We respect our legal obligation to keep health
information that identifies you private.
This notice describes how we protect your health information and what
rights you have regarding it.
PERSONAL/PATIENT HEALTH INFORMATION:
Under federal law your personal health
information is protected and confidential. Personal health information includes
information about your symptoms, test results, diagnosis, treatment and medical
HOW WE USE YOUR PERSONAL HEALTH INFORMATION
We use your health information for preparing
personal reporting back to you, and possibly for working with a personal health
coach at your discretion. Your
identifiable information is shared with no one else. We do not copy, fax or otherwise send
individual health information to anyone else, including your employer. If your information is shared with anyone
else, it will be done by you or authorized by you.
EXAMPLES OF TREATMENT AND HEALTH CARE OPTIONS:
Your personal Health Coach will use your
information to assist you with establishing your health goals. This information will not be shared with any
other healthcare practitioners without your written consent.
Health Care Operations
We may use and disclose your health
information to conduct INTERNAL operations including proper handling of records,
evaluation of the quality of the program, and to conduct Peer Review audits.
We may use your information to contact you
with appointment reminders. We may contact you to provide health info/education
that may be of interest to you.
OTHER USES AND DISCLOSURES:
Required by Law
We may be required by law to report gunshot
wounds, suspected abuse or neglect, or similar injuries and events.
We will never release individual, identifiable
data to any source at any time. Your
information will be used in the aggregate (will be grouped with all the data)
to measure effectiveness and outcomes of this program.
Serious threat to health and safety
We may use and disclose information when
necessary to prevent a serious threat to your health and safety or the health
and safety of the public or another person.
In any other situation, we will ask for your
written authorization before using or disclosing any identifiable health
information about you. If you choose to sign an authorization to disclose
information, you can later revoke that authorization to stop any further uses
You have the following rights with regard to
your health information. Please contact Health
Improvement Solutions listed below to obtain the appropriate process for
exercising these rights.
You may request restrictions on certain uses
and disclosures of your health information. We are not required to agree to
these restrictions, but if we do agree, we must abide by those restrictions.
All communication is confidential between the
Health Coach and you.
You may ask us to
communicate with you confidentially, for example, by sending reminder postcards
or other information to a special address. You may choose to use e-mail as a
method of communication with your Health Coach. You must understand that
because this is Internet based communication, which we cannot control, there is
a chance that someone unknown to you or us could view your communication. If you chose to use email you are indicating
that you are aware of the risks and accept email as a communication tool. You
may request it as a restriction or discuss with your Health Coach the kinds of
information you would not like to have through email.
Inspect or Obtain Copies
You have the right to look at or get a copy of
your health notes maintained by your Health Coach.
Health Coach notes are for internal use only
to note your progress and goals. That
information may be amended, corrected or added to on your request.
Accounting of Disclosures
Health Improvement Solutions never discloses
to anyone, identifiable, personal data or information without your written
We may change our policies at any time. Before we make a significant change we will
change this notice and post the new one.
You may also request a copy of our Notice at any time.
If you are concerned that
we have violated your privacy rights, or if you disagree with a decision we
made about your records, you may send a written complaint to the Department of
Health and Human Services. The person
listed below will provide you with the appropriate address upon request. You will not be penalized in any way for
filing a complaint.
If you have any questions, requests or
complaints please contact: Kane Miller, Vice President – Operations, Health
Improvement Solutions, PO Box 241434, Omaha, NE 68124-5434 ·402-827-3334 or