Notice of Privacy Practices
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.
A2Z Diagnostics, LLC (“A2Z”) is committed to protecting the privacy of your identifiable health information. This information is known as “protected health information” or “PHI.” PHI includes laboratory test orders and test results as well as invoices for the healthcare services we provide.
A2Z’s Protection of PHI
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), A2Z is required by law to maintain the privacy of health information that identifies you, called PHI, and to provide you with notice of our legal duties and privacy practices regarding PHI. A2Z is committed to the protection of your PHI and will make reasonable efforts to ensure the confidentiality of your PHI, as required by statute and regulation. We take this commitment seriously and will work with you to comply with your right to receive certain information under HIPAA.
A2Z’s Use and Disclosure of PHI
As permitted under HIPAA, the following categories explain the types of uses and disclosures of PHI that A2Z may make. Some of the uses and disclosures described may be limited or restricted by state laws or other legal requirements, for example, the Clinical Laboratory Improvement Amendments of 1988 (CLIA). Please contact our Privacy Officer, using the contact information provided at the end of this notice, for specific information regarding your state.
- For treatment – A2Z may use or disclose PHI for treatment purposes, including disclosure to physicians and other health care professionals who provide you with health care services and/or are involved in the coordination of your care, such as providing your physician with your laboratory test results.
- For payment – A2Z may use or disclose PHI to bill and collect payment for laboratory services we provide. For example, A2Z may provide PHI to your health plan to receive payment for the health care services provided to you.
- For health care operations – A2Z may use or disclose PHI for health care operations purposes. These uses and disclosures are necessary, for example, to evaluate the quality of our laboratory testing, accuracy of results, internal audits and for A2Z’s operation and management purposes.
- Individuals involved in your care or payment for your care – A2Z may disclose PHI to a person who is involved in your care or helps pay for your care, such as a family member or friend. We also may notify your family about your location or general condition or disclose such information to an entity assisting in a disaster relief effort. As allowed by federal and state law, we may disclose the PHI of minors to their parents or legal guardians.
- Business associates – A2Z may disclose PHI to its business associates to perform certain business functions or provide certain business services to A2Z. For example, we may use another company to perform billing services on our behalf. All of our business associates are required to maintain the privacy and confidentiality of your PHI.
- Disclosure for judicial and administrative proceedings – Under certain circumstances, A2Z may disclose your PHI in the course of a judicial or administrative proceeding, including in response to a court or administrative order, subpoena, discovery request, or other lawful process.
- Law enforcement – A2Z may disclose PHI for law enforcement purposes, including in response to a court order, warrant, subpoena or summons, or similar process authorized by law. We may also disclose PHI when the information is needed: 1) for identification or location of a suspect, fugitive, material witness or missing person, 2) about a victim of a crime, 3) about an individual who has died, 4) in relation to criminal conduct on A2Z premises, or 5) in emergency circumstances to report a crime, the location of the crime or victims, or the identity, description, or location of the person who committed the crime.
- As required by law – A2Z must disclose your PHI if required to do so by federal, state, or local law.
- Public Health – A2Z may disclose PHI for public health activities, such as disclosures to a public health authority to report, prevent or control disease, injury, or disability.
- Disclosure about victims of abuse, neglect, or domestic violence – A2Z may disclose PHI about an individual to a government authority, including social services, if we reasonably believe that an individual is a victim of abuse, neglect, or domestic violence.
- Health oversight activities – A2Z may disclose PHI to a health care oversight agency for activities authorized by law such as audits, civil, administrative, or criminal investigations and proceedings, or other activities necessary for appropriate oversight of the health care system.
- Coroners, medical examiners, and funeral directors – A2Z may disclose PHI to a coroner, medical examiner, or funeral director for the purpose of identifying a deceased person, determining cause of death, or for performing some other duty authorized by law.
- Personal Representative – A2Z may disclose PHI to your personal representative, as established under applicable law, or to an administrator, executor, or other authorized individual associated with your estate.
- Correctional institution – A2Z may disclose the PHI of an inmate or other individual when requested by a correctional institution or law enforcement official for health, safety, and security purposes.
- Serious threat to health or safety – A2Z may disclose PHI if necessary to prevent or lessen a serious and/or imminent threat to health or safety to a person or the public or for law enforcement authorities to identify or apprehend an individual.
- Research – A2Z may use and disclose PHI for research purposes when an Institutional Review Board or privacy board has reviewed the research proposal and established protocols to ensure the privacy of your PHI and determined that the researcher does not need to obtain your authorization prior to using your PHI for research purposes.
