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.
Effective Date: March 8, 2012
Federal privacy regulations implemented by the government under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) went into effect April 14, 2003. These regulations require our office to maintain the privacy of your medical information and provide you with a Privacy Notice. This Notice describes how your personal medical information may be used and/or disclosed by Manahawkin Urgent Care to carry out treatment, payment, or health care operations and for other purposes that are permitted or required by law. It also describes how you can obtain access and control of this information. The privacy regulations also require our office to obtain your acknowledgement of receipt of this notice. Please take this privacy notice home with you for your records. If you have any questions, please feel free to ask a Manahawkin Urgent Care employee.
PHI refers to any patient information relating to treatment, diagnosis, or payment that identifies a person.
Manahawkin Urgent Care uses PHI when employees within the organization share, examine, or analyze a patient’s medical information. Manahawkin Urgent Care discloses PHI upon the release, transfer, or granting of access of PHI to other external persons or facilities. Except for the following circumstances, Manahawkin Urgent Care will not release your PHI without your written authorization.
Manahawkin Urgent Care will use and/or disclose your PHI to provide medical services, coordinate medical care, and/or help manage your health care and other medical services. Manahawkin Urgent Care may also disclose PHI to external persons or facilities that will be involved in your medical care.
Your PHI will be used and/or disclosed, as needed, to help obtain payment for your services. These uses are often required to obtain payment from third parties. Many services require prior authorization, and your PHI may be disclosed to obtain insurance authorization for such services before they are rendered.
Your PHI may be used and/or disclosed, as needed, to aid in the everyday administration of Manahawkin Urgent Care. In order to provide you and your family with quality care, Manahawkin Urgent Care may use your PHI for quality control reviews, internal investigations, performance reviews, training of new employees, and for other health-related activities. Manahawkin Urgent Care may also use and/or disclose your PHI to provide information to you.
Manahawkin Urgent Care may use and/or disclose your PHI to ensure continuation of care by checking on your progress or notifying you of received test results.
Manahawkin Urgent Care may use and/or disclose your PHI to inform you of various treatment options or programs that may be of benefit to your care.
Manahawkin Urgent Care may use and/or disclose your PHI to inform you of various medical benefit services in the community that may be of use to you.
Certain aspects and components of our services may be performed through contracts with outside persons or organizations, such as auditing, billing, legal services, etc. At times, it may be necessary for us to provide your PHI to one or more of these outside persons or organizations who assist us with our Health Care Operations. In all cases, these business associates are required to appropriately safeguard the privacy of your information.
Manahawkin Urgent Care may use and/or disclose your PHI in the following situations without your authorization:
- Requirements of federal, state, or local law
- Public safety issues that require notification to the proper public health authorities
- Issues of national security or military activity
- Health oversight agencies
- Court-ordered legal proceedings
- Law enforcement
- Correctional institutions at which a patient may be an inmate
- Approved research projects
- Coroners, organ donation services, and funeral directors
- Workers compensation
- Change in ownership of Manahawkin Urgent Care Urgent Care
- The Food & Drug Administration
Manahawkin Urgent Care may use and/or disclose your PHI with your authorization in certain situations. You have the opportunity to authorize or object to the use and/or disclosure of all, or part, of your PHI in the following situations:
If an emergent situation exists where it is impossible to obtain your consent for PHI uses and/or disclosures, MedExpress will make every effort to obtain consent once the emergent situation is resolved.
Manahawkin Urgent Care will not use and/or disclose your PHI to any outside marketing agencies without your written authorization. If the marketing is to result in direct or indirect payment to Manahawkin Urgent Care by a third party, we will state this on the authorization form you sign.
If you authorize Manahawkin Urgent Care to use or disclose protected health information about you, you may revoke that permission in writing at any time and we will no longer use or disclose PHI about you for the reasons covered by your authorization. Please understand that we are unable to take back any uses or disclosures we have already made with your permission and that we are required to retain our records of the medical treatment or other services we have provided to you.
This designated record set includes any records that Manahawkin Urgent Care may have about you that are used for making medical treatment decisions. Under federal law, you may not inspect a copy of information being used in anticipation of legal proceedings, or PHI that is otherwise prohibited. In addition, you have a right to access your PHI in electronic format, where it is available.
You may ask us not to use and/or disclose part of your PHI for treatment, payment, or health care operations. You may also request that any part of your PHI not be disclosed to any of your family members. You must state the specific restriction request, and to whom it applies. Please submit these requests in writing to the Center Manager. Manahawkin Urgent Care has the right not to agree with your request in most circumstances. However, you have the right to require restrictions on disclosures of your PHI to a health plan where you paid out of pocket, in full, for items or services and Manahawkin Urgent Care is required to honor this request.
Please notify the Center Manager in writing of this request.
Please request an accounting list from the Center Manager.
Please submit requests to the Center Manager.
Manahawkin Urgent Care has the right to change the terms of this notice.
Manahawkin Urgent Care will inform you of any changes made to this Privacy Notice. Manahawkin Urgent Care will post a copy of the current Privacy Notice on the Manahawkin Urgent Care website, http://www.lbiurgentcare.com. The Privacy Notice will state the effective date in the top left corner.
In the event of any Breach of unsecured PHI, Manahawkin Urgent Care will fully comply with all legal requirements for breach notification, which will include notification to you of any impact a Breach may have had on you and/or your family members(s) and will inform you of the actions Manahawkin Urgent Care has undertaken to minimize any impact the Breach may or could have on you and/or your family member(s).
If you feel your rights have been violated and/or that Manahawkin Urgent Care has not followed this Privacy Notice, you may file a complaint. Please contact the Center Manager or Privacy Officer at 609-978-0242. In addition, you may file a complaint with the Secretary of the Department of Health and Human Services. You will not be retaliated against for making a complaint.