Joint Notice of The Transcarent Clinic Privacy Practices
Effective Date: March 7, 2024 (Version 1.0)
Effective Date: March 7, 2024 (Version 1.0)
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 Joint Notice of Privacy Practices (“Notice”) applies to 98point6 Physicians PC, 98point6 California Physicians PC, 98point6 Kansas Physicians PA, 98point6 Michigan Physicians PC, and 98point6 New Jersey Physicians PC (collectively referred to as the “PC Groups”); our health care clinicians (including employed physicians, nurse practitioners, nurses, therapists, clinic support staff, and coaches, in addition to independent contractor clinicians who are not employees of the PC Groups) and any other members of the PC Groups workforce who are authorized to use or access your health information (collectively, “we,” “us,” or “The Transcarent Clinic”).
We have chosen to participate in the Transcarent Clinic Organized Health Care Arrangement, an organized system of health care under which we conduct activities cooperatively, including utilization review and quality assessment and improvement activities. We may use and disclose patient Protected Health Information (PHI) with other participants in the Transcarent Clinic Organized Health Care Arrangement as necessary to carry out treatment, payment or health care operations relating to the Organized Health Care Arrangement.
Table of Contents
I. What Is This Notice?
II. Our Responsibilities
III. Our Uses and Disclosures of Your PHI
IV. Your Rights
V. Your Choices
VI. Changes To This Notice
VII. Contact Information
I. What Is This Notice?
This Notice describes how medical information about you may be used and disclosed and how you can get access to this information. Throughout this Notice, we may refer to your medical information as Protected Health Information, or “PHI.” To be clear, your PHI includes information about your health and health care (such as medical records), your personal identifiers (such as your name, phone number, address, and geolocation during a visit with The Transcarent Clinic), and your billing and payment information when you receive care from The Transcarent Clinic. Please read this notice carefully.
II. Our Responsibilities
The Transcarent Clinic is committed to protecting patient PHI and compliance with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). You can learn more about HIPAA by visiting https://www.hhs.gov/hipaa/for-individuals.
By law, we must:
protect the privacy of your PHI;
let you know your rights and our legal responsibility with respect to your PHI;
notify you if there is a breach of unsecured PHI
let you know about our privacy practice and comply with our notice currently in effect.
III. Our Uses and Disclosures of Your PHI
Uses and Disclosures Related to Your Care
The following is a list of reasons why The Transcarent Clinic can use or disclose your PHI without first obtaining your permission.
1. Treatment.
We may use or disclose your PHI to provide you with medical treatment and related services or to help manage the health care treatment you receive. We may use or disclose your PHI with other professionals who are treating you.
Example: A clinician treating you for an injury asks another clinician about your overall health condition.
Disclosures related to human immunodeficiency virus (HIV) test results, diagnosis of acquired immune deficiency virus (AIDS) or an AIDS-related condition, or information about alcohol or drug treatment you received in a related treatment program, however, will not be made without your permission except as required or allowed by law. For example, applicable law may permit us to disclose this information in connection with submitting a claim to your insurance or health plan. We may also disclose your information without your consent if there is an immediate threat to your health or safety, or that of others.
2. Payment. We may use and disclose your PHI to bill and receive payment for services provided to you.
Example: We disclose PHI about you to your health plan to process and pay for the services provided to you.
3. Health Care Operations. We may collect, use, and disclose your PHI to run our business, including technology development and program administration, to improve your care, to contact you, and for other purposes necessary to operate The Transcarent Clinic and provide you with health care services. As part of our health care operations, we may disclose your PHI to our accountants, attorneys, consultants, and others to ensure we are complying with laws applicable to us. We may also disclose your PHI with other health care providers and health plans for their business operations if they have or had a patient relationship with you. We may de-identify your PHI as part of these operations, at which point this Notice will no longer apply.
Additionally, to improve your care experience, we may send you surveys or requests for feedback regarding our services. You may opt out of these types of communications by following the instructions provided in the survey or feedback request; however, please know, we will continue to communicate with you about the care and services you have received or have scheduled.
