I. Introduction“Protected health information” means health information (including identifying information about you) which may include information about your past, present or future physical or mental health condition, the provision of your health care, and payment for your health care services. We are required by law to maintain the privacy of your health information and to provide you with this notice of our legal duties and privacy practices with respect to your health information. We are also required to comply with the terms of our current Notice of Privacy Practices.
II. Uses and Disclosures of Health Information for Treatment, Payment and OperationsWe will use and disclose your health information without your authorization to provide your health care and any related services. We use your personal health information (PHI) in order to provide treatment to you, to obtain payment for your treatment, to perform administrative activities within the practice, and for being able to determine the quality of care that is provided to you. PHI includes all the information that can identify you: your name, address, telephone number, social security number, health policy number, etc. Examples of some of the ways we may use your PHI include calling to remind you about an appointment, contacting your insurance company for payment, assessing the quality of care that was provided to you, speaking to your other health care providers, or just calling you into the treatment area from the waiting room. We may use and disclose health information to tell you about health-related benefits or services that may be of interest to you. If you do not want us to provide you with information about health-related benefits or services, you must notify the Privacy Officer in writing at The Floating Hospital, PO Box 8397, Long Island City, NY 11101. Please state clearly that you do not want to receive materials about health-related benefits or services.
II. Uses and Disclosures That May be Made Without Your Authorization or Opportunity to ObjectWe may use your PHI without prior authorization when we are required to do so by law, if there is a public health concern, if you have a communicable disease, if we believe that there is abuse or neglect, for research studies, for legal proceedings, for law enforcement, for organ and tissue donations, if a crime occurs on our premises, if an emergency occurs, to funeral directors and coroners, for military activity and national security, and for worker’s compensation.
III. Uses and Disclosures of Your Health Information with Your Permission.Uses and disclosures not described in Section II of this Notice of Privacy Practices will generally only be made with your written permission, called an “authorization.” You have the right to revoke an authorization at any time. If you revoke your authorization, we will not make any further uses or disclosures of your health information under that authorization, unless we have already taken an action relying upon the uses or disclosures you have previously authorized.
IV. Your Rights Regarding Your Health Information.You have the right to inspect and ask for a copy of your PHI at any time. You have the right to ask that we make changes or corrections to your information. Your request will be considered, but we do not have to comply with it. You have the right to file a disagreement with the Privacy Officer. You have the right to request a list of all disclosures that we have made of your PHI after September 23, 2013 for any reason other than for treatment, billing, or health care operations. You have the right to ask that we not disclose your PHI except when authorized by you, required by law, or in the case of an emergency. You may also request that your PHI is not disclosed to family members or friends that may be involved in your care. We will consider all such requests, but we are not required to agree or act on them. Any and all requests must be submitted in writing to our Privacy Officer. You have the right to have confidential information sent to you at an alternative location, or by means other than the postal service. We will accommodate all reasonable requests. You have the right to obtain a paper copy of this Notice of Privacy Practices at any time. You have the right to an electronic copy of your electronic health record and to direct that copy to a designated third party. You have the right to opt out of fundraising communications and to prohibit the sale of your PHI without your authorization. You have the right to have any genetic information be treated at PHI.
V. Concerns and ComplaintsIf you feel that your privacy rights have been violated at any time or you do not agree with how your PHI is being disclosed, you can contact our Privacy Officer at the address below. All complaints must be submitted in writing. We will not retaliate against you for filing a complaint. You can also contact the Secretary of Health and Human Services. The Floating Hospital Sean Granahan, Privacy Officer
P.O. Box 8397, Long Island City, NY 11101Phone: (718) 784-2240, extension 105 Fax: (718) 784-0240