Uses and Disclosure of Health Information
This notice describes how medical information about you may be used and how you can get access to this information. Please review it carefully
Purpose of this Notice
BLISS HEALTH (“Bliss”) understands that medical information about you is personal, and protecting that information is important. We maintain records of the care and services you receive here so that we can continue to provide you with quality care and to comply with certain legal requirements. We are required by law to keep your medical information private. We must give you this notice of our legal duties and privacy practices. And we must follow the terms of this notice that is currently in effect. Your health information will not be used or disclosed for purposes other than those described in this notice without your authorization. Please note in most cases, your actual medical record is housed in your provider’s EMR or EHR and can be retrieved through their contact information.
Treatment, Payment and Health Care Operations
Bliss may use and disclose your protected health information for treatment, payment and health care operations. Some examples of when we may use or disclose your health care information for these purposes include, without limitation:
- Sharing treatment results with your referring physician or other health care providers for coordination of care or confirmation of a diagnosis;
- Providing your diagnosis or other information about your health to your health or other insurance carrier to obtain payment for the health care services we provide;
- Reviewing information as part of our quality improvement program.
Other Uses and Disclosures
Bliss may also use or disclose your protected health information, in compliance with guidelines outlined by law, for the following purposes:
- Providing you with information related to your health;
- Contacting you regarding appointments, information about service alternatives, or other health related services;
- Incidental uses or disclosures;
- Compliance with all laws (including reports of suspected abuse, neglect or violence);
- Providing certain specified information to law enforcement or correctional institutions;
- Providing information to a coroner, medical examiner, funeral director, or organ procurement organization;
- Public health activities when requested by a public health authority or the FDA.
- Responding to health oversight agencies;
- Responding to court or administrative tribunal orders, subpoenas, discovery requests or research activities;
- When necessary to avert a serious threat to health or safety;
- Military affairs, veterans affairs, national security, intelligence, Department of State, or presidential protective service activities;
- Providing information regarding your location, general condition or death to public or private disaster relief agencies; or
- Informing a family member, other relative or close personal friend when information is relevant to the individual’s involvement with your care;
- Notification of your location, general condition or death;
- To assist in your heath care (e.g., delivery medications, equipment or other supplies, note follow-up care instructions, etc.).
Authorization for Other Uses
Bliss will make other uses and disclosure of your protected health information only after obtaining your written authorization. If you authorize a use not contained in this notice, you may revoke your authorization at any time by notifying us in writing that you wish to revoke your authorization.
Your Rights Regarding the Privacy of Your Health Information
Subject to limitations outlined by law, you have certain rights related to use and disclosure of your protected health information, including the right to:
- Request restrictions on certain uses and disclosures related to treatment, payment, or health care operations. However, Bliss is not obligated to agree to requested restrictions. If we do agree, we will comply with your request unless the information is needed to provide you with emergency care.
- Receive confidential communications of protected health information.
- Inspect and copy your protected health information with some limited exceptions;
- Amend your health information;
- Receive an accounting of disclosures of your health information we have made for which you did not sign an authorization, except for uses regarding your treatment, payment or other health care operations;
- Obtain a copy of this notice.
Bliss’s Duties Regarding the Privacy Of Your Health Information
Subject to limitations outlined by law, Bliss has certain duties related to your protected health information, including:
- maintaining the privacy of protected health information and to provide individuals with notice of our legal duties and privacy practices with respect to protected health information.
- abiding by the terms of the privacy notice that is currently in effect.
Bliss reserves the right to change a privacy practice described in this notice and to make such change effective for all protected health information. Any revised notice will be posted on our website and available upon request.
For More Information or to Report a Problem
If you have questions and would like additional information, you may contact Mina Bancroft, who also serves as our Privacy Officer, at (844)282-5477 Ext 101 or email@example.com. If you believe your privacy rights have been violated, you may make or file a complaint by contacting our Privacy Officer at the above telephone number or the Secretary of the United States Department of Health and Human Services. No individual will be retaliated against for making or filing a complaint.
Enforcement of This Privacy Statement
If you have questions regarding this statement, you should contact us at firstname.lastname@example.org. If you do not receive acknowledgement of your inquiry or we have not addressed your inquiry to your satisfaction, you should then contact us through phone call at (844)282-5477 Ext 101
We welcome your comments regarding this privacy statement. If you have questions about this statement or believe that we have not adhered to it, please contact us by email at email@example.com
Our address is:
4819 Emperor Blvd
Durham, NC 27703