Example: We use your PHI to review and improve the quality of services you received, the performance of the professionals who provided care to you, provide customer service, and other health care operations activities.
4. Appointments and Services. We may contact you to remind you of an appointment, arrange follow up or other health care services, or provide a test result. We may also contact you to provide you with information about treatment alternatives or other services and benefits we offer.
Other Uses and Disclosures Related to Your PHI
We are allowed or required by law to disclose your PHI without your authorization in some additional circumstances – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. These circumstances include:
1. Help with Public Health and Safety Issues.
We may disclose PHI in certain situations such as to prevent disease, support product recalls, report adverse reactions or product complaints, or reporting suspected abuse, neglect, or domestic violence.
2. Serious and Imminent Threats.
We may disclose your information when needed to prevent or reduce a serious threat to you, another person, or the public.
3. Conduct Research.
We can use or disclose your information for health research without your permission if an Institutional Review Board (IRB) approves such use or disclosure. (An IRB is a committee that is responsible, under federal law, for reviewing and approving human subjects research to protect the safety of the participants and the confidentiality of PHI.) In the absence of such approval from an IRB, we may only use or disclose your information for research if we first obtain your permission.
4. Health Information Exchange.
We may share your PHI electronically with other organizations through a Health Information Exchange (HIE) network. These other organizations may include hospitals, laboratories, health care providers, public health departments, health plans, and other participants. We do this in order to get your health information to the health care providers treating you quickly and efficiently. HIE participants like The Transcarent Clinic are required to meet rules that protect the privacy and security of your health and personal information. Please note that, if your medical record contains certain information (such as from a substance use disorder program) that requires your authorization under state or federal law before information is shared, then we will not release that information to your other treating providers through HIE until you provide authorization.
5. Comply with Applicable Laws.
We may disclose PHI about you when required to do so by federal, state, or local law, judicial or administrative proceedings or law enforcement. For example, we may disclose PHI to government agencies or law enforcement personnel about victims of abuse, neglect or domestic violence or pursuant to federal, state or local laws, subpoena or court order, or other legal process.
6. Respond to Organ and Tissue Donation Requests and Work with a Medical Examiner.
We may disclose PHI with organ, eye, or tissue procurement or placement organizations or banks to facilitate donation and transplantation. We also may disclose PHI with a coroner, medical examiner, or funeral director when an individual dies.
7. Address Workers’ Compensation, Law Enforcement, and Specific Government Requests.
We may use or disclose PHI about you for workers’ compensation claims, law enforcement purposes or with a law enforcement official, special government functions such as military, national security, and presidential protective services and with health oversight agencies for legally authorized activities.
8. Respond to Lawsuits and Legal Actions.
We can disclose health information about you in response to a court or administrative order, a subpoena request, or other lawful processes, such as if you are involved in a lawsuit or a dispute.
9. Uses and Disclosures Requiring your Authorization
In certain cases, we may need your permission, called an Authorization, to use and/or disclose your PHI.
Once we receive your written revocation, it will apply to future PHI uses and disclosures. You may change your mind at any time. Let us know in writing if you change your mind.
10 This Notice of Privacy Practices Applies to the Following Organizations
All participants of the Transcarent Clinic Organized Health Care Arrangement.
We contract with third parties to perform some services for us, such as billing or consulting. These third-party service providers, known as Business Associates under HIPAA, can access PHI to perform these services on our behalf. They are required by law, and their agreements with us, to protect your PHI in the same way we do. Transcarent, Inc. is one of our Business Associates.
IV. Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Your Right to See and Obtain Copies of Your Health Information
You (or your legally authorized representative) can submit a request using this Medical Records Authorization Form to:
request to see or get an electronic or paper copy of your medical record and your other PHI for your records, or
send your medical record and your other PHI to third-party health care providers or other entities.
Once we receive a request, we will provide a copy and/or summary within the time frames established by law, typically within 30 days. We may charge a reasonable cost-based fee to cover, for example, applicable copying or mailing costs.
In certain limited circumstances, we may deny your request to see or receive your PHI. If your request is denied, we will inform you in writing of our reasons for denying your request and explain how you may request a review of that decision, if applicable.
