provider if such information is needed by the other health care provider to obtain payment for medical services provided to you.
At times, AppleCare may access information, such as your name, address and general medical condition to contact you to:
- Set up or remind you about future appointments; provide information about treatment alternatives or other information that may be of interest to you; or
- Disclose health-related benefits or services that may be of interest to you
Family Members and Others Involved in Your Care
AppleCare may disclose relevant PHI to a family member or friend who is involved with your care in order to keep them up to date on your care, to help you understand your care, to help handle your bills or to help scheduling appointments.
II. Other Potential Uses and Disclosures
This section describes the less common circumstances in which AppleCare may use or disclose PHI.
To Avert a Serious Threat of Harm
AppleCare may use and disclose PHI to alert those able to prevent or lessen a serious and immediate threat to the health or safety of a patient, another person or the public.
If a patient is a member of the military, AppleCare may release PHI about foreign military personnel to the appropriate foreign military authority. When the military organization is sponsoring the medical evaluation, the patient’s protected PHI is shared with both the patient and the sponsoring organization. Patients being evaluated on behalf of the military should be aware of these arrangements.
AppleCare may disclose PHI for workers’ compensation or similar programs as authorized or required by law. These programs provide benefits for work-related injuries or illness.
Public Health Purposes
AppleCare may disclose PHI for public health purposes. The following are some examples of releases that are allowed for public health purposes:
- To report vital statistics (e.g. births, deaths);
- To report to the federal government adverse reactions to medication it safety problems with FDA- regulated products;
- To notify people of product recalls; and to report communicable diseases to local, county, state and federal health officials.
Law Enforcement Activities
AppleCare may disclose PHI to law enforcement officials. For example:
- In response to a valid court order, grand jury subpoena, or search warrant;
- To identify a suspect, fugitive or missing person;
- About the victim of a crime under certain limited circumstances;
- About a death believed to be a result of criminal conduct; or
- About a crime committed on AppleCare property.
Uses and Disclosures Pursuant to an Authorization
Except as described in this notice or specifically required or permitted by law, AppleCare will not use or disclose your PHI without your specific written authorization. At times, AppleCare may ask you to provide specific written permission to disclose PHI. AppleCare generally will not use or disclose your PHI for marketing purposes, in exchange for remuneration, or use to disclose any psychotherapy notes about you unless AppleCare receives your authorization to do so. A valid authorization may be revoked in writing at any time. Written revocation of authorization must be submitted to AppleCare Immediate Care. Once the authorization is revoked, AppleCare will no longer be allowed to use or disclose PHI for the purposes described in the authorization except content to the extent AppleCare has already taken based upon the authorization.
Information with Additional Protections
Certain types of PHI may have additional protection under federal and state law. PHI about mental health, HIV/AIDS and genetic testing is treated differently. Additionally, federally assisted alcohol and drug abuse programs are subject to certain special restrictions.
III. Patients’ Rights with Respect to PHI
This section describes the rights of AppleCare patients to PHI
Right to Inspect and Copy
You have the right to inspect and request a copy of information maintained in AppleCare’s designated medical record about you. This includes medical and billing records maintained and used by AppleCare to make decisions about your care. To inspect a copy of your PHI, submit a written request to AppleCare. AppleCare generally may charge a reasonable, cost-based fee to cover the expense of providing copies.
Most patients have full access to inspect and receive a copy of the full medical record. On rare occasions, AppleCare may deny a request. For example, in the professional judgment of a patient’s physician, the release of information would be reasonably likely to endanger the life or physical safety of the patient or another person.
Right to Request Alternate Methods of Communication
You have a right to request that Applecare communicate with you in certain ways (such as a letter or by phone) or at a certain location. For example, you may ask that we contact you only at home or only at your place of business. In this situation, you may submit a written request to the applicable AppleCare specifying the communication method being requested. The request should be addressed to the attention of the Compliance Officer. AppleCare will accommodate reasonable requests. However, if the request could result in AppleCare not being able to collect for services or cause significant administrative burden, AppleCare reserves the right to require you to provide additional information about how payment for services will be handled.
Right to Request Amendment
You have the right to request that you are protected health information in AppleCare’s designated medical record for you be amended. If you wish to request amendment of the information in your record, submit a written request to the attention of the Practice Manager. The request must include a reason to support the amendment. AppleCare may deny a request for amendment based upon any following circumstances:
- The request is not in writing or does not include a supporting reason;
- The information you want to change was not created by AppleCare, and the originator of the information is not available to make the amendment;
- The information is not part of the designated medical record
- The information is accurate and complete
If AppleCare denies your request for an amendment, AppleCare will give you a written explanation of the denial. If you still disagree with the explanation provided, you can submit your written disagreement to AppleCare as referenced above, or you can ask that your request for amendment and explanation of the denial, or an accurate summary of such information, be included in any future disclosure of the pertinent PHI. If you submit a statement of disagreement, AppleCare may include a rebuttal statement addressing your statement of disagreement in the designated medical record.
Right to a List of Certain Disclosures
You can ask AppleCare for a list of persons or organizations to which AppleCare has disclosed your PHI. This list would provide you with a summary of certain disclosures AppleCare has made that you would not otherwise be in a position to know about. The following are examples of disclosures that would not be included in the list:
- Disclosures to carry out treatment, payment and health care operations;
- Disclosures made directly to you (the patient) or disclosures that you have specifically authorized;
- Disclosures made from the facility directory/patient census;
- Disclosures to persons involved in your case;
- Disclosures incident to a use or disclosure that is otherwise permitted or required by law;
- Disclosures made by national security or intelligence purposes;
- Disclosures made to correctional institutes or law enforcement officials having custody over a patient; or
- Disclosures that took place before April 14, 2003.
To obtain a copy of the list, submit a written request to AppleCare and address the request to the attention of the Compliance Officer. Your request must state a time period (beginning no earlier than April 14, 2003 when the federal privacy rules go into effect and for no longer than six years). The first list requested within a 12-month period shall be provided at no charge. For additional lists requested during the same 12-month period, AppleCare may charge for the costs of providing the list.
Right to a Request Restrictions
You can ask AppleCare to restrict the use or disclosure of PHI about you for treatment, payment, or health care operations. If you or someone on your behalf pays for a health care item or service in full, you can request AppleCare not disclose your information about the item or service to your health plan for payment, and AppleCare will agree to your request unless
required by law to make the disclosure. Your request must be in writing and submitted to AppleCare. The request should be addressed to the compliance officer. AppleCare will carefully consider all requests.
If you want to file a complaint or express concerns about AppleCare’s use or disclosure of PHI, please contact as follows:
AppleCare Immediate Care
Attn: Director of Operations
401 Mall Blvd, Suite 202E
Savannah, GA 31406
You may also write a written complaint to the United States Department of Health and Human Services- Office for Civil Rights. AppleCare honors your right to express concerns regarding your privacy. AppleCare would not- nor could it legally or ethically- take action against you for filing a concern or complaint regarding the use, disclosure, and rights of your protected health information.
Key Information about this Notice
- This is a revised notice for AppleCare. The effective date of this notice is September 23, 2013.
- AppleCare reserves the right to change the terms of this notice and make the new notice provisions effective for all PHI maintained by AppleCare. AppleCare will follow the terms and conditions of the notice that is currently in effect.
- When the notice is revised, it will be posted in all AppleCare facilities.
Need More Information?
If you have any questions, or would like to discuss this notice in more detail, please contact the compliance officer for AppleCare at (912)264-0587.