Uses And Disclosures Not Requiring Your Authorization
We may use and disclose your health information for treatment, payment and healthcare operations purposes, as such terms are defined under HIPAA, or to the extent required by law. Not every use or disclosure is listed in this Notice, but all of our uses or disclosures of your PHI will fall into one of the categories listed below:
- Treatment: We may use and disclose your PHI for the purposes of “treatment” (as defined by HIPAA). This includes, for example, but is not limited to when we or our workforce members, or our participating laboratories and providers perform laboratory tests or review test results with you. It also includes, among other things, the coordination or management of care with other providers or workforce members, or the referral of a patient from one health care provider to another, such as, for example, when a clinician orders a laboratory test from a clinical laboratory or a medication order to a pharmacy.
- Payment: We may use and disclose your PHI for the purposes of “payment” (as defined by HIPAA). This includes, for example, when we bill you for services, we have furnished to you. It also includes, among other things, determining eligibility or coverage (including coordination of benefits or the determination of cost sharing amounts), billing, claims management, collection activities, obtaining payment from third party payers, review of health care services with respect to medical necessity, appropriateness of care, or justification of charges, utilization review activities, pre-certification and preauthorization of services, concurrent and retrospective review of services, disclosure of certain information to consumer reporting agencies and related health care data processing.
- Health Care Operations: We may use and disclose your PHI for the purposes of “health care operations” (as defined by HIPAA). This includes, for example, the use of your PHI in our general business and administrative activities, such as providing health care services to you and customer service. It also includes, among other things, care coordination and case management, population-based activities relating to improving health or reducing costs, protocol and clinical guideline development, quality assessments and improvement activities, auditing functions, evaluating practitioner and provider performance, cost management analysis and customer service, and the creation of limited data sets and de-identified health information.
- Public Health Activities, etc. As permitted by HIPAA, we may disclose your health information to public health authorities, workers compensation agents, social services agencies or other governmental authorities for purposes of preventing and controlling disease and reporting to the Food and Drug Administration regarding the quality, safety and effectiveness of a regulated product or activity.
- Health Oversight Activities. We may disclose your health information to a health oversight agency for authorized activities such as audits, investigations, inspections, licensing and disciplinary actions relating to the healthcare system or government benefit programs.
- Decedents. We may, under certain circumstances, disclose your health information to authorized representatives of decedents.
- Business Associates. MediVix may provide your PHI to other companies or individuals that need it to provide services to us. These companies are called Business Associates. They are also required to safeguard your PHI.
- Individuals Involved in Your Care: We may disclose relevant PHI to a family member, friend, caregiver or other individual involved in your healthcare or for payment of your healthcare if you agree or do not object. We may use or disclose your PHI to notify your family or personal representative of your location or condition.
- Emergency Situations: We may use and disclose your PHI if necessary to prevent or lessen a serious threat to your health and safety or that of another person.
- As Required by Law; Legal Process or Proceedings: We may use and disclose your PHI as required by law. We may also provide PHI to law enforcement officials, for example, in response to a warrant, investigative demand or similar legal process, or for officials to identify or locate a suspect, fugitive, material witness, or missing person. We may disclose your PHI as required to comply with a court or administrative order. We may disclose your PHI in response to a subpoena, discovery request or other legal process in the course of a judicial or administrative proceeding, but only if efforts have been made to tell you about the request or to obtain an order of protection for the requested information.
- Research: We may use or disclose PHI for research purposes when permitted by law, such as when an Institutional Review Board (an administrative body established to protect the rights and welfare of human research subjects recruited to participate in research activities) or privacy board has reviewed the research proposal and plans to safeguard the privacy of your PHI and determined that your authorization is not required. We may also use or disclose PHI about deceased patients to researchers if certain requirements are met. We may use and disclose a limited data set containing some of your PHI for research purposes. However, we will only disclose a limited data set if we enter into a data use agreement with the recipient.
- Incidental Uses and Disclosures: Sometimes, your PHI may be used or disclosed in the course of our primary uses and disclosures, such as for treatment, payment or healthcare operations.
Uses And Disclosures Requiring Your Authorization
We need your authorization to use or disclose your PHI for any purpose not covered by this Notice or the laws that apply to us. You may revoke any authorization you sign at any time in writing. If you revoke your authorization, we will no longer use or disclose your PHI except to the extent we have already taken action to satisfy your authorization.