Your Right to Ask Us to Correct or Update Certain PHI
If you believe that the information we have about you is incorrect or that a piece of important information is missing from your medical records, you may submit an amendment request to us. To do so, you must Contact Us in writing, identifying the specific correction, update, or addition you are requesting, as well as your reason for making such request.
We will review all requests. In some situations, we may ask for additional information. Also, we may say “no” to your request, but we will let you know the reason for our decision in writing, usually within 60 days of our receipt of your written request. Please note, any future disclosures of the disputed information may include your written disagreement statement.
Your Right to Request How We Send Your PHI to You
There may be times when you want to change how and where you receive confidential communications from The Transcarent Clinic. For example, you may wish for us to contact you at a different email address or phone number, or you may prefer that we send mail to a different address. You can submit these types of requests in writing when you Contact Us. Please be sure to send us complete and accurate information. We will consider all reasonable requests, and must say “yes” if you tell us you would be in danger if we do not.
Your Right to Ask Us to Limit What We Use or Disclose
You may ask us not to use or disclose certain PHI for treatment, payment, or our health care operations. To submit a request, you must Contact Us in writing. We are not required to agree to your request.
Your Right to Get a List of Those with Whom We’ve Shared Information
You can request a list (or an “accounting”) of certain disclosures of your PHI for up to six years prior to the date of your request, including who we disclosed it to, and why.
We will include all PHI disclosures except for those that you asked us to make.
To get this list, you must Contact Us in writing. We will provide you with one free accounting once every 12 months. Additional requests may be charged a reasonable, cost-based fee.
Your Right to Choose Someone to Act for You
If you have a legally authorized health care representative, such as a legal guardian or medical/health care power of attorney, that person will need to show proof of their authority to act on your behalf. Once provided, your health care representative will be able to exercise your rights and make choices related to your PHI.
Your Right to Receive This Notice
You can view a copy of this Notice on our website (www.transcarent.com/notice-of-privacy-practices). You can ask for a paper copy of this Notice at any time, even if you have agreed to receive electronic notifications. Please Contact Us to submit your request.
Your right to receive a written notification of any breach of your unsecured PHI
If we discover your unsecured PHI is subject to a Breach, as defined under HIPAA, we will let you know.
Your Right to File a Complaint if You Feel Your Rights are Violated
You can complain if you feel we have violated your rights by contacting us using the information in Section VII of this Notice.
If you believe that your privacy rights have been violated or you disagree with a decision we made about your PHI, you may file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue SW, Washington, D.C. 20201; calling 1-877-696-6775; or visiting www.hhs.gov/ocr/privacy/hipaa/complaints.
We will not retaliate against you for reaching out to us or filing a complaint. You should keep a copy of any notices you send for your records.
V. Your Choices
For certain health information, you can tell us your choices about what we disclose. You can also let us know your preference for how we disclose your information in the situations described below.
In these cases, you have both the right and choice to tell us to:
disclose information with your family, close friends, or others involved in payment for your care;
disclose information in a disaster relief situation;
contact you for fundraising efforts; and/or
disclose information with other health care providers involved in your care or treatment.
If you are not able to tell us your preference, for example if you are unconscious or unresponsive, we may go ahead and disclose your information if we believe it is in your best interest. We may also disclose your information when needed to lessen a serious and imminent threat to health or safety.
Please know that we never disclose your protected health information, for marketing purposes or to sell your information, unless you give us written permission.
VI. Changes To This Notice
We reserve the right to change our privacy practices and/or this Notice. When changes are made, they will apply to all information we have about you. If our privacy practices change at any time in the future, we will promptly change and post the new Notice on our website. Digital copies of the new Notice will be available upon request.
VII. Contact Information
We welcome hearing from you about this Notice and any privacy-related concerns you may have, through these channels:
By email
Privacy@Transcarent.com
By phone
(888) 388-9151 (toll free)
In writing
Privacy Officer
Transcarent
4700 S. Syracuse Street
Suite 900
Denver, CO 80237