Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASR REVIEW THIS NOTICE CAREFULLY
Questions? If you have questions about this Notice or need additional information, please contact us at 505-508-1739.
Protection of Health Information We understand that your health information is personal, and we are committed to protecting your health information. Clinica La Esperanza, creates records of the care and services provided to you. We need these records to provide you with quality care and services and to comply with certain legal requirements.
Purpose of Notice This notice describes how we may use and disclose your health information to carry out treatment, payment or health care operations and for other purposes permitted or required by law. It also describes your legal rights to access and control your health information.
Who Will Follow this Notice? This Notice describes the privacy practices of Clinica La Esperanza, its employees, clinics and other programs, as well as its affiliated healt care professionals who work for us on our behalf. We will share information with each other as necessary to carry out our respective treatment obligations, payment activities and health care operations.
Your Rights Although the records containing your health information are the property of Clinica La Esperanza, the information belongs to you. By law, you have the right to:
- Inspect and obtain a copy of your health information. Generally, we will respond to your request 30 days but, under circumstances, we may deny your request.
- Request a restriction on certain uses and disclosures of your health information; however, we are not required to agree to a request restriction.
- Request that we communicate with you by using alternative means or at an alternative location.
- Request an amendment of your health information, if you believe it is inaccurate; however, we may deny your request for amendment if we believe your health information is accurate.
- Request an accounting of certain disclosures we have made, if any, of your health information.
- Restrict disclosures to health plans where you have paid out-of-pocket and in full for care.
- Opt out of receiving fundraising communications from Clinica La Esperanza.
- Revoke any authorization you have provided to use or disclose your health information except to the extent that action has already been taken in reliance on such authorization.
- Obtain a paper copy of this Notice upon request.
- You can exercise any of these rights by speaking with the Office Manager of the Clinica La Esperanza site at which you received care or services, or by contacting us at 505-508-1739.
Our Duties We are required by law to:
- Maintain the privacy of your health information.
- Not sell your health information without your consent.
- Notify you following a breach of unsecured health information.
- Provide you with a copy of our Notice of Privacy Practices.
- Abide by the terms of our Notice of Privacy Practices.
How We May Use and Disclose Your Health Information The following are examples
of the types of uses and disclosures of your health information that are permitted:
Treatment. We may use and disclose your health information to provide, coordinate or manage your health care and any related services. For example, we may disclose your health information to the doctors or technicians that care for you, even if the doctors or technicians are not affiliated with Clinica La Esperanza.
Payment. Your health information may be disclosed, as needed, to obtain payment from your insurance company or other person/party responsible for payment services we provide to you. For example, we may disclose your health information to your health plan to determine your eligibility or coverage for insurance benefits.
Health Care Operations. We may use or disclose your health information for our internal operations, which include activities necessary to operate the Clinica La Esperanza sites or programs from which you receive services. For example, we may use your health information for quality improvement services to evaluate the care or other services provided to you. We may also use your health information to evaluate the skills and qualifications of our health care providers, or to resolve grievances within our organization.
Appointment Reminders and Treatment Alternatives. We may use and disclose your health information to provide a reminder to you about an appointment you have with us for treatment or health care. We may also use or disclose your health information to tell you about or recommend possible treatment options or alternatives or inform you of other health-related benefits and services, that may be of interest to you.
Other Permitted Uses and Disclosures We may use and/or disclose your health information in a number of circumstances in which it is not required that we obtain your consent or authorization or provide you with an opportunity to agree or object. Those circumstances include:
- Unless you object, we may disclose your health information to a family member, relative, close friend or other person that you identify.
- We may be required by law to disclose your health information.
- We will make your health information available to you and the Secretary of the Department of Health and Human Services.
- We may disclose your health information to a public health agency to help prevent or control disease, injury or disability. This may include disclosing your health information to report certain diseases, death, abuse, neglect or domestic violence or reporting information to the Food and Drug Administration, if you experience an adverse reaction from any of the drugs, supplies or equipment that we use.
