Purpose

United Health Centers of San Joaquin Valley (UHC) upholds its’ duty to protect your privacy.  Under HIPAA we are required to provide the Notice of Privacy Practices.  This notice goes over how your protected health information (PHI) may be used and your rights to protect it.

The Notice of Privacy Practices is subject to change, at any given time.  All changes will reflect on this page, and will be accessible to anyone who has access to internet connection.  Upon your request, we can provide you with an electronic or paper copy.

Who

All employees at UHC are required to abide by this notice.  Which includes providers, clinical team, corporate staff, contracted employees, staffing agency employees, call centers.

How We May Use and Disclose Health Information About You

UHC will provide you with a consent form to complete.  This consent form is confirmation that we can use and disclose your PHI for treatment, payment, and operations use only. 

Below are the following ways we may use or disclose your PHI for Treatment, Payment and Operations:

Treatment

Your PHI will be used to provide, coordinate, or manage your health care and any related services.  If required for treatment purposes, your provider may share your PHI with another provider added to your treatment plan.  UHC may use or disclose your PHI to external providers for treatment purposes only, such as laboratory, x-rays, or a specialist.  We may use your PHI to coordinate your care with a home health agency that provides care to you (if applicable). 

Example:

When a patient receives a blood draw this is performed by a lab group who will have your PHI for treatment use.

If a patient is getting treated for diabetes and has to return to acute care for after surgery care, UHC would disclose the treatment for the diabetes to the assigned physician at the facility.

Payment

PHI will be disclosed to health insurance plans for confirming the coverage of your health insurance and which services are covered.  Your PHI may be sent to health insurance plans to approve a service prior to it being performed or whether it is deemed necessary.  Pre-authorization requests with information about treatment that is planned would be sent prior to receiving this treatment.

Your protected health information will be used, as needed, to obtain payment for your health care services. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we recommend for you.  Examples are: deciding of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities.

Example:

Annual physicals are only performed once a year, if you need one we would confirm that you did not have one performed in that given year.

Obtaining approval for a hospital stay may require that your relevant protected health information be disclosed to the health plan to obtain approval for the hospital admission. 

Healthcare Operations

We may use or disclose your PHI for health care operations.  To provide you with the utmost of care, we use our patients’ experience and care to review the quality of care provided.  A few instances we would use your PHI for operational use are: appointment preference, services requested, location of care, and more.  We may use the services you received to ensure if we need more resources in place or additional providers who specialize for these services.  Your treatment and care may be evaluated to ensure our staff is caring for you properly.  Information we receive on care and treatment of patients may be used in training to provide better care for our patients.  Your PHI may be shared with our third party vendors for quality purposes. 

Example:

If patients are more likely to schedule appointments for diabetes check in one location, we then would plan to have more resources and treatment for diabetes available.

Below are additional ways we may use or disclose your PHI:

Others Involved in Your Healthcare

We may disclose your PHI to a member of your family, a relative, a close friend or any other you authorize to be involved in the health care plan. In situations where you are not able to agree or object to this disclosure, we may disclose this using our professional judgement. Additionally, your PHI may be disclosed or used to notify a family member, personal representative or caregiver.

Emergencies

In the case of any emergency, we may use or disclose your protected health information. Your physician will try to obtain your consent before and/or after treatment.  In the instance, where the you are not able to provide consent the physician may need to disclose your PHI to your family, relative or any other caregiver to provide the correct treatment. 

Abuse or Neglect

In the case of reported abuse and neglect (child or elderly), we may disclose your PHI to a public health authority that is authorized by law to receive these reports. If you have been a victim of abuse, neglect or domestic violence we may be required to report this to the appropriate party in accordance to the federal and state laws. 

Required By Law

We may use or disclose your protected health information if required by federal, state or local law.  You will be notified if your PHI is used or disclosed in this instance.

Legal Proceedings

We may disclose your PHI in the course of any judicial or administrative proceedings.  For example, in response to a subpoena, discovery request or other lawful process. 

Law Enforcement

We may disclose your PHI, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual. We may also disclose PHI for law enforcement purposes, such as: (1) legal processes and otherwise required by law, (2) limited information requests for identification and location purposes, (3) pertaining to victims of a crime, (4) suspicion that death has occurred as a result of criminal conduct, (5) in the event that a crime occurs on the premises of the practice, and (6) medical emergency (not on the Practice’s premises) and it is likely that a crime has occurred. 

Inmates

We may use or disclose your PHI if you are an inmate of a correctional facility. Your PHI will be disclosed to the correctional facility and/or the law enforcement official.  This disclosure is the ensure you receive similar treatment at the correctional facility if needed.

Military Activity and National Security

When the appropriate conditions apply, we may use or PHI of individuals who are Armed Forces personnel for: (1) activities deemed necessary by appropriate military command authorities; (2) the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) foreign military authority if you are a member. We may also disclose your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized. 

