Notice of Confidentiality and Privacy Practices
Monitor Health, LLC
Disclosure of the use of patient’s medical information. Please review it carefully.
Security and protection of private health information
Monitor Health LLC prioritizes the importance of privacy of all patient’s private information. Monitor Health is compliant with a law to maintain the privacy of health information that identifies you or can be used to identify you. We are also required to provide you with this notice of our privacy practices, our legal duties and patient’s rights concerning health information. We are required to abide by the terms of this notice currently in effect. We may modify or change our privacy practices described in this notice from time to time, particularly as new laws and regulations become effective. Any changes will be effective for all the health information that we maintain, even information in existence before the change. Revised copies with any changes are available on company’s website at www.monitorhealth.net and may be obtained by contacting email@example.com
Disclosure of Private Health Information
Monitor Health may use and disclose private health information, without authorization, in the following ways:
Treatment: Monitor Health may use and disclose patients health information to provide, coordinate or manage patient’s treatment. For example: we may disclose health information to a provider who requests this information to treat you.
Health Care Operations: We may use and disclose patient’s health information in order to support our business activities. For example, we may use health information to conduct quality improvement activities, to engage in care coordination and case management, to conduct business management and general administrative activities, and other similar activities.
Research; Death; Organ Donation: We may use or disclose patient’s health information for research purposes in limited circumstances. We may disclose health information to a coroner, medical examiner, funeral director or organ procurement organization for certain purposes.
Public Health and Safety: We may use and disclose patient’s health information to the extent necessary to avert a serious and imminent threat to patient’s health or safety or the health or safety of others. We may disclose patient’s health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, domestic violence or other crimes.
Required by Law: We will use or disclose patient’s health information when we are required to do so by law.
Process and Proceedings: We may disclose patient’s health information in response to a court or administrative order, subpoena, discovery request or other lawful process.
Law Enforcement: We may disclose patient’s health information, so long as applicable legal requirements are met, to a law enforcement official, such as for providing information to the police about the victim of a crime.
Inmates: We may disclose patient’s health information if patient is an inmate of a correctional institution and we created or received patient’s health information in the course of providing care to patient.
Military and National Security: We may disclose patient’s health information to military authorities if patients is a member of the Armed Forces. We may disclose patient’s health information to authorized federal officials for lawful intelligence, counterintelligence and other national security activities.
Workers’ Compensation: We may disclose patient’s information as authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs, established by law, that provide benefits for work-related injuries or illness without regard to fault.
Business Associates: We may disclose patient’s health information to persons who perform functions, activities or services to us or on our behalf that require the use or disclosure of health information. To protect patient’s health information, Monitor Health require the business associate to appropriately safeguard information.
To patient: We will disclose patient’s health information to the patient, as described in the Individual Rights section of this notice.
Uses and Disclosures That May Be Made Either With Patient’s Agreement or the Opportunity to Object
Unless patient objects, we may disclose to a member of patient’s family, a relative, a close friend or any other person patient’s identify, orally or in writing, patient’s health information that directly relates to that person’s involvement in patient’s health care. If patient is unable to agree or object to such disclosure, Monitor Health may disclose such information as necessary if we determine that it is in patient’s best interest based on our professional judgment. Monitor Health may use or disclose patient’s health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for patient care of location or general condition.
Written Authorization Disclosure
Marketing: Monitor Health must obtain patient’s written authorization to use and disclose patient’s health information for most marketing purposes.
Sale of Health Information: We must obtain patient’s written authorization for any disclosure of patient’s health information which constitutes a sale of health information.
Other Uses: Other uses and disclosures of patient’s health information will be made only with patient’s written authorization, except as described in this notice or as otherwise required or allowed by applicable law.
In the event that we ask for patient’s authorization to use or disclose patient’s health information, Monitor Health will provide patient with an appropriate authorization form. Once patient has given Monitor Health a written authorization, patient can revoke that authorization at any time, except to the extent that Monitor Health has taken action in reliance on patient’s authorization.
Access: Patient have the right to see or get an electronic or paper copy of health information by submitting a request to Monitor Health in writing at firstname.lastname@example.org. There are certain exceptions to patient’s rights to obtain a copy of health information. Monitor Health may deny patient’s request if we believe the disclosure will endanger patient’s life or that of another person. Depending on the circumstances of the denial, patient may have a right to have this decision reviewed.
Disclosure Accounting: Patients have the right to an accounting of disclosures of health information made by Monitor Health by submitting a request to us in writing at email@example.com of this notice. This right only applies to instances when Monito Health or our business associates disclosed patient’s health information for purposes other than treatment, payment, health care operations, upon patient’s written authorization, and other activities. The right to receive this information is subject to certain exceptions, restrictions and limitations. Patient must specify a time period, which may not be longer than 6 years. Patient may request a shorter timeframe.
Restriction Requests: Patient have the right to request restrictions on the use and disclosure of patient’s health information by submitting a request to Monitor Health in writing at firstname.lastname@example.org. Patient’s request must state the specific restriction requested and to whom you want the restriction to apply. Monitor Health is not required to agree to these additional restrictions, except we must agree not to disclose patient’s health information to patient’s health plan if the disclosure (1) is for payment or health care operations and is not otherwise required by law, and (2) relates to a health care item or service which patient paid for in full out of pocket.
Confidential Communication: Patient have the right to receive certain communications confidentially. That means that patient can request that we communicate with patient by alternative means or to an alternative location by submitting a request to us in writing using at email@example.com. Monitor Health will accommodate patient’s request if it is reasonable and specifies the alternative means or location. Monitor Health may also condition this accommodation by asking patient for information as to how payment will be handled.
Amendment: Patient has the right to amend health information in our records for as long as we maintain the information. Patient must make a request in writing at firstname.lastname@example.org, to obtain an amendment. Patient’s written request must explain why the information should be amended. If Monitor Health agree to amend patient, we will make reasonable efforts to inform others of the amendment and to include the changes in any future disclosures of that information. Monitor Health may deny patient’s request if, for example, we determine that patient’s health information is accurate and complete. If we deny patient’s request, we will send patient a written explanation and allows patient to submit a written statement of disagreement to be appended to the information you want amended.
Paper Notice: If patient receives this notice electronically, patient is entitled to receive this notice in written form. Please make a request in writing at email@example.com
Breach: Patient has the right to be notified if you are affected by a breach of unsecured health information.
Questions and Complaints
If patient wants more information about our privacy practices or have questions or concerns, please make a request in writing at firstname.lastname@example.org
If patient is concerned that we may have violated privacy rights, or patient disagrees with a decision Monitor Health has made about rights to your health information, patient may complain to us in writing at email@example.com.
Monitor Health LLC
5600 Chestnut Street
Philadelphia, PA 19139
Telephone: 215 748 5830
Update Effective Date 4/16/2020