855-808-5120This 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. Your Rights You have the right to:
•Get a copy of your paper or electronic medical record
•Correct your paper or electronic medical record
•Request confidential communication
•Ask us to limit the information we share
•Get a list of those with whom we’ve shared your information
•Get a copy of this privacy notice
•Choose someone to act for you
•File a complaint if you believe your privacy rights have been violated
You have some choices in the way that we use and share information as we:
•Tell family and friends about your condition
•Provide disaster relief
•Include you in a hospital directory
•Provide mental health care
•Market our services and sell your information
Our Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
We can use your health information and share it with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.
Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will pay for your services.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
We can share health information about you for certain situations such as:
•Helping with product recalls
•Reporting adverse reactions to medications
•Reporting suspected abuse, neglect, or domestic violence
•Preventing or reducing a serious threat to anyone’s health or safety
We can use or share your information for health research.
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
•For workers’ compensation claims
•For law enforcement purposes or with a law enforcement official
•With health oversight agencies for activities authorized by law
•For special government functions such as military, national security, and presidential protectiveservices
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
•We are required by law to maintain the privacy and security of your protected healthinformation.
•We will let you know promptly if a breach occurs that may have compromised the privacy orsecurity of your information.
•We must follow the duties and privacy practices described in this notice and give you a copy ofit.
•We will not use or share your information other than as described here unless you tell us we canin writing. If you tell us we can, you may change your mind at any time. Let us know in writing ifyou change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.
Effective Date: 1/1/20 This notice applies to all AffinityOne Residences throughout New Jersey and Massachusetts.