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.
LifeCare understands it is important to protect the privacy of your health information. We are committed to protecting your health information and following all laws regarding the use of your health information. The law states we may use your health information to:
LifeCare Alliance may use your health information to coordinate care within the agency and with others outside the agency involved in your care, such as doctors, nurses, therapists, social workers and pharmacists who take care of you. For example doctors involved in your care will need information about your symptoms in order to prescribe medications. We may also disclose your health care information to other individuals who help coordinate your care including family members, case managers, suppliers of medical equipment and other health care professionals.
The agency may include your health information in bills it sends to Medicare, Medicaid and other health care insurers. For example, the bill contains information about your health care status and the services you received from the agency. Also we may need prior approval from your insurer and may need to explain to the insurer your need for home care and the services that will be provided to you.
The following list details the circumstances under which and purposes for which we may release your health information:
If the agency needs to send your health care information for reasons other than those stated above you may be asked to sign a separate form called an authorization form. The authorization form tells us what, where and to whom the information must be sent. The authorization is good for sixty days or the date you put on the form. You can cancel or limit the amount of information sent at any time by letting us know in writing.
Yes. You may request restrictions on certain uses and disclosures of your health information. You may request a limit on the agency’s disclosure of your health information to someone who is involved in your care or the payment of your care. However the agency is not required to agree to your request. To request restrictions, please contact the privacy officer, Kathy Papp at 614 437-2880.
Yes. You may ask the agency to communicate with you in a certain way. For example, you may ask that the agency only conduct communications pertaining to your health information with you privately with no other family members present. If you wish to receive confidential communications, please contact, the privacy officer, Kathy Papp at 614-437-2880. We will attempt to honor reasonable requests.
You may see your health information, unless it is the private notes taken by a mental health provider. You can receive a copy of your health information if you ask. You may have to pay a small fee for copying costs. Please contact the privacy officer, Kathy Papp at 614-437-2880 to request a copy of your health information.
If you think some of the information is incorrect you may ask in writing that it be amended or that new information be added. A request to amend your record should be sent to:
Kathy Papp, Privacy Officer
LifeCare Alliance
1699 West Mound St.
Columbus, Ohio 43223
The agency may deny the request to change the record if the request is not in writing or does not include a reason for the amendment, if the information in question was not created by the agency, or if in the opinion of the agency the records are complete and accurate.
We are required by law to maintain the privacy of your health information and to provide you this notice of our duties and privacy practices. We are required to abide by the terms of this notice as may be amended from time to time. We reserve the right to change this notice.
The agency may use information about you including your name, address, phone number and the dates you received care in order to contact you to raise money for the agency. The agency may also release this information to a related agency foundation. If you do not want the agency to contact you, notify Kathy Papp, privacy officer at 614-437-2880 and indicate that you do not wish to be contacted.
The agency must obtain authorization to use and disclose health information to third parties for marketing activities such as selling lists of patients.
This notice is yours and describes how we will use and disclose your health information. You can find an up-to-date copy of this notice posted in our main building, posted in our wellness centers or on our website www.lifecarealliance.org. You may also call the agency and the most recent privacy notice will be sent to you. Please call Kathy Papp the privacy officer, at 437-2880 to request a copy.
Nothing. We will not discontinue your services or retaliate in any other way if you file a complaint. You have the right to express complaints to the agency and to the Secretary of the Department of Health and Human Services if you believe that your privacy rights have been violated. We encourage you to express any concerns you may have regarding the privacy of your information.
If you have any questions about this notice or you think that we have not protected your private health information and you wish to complain about it, please contact:
Kathy Papp, RN
Privacy Officer
LifeCare Alliance
1699 West Mound St.
Columbus, Ohio 43223
614-437-2880
You can also complain to the federal government by calling the Office for Civil Rights (800) 368-1019