Workers’ Compensation

We may disclose or use your PHI in the case of treatment or applying for workers’ compensation.

Public Health

We may disclose your PHI to a public health authority.  This disclosure will be done on an as needed basis.  Examples include: controlling disease, injury or disability or if information is needed to prevent transmission of the disease.  If you are exposed to a contagious disease that is easily transmissible, we may disclose your information to protect others who may be at risk for contracting this disease. 

Health Oversight

We may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws. 

Food and Drug Administration

We may by required, by the Food and Drug Administration (FDA), to disclose your PHI.  This disclosure will be relevant to any events that occurred related to Food or Drugs approved by the FDA.  Examples of such are: adverse events, product defects or problems, biologic product deviations, track products, to enable product recalls, or to conduct post marketing surveillance. 

Coroners, Funeral Directors, and Organ Donation: 

We may disclose protected health information to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose protected health information to a funeral director, in order to permit the funeral director to carry out their duties. We may disclose such information in reasonable anticipation of death. Protected health information may be used and disclosed for cadaveric organ, eye or tissue donation purposes. 

Facility Directories: 

We may use and/or disclose your PHI in our facility directory only if you are under care at the facility.  The information that may be used and disclosed is not limited to: you name, where you are getting treatment, religious affiliation and your condition.  If someone comes into the facility asking for you by using your full name we may disclose the information above to them.  If a priest or clergy asks for you, your religious affiliation may be released to them.  You have a right to object to this use and disclosure.

Marketing

We may use and disclose your protected health information for marketing activities. For example, your name and address may be used to send you a newsletter about our practice and the services we offer. We may also send you information about products or services that we believe may be beneficial to you. If you prefer to opt out of these may contact our office at (800) 229-4943.

Fundraising

We may use or disclose your PHI in order to contact you for fundraising events supported by the UHC Foundation. If you would like to opt out please contact our office at (800) 229-4943. 

Research

Your PHI may be disclosed and used for research.  Although research projects need to be approved by the institutional review board, your PHI may be disclosed to the researcher to ensure your information is needed for the project.  If your PHI is compatible with the research, after the project is approved the researchers will have a form or document available on how your PHI is protected.

Your Rights for Use and Disclosure of your PHI

You have the right to inspect and copy your PHI. 

You may inspect and obtain a copy of your PHI that is contained in a designated record set for as long as we maintain the protected health information. A “designated record set” contains medical and billing records and any other records that your physician and the practice use.

However, under federal law you may not inspect or copy the following records; psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and protected health information that is subject to law that prohibits access to protected health information. Depending on the circumstances, a decision to deny access may be reviewable. In some circumstances, you may have a right to have this decision reviewed. Please contact our office at (800) 229-4943, if you have questions about access to your medical record. 

You have the right to request a restriction of your protected health information. 

You may ask us not to use or disclose any part of your PHI for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply to. 

Your physician is not required to agree to a restriction that you may request. If physician believes it is in your best interest to permit use and disclosure of your PHI, your PHI will not be restricted, If your physician does agree to the requested restriction, we may not use or disclose your PHI unless it is needed to provide emergency treatment. Please discuss any restriction you wish to request with your physician. Please make this request for a restriction in writing to the Administration Office, 3875 W. Beechwood Ave, Fresno, CA 93711 or call (800) 229-4943.

You have the right to request to receive confidential communications from us by alternative means or at an alternative location. 

We will accommodate reasonable requests. We may also condition this accommodation by asking you for information on how payment will be handled, specification of an alternative address, or other forms of contact.  Please make this request in writing to the Administration Office, 3875 W. Beechwood Ave, Fresno, CA 93711 or call (800) 229-4943.

You may have the right to have your physician amend your PHI. 

You may request an amendment of your PHI in a designated record set for as long as we maintain this information. In the case the physician used his/her best professional judgement and does not agree with the amendment submitted, it may be denied. If we deny your request for amendment, you have the right to file a statement of disagreement with us and may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. Please contact: Administration Office, 3875 W. Beechwood Ave, Fresno, CA 93711 or call (800) 229-4943 to determine if you have questions about amending your medical record. 

You have the right to receive an accounting of certain disclosures we have made of your PHI. 

This right applies to UHC disclosing your PHI for non T.P.O. reasons.  It excludes disclosures we may have made to you, to the facility directory, family members or friends involved in your care. You have the right to receive the accounting of disclosures that occurred after April 14, 2003.  The right to receive this information is subject to certain exceptions, restrictions and limitations.

You have the right to obtain a paper copy of this notice from us, upon request.

Complaints

If you feel that your privacy has been violated and need to report a complaint please notify UHC or the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filling a compliant.