- Government functions – In certain situations, A2Z may disclose the PHI of military personnel and veterans, including Armed Forces personnel, as required by military command authorities.
- Workers’ compensation – As authorized by applicable laws, A2Z may use or disclose PHI to comply with workers’ compensation or other similar programs established to provide work-related injury or illness benefits.
- De-identified Information and Limited Data Sets: A2Z may use and disclose health information that has been “de-identified” by removing certain identifiers making it unlikely that you could be identified. A2Z also may disclose limited health information, contained in a “limited data set”. The limited data set does not contain any information that can directly identify you. For example, a limited data set may include your city, county and zip code, but not your name or street address.
Other Uses and Disclosures of PHI
For purposes not described above, including uses and disclosures of PHI for marketing purposes and disclosures that would constitute a sale of PHI, A2Z will ask for patient authorization before using or disclosing PHI. If you signed an authorization form, you may revoke it, in writing, at any time, except to the extent that action has been taken in reliance on the authorization.
Information Breach Notification
A2Z is required to provide patient notification if it discovers a breach of unsecured PHI unless there is a demonstration, based on a risk assessment, that there is a low probability that the PHI has been compromised. You will be notified without unreasonable delay and no later than 60 days after discovery of the breach. Such notification will include information about what happened and what can be done to mitigate any harm.
Patient Rights Regarding PHI
Subject to certain exceptions, HIPAA establishes the following patient rights with respect to PHI:
- Right to Receive a Copy of the A2Z Notice of Privacy Practices – You have a right to receive a copy of the A2Z Notice of Privacy Practices at any time by contacting us at email@example.com.
- Right to Request Limits on Uses and Disclosures of your PHI – You have the right to request that we limit: 1) how we use and disclose your PHI for treatment, payment, and health care operations activities; or 2) our disclosure of PHI to individuals involved in your care or payment for your care. A2Z will consider your request, but is not required to agree to it unless the requested restriction involves a disclosure that is not required by law to a health plan for payment or health care operations purposes and not for treatment, and you have paid for the service in full out of pocket. If we agree to a restriction on other types of disclosures, we will state the agreed restrictions in writing and will abide by them, except in emergency situations when the disclosure is for purposes of treatment.
- Right to Request Confidential Communications – You have the right to request that A2Z communicate with you about your PHI at an alternative address or by an alternative means. A2Z will accommodate reasonable requests.
- Right to See and Receive Copies of Your PHI – You and your personal representative have the right to access PHI consisting of your laboratory test results or reports ordered by your physician. Within 30 days after our receipt of your request, you will receive a copy of the completed laboratory report from A2Z unless an exception applies. Exceptions include a determination by a licensed health care professional that the access requested is reasonably likely to endanger the life or safety of you or another person, and our inability to provide access to the PHI within 30 days, in which case we may extend the response time for an additional 30 days if we provide you with a written statement of the reasons for the delay and the date by which access will be provided. You have the right to access and receive your PHI in an electronic format if it is readily producible in such a format. You also have the right to direct A2Z to transmit a copy to another person you designate, provided such request is in writing, signed by you, and clearly identifies the designated person and where to send the copy of your PHI.
- Right to Receive an Accounting of Disclosures – You have the right to receive a list of certain disclosures of your PHI in the past six years from the date of your written request. Under the law, this does not include disclosures made for purposes of treatment, payment, or healthcare operations or certain other purposes.
- Right to Correct or Update your PHI – If you believe that your PHI contains a mistake, you may request, in writing, that A2Z correct the information. If your request is denied, we will provide an explanation of the reasoning for our denial.
How to Exercise Your Rights
To exercise any of your rights described in this notice, you must send a written request to: firstname.lastname@example.org. Except, patients may update insurance and/or billing information through our website or by contacting the phone number indicated on the billing invoice.
How to Contact Us or File a Complaint
If you have questions or comments regarding the A2Z Notice of Privacy Practices or have a complaint about our use or disclosure of your PHI or our privacy practices, please contact: email@example.com. You also may file a complaint with the Secretary of the U.S. Department of Health and Human Services. A2Z will not take retaliatory action against you for filing a complaint about our privacy practices.
Changes to the A2Z Notice of Privacy Practices
A2Z reserves the right to make changes to this notice and to our privacy policies from time to time. Changes adopted will apply to any PHI we maintain about you. A2Z is required to abide by the terms of our notice currently in effect. When changes are made, we will promptly update this notice and post the information on the A2Z website at www.yourgotolab.com. Please review this site periodically to ensure that you are aware of any such updates.