This Joint Notice is being provided to you on behalf of B Above Services, LLC. (“B Above Services” or the “Company”) and the employees and practitioners that work at the Company with respect to services provided at the Company (collectively referred to herein as “We” or “Our”). We understand that your medical information is private and confidential. Further, we are required by law to maintain the privacy of “protected health information” (or “PHI”) which includes any individually identifiable information that we obtain from you or others that relates to your past, present or future physical or mental health, the health care you have received, or payment for your health care. We will share PHI with one another, as necessary, to carry out treatment, payment or health care operations relating to the services to be rendered at the Company.
The following is a summary of your rights. A more detailed description of each right is also included in this document.
• Get a copy of your paper or electronic health record.
• Request correction of your paper or electronic health record.
• Request confidential communication.
• Ask us to limit the information we share.
• Get a list of those with whom we have shared your information.
• Get a copy of this privacy notice.
• Choose someone to act for you.
• File a complaint if you believe your privacy rights have been violated.
You have some choices in the way that B Above Services uses and shares information as we:
• Tell family and friends about your condition.
• Provide disaster relief.
• Include your information in a hospital directory.
• Provide mental healthcare.
• Market our services.
• Raise funds.
OUR USES AND DISCLOSURES
B Above Services may use and share your information as we:
• Treat you and coordinate your care.
• Run our organization.
• Bill for your services.
• Help with public health and safety issues.
• Do research.
• Comply with the law.
• Respond to organ and tissue donation requests.
• Work with a medical examiner or funeral director.
• Address workers’ compensation, law enforcement, and other government requests.
• Respond to lawsuits and legal actions.
A Word About United States (U.S.) Federal and State Law B Above Services may use, process, and disclose your PHI in accordance with U.S. law. U.S. federal and state laws require B Above Services to protect your PHI and federal law requires us to describe to you how we handle that information. When federal and state privacy laws are different and conflict, and the state law is more protective of your information or provides you with greater access to your information, then we will follow state law.
When it comes to your health information, you have certain rights. This section explains your rights and some of B Above Services Responsibilities To help you.
Get an electronic or paper copy of your medical record
• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. If you would like, we also can send this information in either paper or electronic form to another person you identify in your request. We will provide a copy or a summary of your health information, usually within 30 days of your request. We May charge a reasonable, cost-based fee.
Ask B Above Services to correct your medical record
• You can ask us to correct health information about you that you think is incorrect or incomplete.
• We may say “no” to your request, but we will tell you why in writing within 60 days.
Request confidential communications
• You can ask us to contact you in a specific way (for example, home or office phone)or to send mail to a different address.
• We Will Say “yes” to all reasonable requests.
Ask B Above Services to limit what we use or share
• You can ask us not to use or share certain health information for treatment, payment, or B Above Services’ operations. We are not required to agree to your request, and we may say “no” if it would be harmful or compromise your care.
• If you pay for a service or healthcare item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we have shared information
• You can ask for a list (accounting) of the times we have shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and healthcare operations, and certain other disclosures (such as any you asked us to make). We will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
• You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. B Above Services will provide you with a paper copy promptly.
Choose someone to act for you
• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise • your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
• You can complain if you feel we have violated your rights by contacting us.
• You can file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights or visitingwww.hhs.gov/hipaa/filing-a
We will not retaliate against you for filing a complaint.
CALLING, TEXTING, AND EMAILING
We may contact you about your healthcare using the phone numbers and email addresses that you provide us. This may include using an automated phone dialing system, pre recorded or synthetic voice messages, texting, or email. When we contact you in this manner, you will be given the opportunity to opt out of receiving similar communications going forward.
Our messages may include, but are not limited to, information about appointment reminders, discharge planning, billing, prescription reminders, research opportunities, our products and services, treatment alternatives, your general health, and regulatory notices provided in lieu of first-class mail. Because any texts and emails would not be encrypted, there is a risk that someone else could read or access these messages. We therefore take steps to limit the amount of protected health information that they contain. If you do not wish to receive these types of text or email messages, please let us know, and we will honor your request.
For certain health information, you can tell us your choices about what we share.
If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to:
• Share information with your family, close friends, or others involved in your care.
• Share information in a disaster relief situation.
• Include your information in a hospital directory.
• If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
• Marketing purposes.
• Most sharing of psychotherapy notes.
B Above Services does not sell or rent our patients’ names or addresses to any organization outside of B Above Services.
We may contact you to provide information about our health related products or services that may be of interest to you, treatment alternatives and your general health. We may also contact you as part of our fundraising efforts. If you do not wish to be contacted for these reasons, please contact the Company to let us know of your request to opt out of these communications.
OUR USES AND DISCLOSURES
How does B Above Services typically use or share your health information?
We typically use or share your health information in the following ways:
To treat you and coordinate your care
We can use your health information and share it with other professionals who are treating you and to help coordinate your care.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.
To run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary. We may also share health information with another healthcare provider who has treated you, or to your insurance company. This may be done when the information is needed for healthcare operations of the healthcare provider or the insurance company, such as quality improvement activities, evaluations of healthcare professionals, and state and federal regulatory reviews.
Example: We use health information about you to manage your treatment and services.
To bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will pay for your services.
How else can B Above Services use or share your health information?
We are allowed or required to share your information in other ways—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.
For more information, you can go to this online link: www.hhs.gov/hipaa/for-individuals/index.html
Help with public health and safety issues
We can share health information about you for certain situations such as:
• Preventing disease.
• Helping with product recalls.
• Reporting adverse reactions to medications.
• Reporting suspected abuse, neglect, or domestic violence.
• Preventing or reducing a serious threat to anyone’s health or safety.
We can use or share your information for health research. Private-pay patients may be able to opt out of the use or disclosure of your information for research purposes.
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it requests to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests
B Above Services can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
B Above Services can use or share health information about you:
• For workers’ compensation claims.
• For law enforcement purposes or with a law enforcement official.
• With health oversight agencies for activities authorized by law.
• For special government functions such as military, national security, and presidential protective services.
OTHER PARTICULARLY SENSITIVE CONDITIONS
Certain other types of health information may have additional protection under state law. For example, health information about mental health, HIV/AIDS and genetic testing results is treated differently than other types of health information under certain state laws. To the extent applicable, B Above Services would need to get your written permission before disclosing these categories of information to others in many circumstances.
THE COMPANY’S RESPONSIBILITIES
• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see:
CHANGES TO THE TERMS OF THIS NOTICE
B Above Services can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website at www.baboveservices.org
WHO IS COVERED BY THIS NOTICE
This notice applies to B Above Services entities (collectively referred to as “B Above Services”).
This notice also covers other healthcare providers that come to B Above Services Facilities To care for patients (such as therapists, and other healthcare providers not employed by B Above Services), unless these other healthcare providers give you their own notice of privacy practices that describes how they will protect your PHI.
If you want to file a complaint, express concerns, or further inquire about the Company’s use or disclosure of health information, please contact the Company Privacy Officer by calling (317)-773-0500 or send an email to firstname.lastname@example.org. You also may file a complaint with the Secretary of the U. S. Department of Health and Human Services.
The Effective Date of this Notice is December 1, 2023.
DISCRIMINATION IS AGAINST THE LAW
B Above Services complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, creed, religion, gender, marital status, sexual orientation, gender identity or expression, veteran’s status, status with regard to public assistance, national origin, disability, or age in admission to, participation in, or receipt of the services and benefits under any of its programs and activities.