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.
This Notice describes the privacy practices of Sagely Health, LLC. (“Sagely Health”). This Notice applies to uses and disclosures of protected client medical information collected by Sagely Health -- which is legally required to provide this Notice.
To receive another copy of this notice, electronically or on paper, call 1-844-SAGELY1, send an e-mail to firstname.lastname@example.org. Sagely Health may change this policy at any time and without prior notice. Those changes will apply to any protected health information (“PHI”) already held by Sagely Health. Sagely Health will keep the current policy available at its offices and on its website.
Sagely Health may collect PHI for use as described herein. The information will be used and disclosed in providing Sagely Health services (the “Services”). Sagely Health will handle your PHI in accordance with the Health Insurance Portability and Accountability Act (“HIPAA”) and all related federal and state rules and regulations, as well as the provisions of this Notice.
Sagely Health may disclose your PHI to associates and consultants of Sagely Health who are bound by agreements requiring them to preserve the confidentiality of this information, to use the information for providing Services. In some cases your PHI may be sent to an outside Party in order to facilitate the Services, including but not limited to diagnostic service companies, medical facilities, advocate groups, and consultations outside of Sagely Health. Sagely Health may share the PHI with your physicians involved in your care.
Sagely Health will not disclose your PHI to unaffiliated parties (ie those not under confidentiality) without your expressed consent. Sagely Health holds an active certificate for the highest level of security provided by Secure Sockets Layer (SSL) on the Internet. However, Sagely Health will not be held responsible for unintentional breech of information regarding PHI or result of unauthorized individuals (e.g. ‘hackers’) gaining access to PHI information without approval by or knowledge of Sagely Health or its associates.
Sagely Health also may use your PHI to evaluate the performance of our Services.
Sagely Health may also keep, use or share de-identified PHI based upon information you have provided to Sagely Health. De-identified PHI is information that does not include your name, address, birth date, or other information that could be used to identify you. This de-identified PHI could be used for understanding trends in diagnostics, reference and research or commercial purposes. For example, Sagely Health could use this de-identified information to demonstrate the reliability of Sagely Health’s information management systems or to generate medical research information. Sagely Health would not identify you by name in any resulting reports.
Sagely Health may use your contact information during the course of providing Services to you as either part of the ongoing process or as part of an effort to follow-up with you after Services are complete. Sagely Health may contact you through the mail, electronically (e.g. e-mail, text, etc.) or by phone.
Sagely Health may disclose your PHI for the following purposes without your authorization: (i) as required by law; (ii) for public health activities; (iii) to protect victims of abuse, neglect or domestic violence; (iv) for health oversight conducted by government agencies; (v) for judicial and administrative proceedings after proper legal process; and (vi) for law enforcement purposes.
Other uses or disclosures about your PHI may require your written or recorded verbal authorization, for example marketing or testimonial purposes. You can revoke that authorization at any time but that revocation will not affect any use or disclosure made prior to revocation.
Sagely Health may disclose your PHI to you, to your representative or to other individuals designated by you.
You have the right to inspect, copy, restrict access to and amend your PHI maintained by Sagely Health. To inspect your medical records or PHI, please make a signed and dated written request to Sagely Health, Privacy Officer. In some cases we may not honor your requests, such as if disclosing records will cause you harm, if they are part of legal proceedings or if they are part of ongoing research. In the event that we deny your request you will be notified of any denial within 60 days and be given additional options or information. To make an amendment to your PHI, please make a signed and dated written request to Sagely Health, Privacy Officer at the Address above. In the request please describe the changes that you would like to make and the reason why. In the event that we deny your request you will be notified of any denial within 60 days and be given additional options or information.
You have the right to request restricted disclosures or uses or to request that we limit access to your PHI. Please make a signed and dated written request to Sagely Health, Privacy Officer. Please include all of the specific information that you want to have restricted and the person or categories of persons who should or should not have access to the information. We have the right to deny your requests, to the extent required by law, or ask for additional information. In the event that we deny your request you will be notified of any denial within 60 days.
You have the right to an accounting of disclosures of your PHI that were made without your knowledge (ie you have not been included in the disclosure). Please make a signed and dated written request to Sagely Health, Privacy Officer. We are only obligated to share disclosure accounting for the proceeding six years. This accounting will include disclosures made in the course of providing Services.
You have the right to request to receive confidential communications about your PHI, such as having information sent to a particular address or in a particular way. Please make a signed and dated written request to Sagely Health, Privacy Officer. In your request specify the methods with which you would like to be communicated.
You have the right to make complaints about any possible violation to your Privacy Rights (as defined by state or federal law) to Sagely Health. Sagely Health will not penalize you for making a complaint. To make a complaint to Sagely Health, please make a signed and dated written complaint to Sagely Health, Privacy Officer. You may contact the Department of Health and Human Services if you believe your privacy rights have been violated.
If, for any reason, you would like to discuss any matter concerning our privacy policies or to request copies of our privacy policies, please contact Sagely Health directly via email or phone above.
Effective as of January 6, 2015. Copyright 2015 Sagely Health LLC