- We may disclose your health information to government agencies so they can monitor, investigate, inspect, discipline or license those who work in the health care system or for government benefit programs.
- We may disclose your health information as authorized by law to comply with workers’ compensation laws.
- We may disclose your health information in the course of a judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), and in response to a subpoena, discovery request, or other lawful process.
- We may disclose your health information to law enforcement officials to report or prevent a crime, locate or identify a suspect, fugitive or material witness or assist a victim of crime.
- We may use or disclose health information for research purposes when the research received approval of an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.
- If you are a member of the armed forces, we may disclose your health information as required by military command authorities or to evaluate your eligibility for veteran’s benefits, for conducting national security and intelligence activities, including providing protective services to the President of the United States or other persons providing protective services under Federal law.
- We may disclose your health information to coroners, health examiners and funeral directors so that they can carry out their duties or for purposes of identification or determining cause of death.
- We may disclose your health information to people involved with obtaining, storing or transplanting organs, eyes or tissue of cadavers for donation purposes.
- We may use or disclose your health information to prevent or avert a serious threat to your health or safety, or the health or safety of another person.
- We may disclose your health information to a health oversight agency that is authorized by law to oversee operations.
- If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release your health information to the law enforcement official or correctional institution. This disclosure is required for the institution to provide health care for you, to protect the health and safety of others, or to protect the health and safety of law enforcement personnel or correctional facility staff.
- We may share your health information with third party “business associates” that perform various services for us. For example, we may disclose your health information to third parties to provide billing or copying services. To protect your health information, however, we require our business associates to safeguard your health information.
Other Uses and Disclosures of Health Information Other uses and disclosures of your health information not covered by this Notice or applicable law will be made only with your written authorization. If you give us your written authorization to use or disclose your health information, you may revoke your authorization, in writing at any time. If you revoke your authorization, we will no longer use or disclose your health information for the reasons covered by your written authorization. You understand that we are unable to take back any uses and disclosures that we have already made with your authorization, and that we are required to retain our records of the care or services that we have provided you.
New Mexico Law In the event that New Mexico law requires us to give more protection to your health information than stated in this Notice or required by Federal law, we will provide that additional protection. For example, we will comply with state law confidentiality provisions relating to communicable diseases, such as HIV and AIDS. We will also comply with additional state law confidentiality protections relating to treatment for behavioral health and substance abuse. Those laws generally require that we obtain your consent before we disclose your information related to behavioral health or substance abuse, subject to certain exceptions permitted by law.
If you apply for and receive substance abuse services from us, Federal law (42 CFR Part 2) requires that we obtain your written consent before we may disclose information that would identify you as a substance abuser or a patient for substance abuse services. These are exceptions to this general requirement. We may disclose such information to our workforce as needed to coordinate your care, to agencies or individuals who help us carry out services to you; when the disclosure is allowed by a court order; or the disclosure is made to health personnel in a health emergency or to qualified personnel for research audit, or program evaluation. Federal law does not protect any information about crime committed by a patient either at the program or against any person who works for a program or about any threat to commit such a crime. Federal law does not protect any information about suspected child abuse or neglect from being reported under State law to appropriate State or local authorities.
Changes to this Notice We reserve the right to change our privacy practices and/or this Notice. If we revise this Notice, the revised Notice will be effective for all health information we maintain. Any revised Notice will be available by accessing our website, www.abqesperanza.com or you can obtain a copy of the revised Notice by requesting that we send you a copy by mail or by requesting a copy upon your next visit to one of our sites.
Complaints If you believe your privacy rights have been violated, you may file a written complaint with our Office Manager or the Secretary of the Department of Health and Human Services. You may submit your written complaint to Clinica La Esperanza, 4201 Central Ave NW, Albuquerque NM 87105 or you may call us at the phone numbers listed at the top of this Notice. We will not retaliate against you for filing a complaint.