HIPAA and PHI
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.
1. Purpose and Scope
This Notice of Privacy Practices applies to OpAns, LLC and our handling of the privacy of your “protected health information” or “PHI” during the conduct of clinical diagnostics testing services, and describes our legal duties, privacy practices and your patient rights as determined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
OpAns is committed to protecting the privacy of your PHI. PHI includes information regarding ordered laboratory tests, including requisitions, test results, and invoices for healthcare services we provide.
This Notice does not apply to non-diagnostic services that we perform, including but not limited to: performance of occupational screening, forensic tests, paternity/identity tests, clinical trials tests or other services that do not involve standard electronic transactions for which the Department of Health and Human Services (“HHS”) has adopted standards.
OpAns is required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to: i) maintain the privacy of your PHI, and ii) provide you with this Notice of our legal duties and privacy practices upon request. We are required to follow the terms of this Notice currently in effect, and to notify affected individuals in the event of a breach involving unsecured protected health information. PHI is stored electronically, and is subject to electronic disclosure.
3. Use or Disclosure of PHI
As permitted under HIPAA, the following categories explain the types of uses and disclosures of PHI that OpAns 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).
TREATMENT - we may use or disclose PHI for treatment purposes. This includes disclosure to authorized health care professionals who order tests, provide you with health care services and/or are involved in the coordination of your care, and may include: physicians, nurses, medical students, pharmacies, and others involved in providing your physician with your laboratory test results for treatment purposes.
PAYMENT - we may use or disclose PHI to bill and collect payment for laboratory services we provide. For example, we may provide PHI to your health plan provider to receive payment for the health care services that we have provided to you. If you are insured under another person’s health insurance policy (for example, parent, spouse, domestic partner or a former spouse), we may also send invoices to the subscriber whose policy covers your health services.
HEALTHCARE OPERATIONS - we may use or disclose PHI for healthcare operations purposes, including disclosures (as necessary), for example, to evaluate the quality of our laboratory testing, accuracy of our results, accreditation functions and for our laboratory operations and management purposes. We may also disclose PHI to other healthcare providers or health plans providers that are involved in your care for their healthcare operations. For example, we may provide PHI to manage disease, or to coordinate healthcare or health benefits.
INDIVIDUALS INVOLVED IN YOUR CARE OR PAYMENT FOR YOUR CARE - we 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. As allowed by federal and state law, we may disclose PHI of minors to their parents or legal guardians.
BUSINESS ASSOCIATES - we may provide your PHI to other companies or individuals that need the information to provide services to us. 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. In addition, at the request of your healthcare providers or health plan providers, we may disclose PHI to their business associates for purposes of performing certain business functions or healthcare services on their behalf. For example, we may disclose PHI to a business associate of Medicare for purposes of medical necessity review and audit.
AS REQUIRED BY LAW - we must disclose your PHI if required to do so by federal, state, or local law. Under certain circumstances, we 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 AND LEGAL PROCEEDINGS - 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. 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 also disclose PHI to appropriate agencies if we reasonably believe an individual to be a victim of abuse, neglect or domestic violence. We 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.
PUBLIC HEALTH - we may disclose PHI for public health activities, including: i) disclosures to a public health authority to report, prevent or control disease, injury, or disability; ii) disclosures to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and iii) disclosures to an employer about an employee to conduct medical surveillance in certain limited circumstances concerning work-place illness or injury.
PERSONAL REPRESENTATIVE - we 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 - we 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.
RESEARCH - we may use and disclose PHI for research purposes, for example, data/records may be viewed by researchers to identify patients who may qualify for their research project or for other similar purposes, so long as the researchers do not remove or copy any of the PHI. Before we use or disclose PHI for any other research activity, one of the following will happen: i) a special committee will determine that the research activity poses minimal risk to privacy and that there is an adequate plan to safeguard PHI; ii) if the PHI relates to deceased individuals, the researchers give us assurances that the PHI is necessary for the research and will be used only as part of the research; or iii) the researcher will be provided only with information that does not identify you directly.
GOVERNMENT FUNCTIONS - we may disclose the PHI of military personnel and veterans, including Armed Forces personnel, as required by military command authorities. Additionally, we may disclose PHI to authorized officials for national security purposes, such as protecting the President of the United States, conducting intelligence, counter-intelligence, other national security activities, and when requested by foreign military authorities. Disclosures will be made only in compliance with U.S. Law.
WORKERS COMPENSATION - we 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 - we may use and disclose health information that has been “de-identified” by removing certain identifiers making it unlikely that you could be identified.
4. Patient PHI Rights
COPY OF OPANS NOTICE OF PRIVACY PRACTICES - You have a right to receive a printed copy of our Notice of Privacy Practices at any time by contacting us at (919) 323-4300, or by sending a written request to: Compliance Officer - HIPAA, OpAns, LLC, 4134 S Alston Ave, Durham, NC 27713. This Notice will also be posted on the OpAns website (www.opans.com).
LIMITS ON USE AND DISCLOSURE - You have the right to request that we limit: i) how we use and disclose your PHI for treatment, payment, and health care operations activities; or ii) our disclosure of PHI to individuals involved in your care or payment for your care. OpAns 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 provider for payment or healthcare 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.
REQUEST CONFIDENTIAL COMMUNICATIONS - You have the right to request that OpAns communicate with you about your PHI at an alternative address or by an alternative means. We will accommodate reasonable requests.
RIGHT TO SEE AND RECEIVE COPIES OF YOUR PHI - You and your personal representative have the right to access your 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 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 OpAns 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 ACCOUNTING DISCLOSURES - You have a right to receive a list of certain instances in which OpAns disclosed your PHI. This list will not include certain disclosures of PHI, such as (but not limited to) those made based on your written authorization or those made prior to the date on which OpAns was required to comply. If you request an accounting of disclosures of PHI that were made for purposes other than treatment, payment, or health care operations, the list will include disclosures made in the past six years, unless you request a shorter period of disclosures. If you request an accounting of disclosures of PHI that were made for purposes of treatment, payment, or health care operations, the list will include only those disclosures made in the past three years for which an accounting is required by law, unless you request a shorter period of disclosures.
RIGHT TO CORRECT OR UPDATE YOUR PHI - If you believe that your PHI contains a mistake, you may request, in writing, that OpAns correct the information. We will consider your request and provide you with a response.
To exercise any of your rights described in this notice, you must send a written request to: Compliance Officer - HIPAA, OpAns LLC, 4134 S Alston Ave, Durham, NC 27713. Except, patients may update insurance and/or billing information through our website or by contacting the Patient Billing Department using the phone number indicated on the billing invoice.
If you believe your privacy rights have been violated, you have the right to file a complaint with us. You also have the right to file a complaint with the Secretary of the U.S. Department of Health and Human Services, Office for Civil Rights. OpAns will not retaliate against any individual for filing a complaint. To file a complaint with us, or should you have any questions about this Notice, write to us at the following address:
4134 S Alston Avenue
Durham, NC 27713
Attn: Compliance Officer - HIPAA
We reserve the right to amend the terms of this Notice to reflect changes in our privacy practices, and to make the new terms and practices applicable to all PHI that we maintain about you, including PHI created or received prior to the effective date of the Notice revision. Our Notice is displayed on our website and a copy is available upon request.
This Notice of Privacy Practices was last updated on: 06/01/2020