Notice of Privacy Practices

Each time you visit a hospital, physician, or other healthcare providers, the provider makes a record of your visit. Typically, this record contains your health history, current symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your medical record, serves as:

  • Basis for planning your care and treatment

  • Means of communication among the many health professionals who contribute to your care

  • Legal document describing the care you received

  • Means by which you or a third-party payor can verify that you received the services billed for

  • A tool in medical education

  • A source of information for public health officials charged with improving the health of the regions they serve

  • A tool to assess the appropriateness and quality of care you received

  • A tool to improve the quality of healthcare and achieve better patient outcomes Understanding what is in your health records and how your health information is used helps you to:

  • Ensure its accuracy and completeness

  • Understand who, what, where, why, and how others may access your health information

  • Make informed consent decisions about permitting disclosure to others

  • Better understand how to protect your right to confidentiality

  • Better understand the health information rights detailed below

 

OUR RESPONSIBILITY UNDER THE FEDERAL PRIVACY STANDARD

Life Recovery Center has a duty to protect the privacy of health information about you, called “protected health information,” or “PHI,” for short. Life Recovery Center must give you notice of its legal duties and privacy practices concerning PHI. Life Recovery Center’s responsibilities including the following:

  • Maintain the privacy of your health information, including implementing reasonable and appropriate physical, administrative and technical safeguards to protect the information

  • Provide you with this notice as to Life Recovery Center’s legal duties and privacy practices with respect to PHI about you

  • Explain how, when and why Life Recovery Center uses and/or discloses PHI about you

  • Abide by the terms of this Notice, as may be revised from time to time

  • Train Life Recovery Center personnel concerning privacy and confidentiality

  • Implement a sanction policy to discipline those who breach privacy/confidentiality or Life Recovery Center policies with regard thereto

  • Mitigate (lessen the harm of) any breach of privacy/confidentiality

Life Recovery Center will make copies of the Notice available at its facilities upon request. If you would like a copy printed for you, please request one from a staff member. Life Recovery Center will also post this Notice on our patient portal and website, so that you may receive it electronically.

 

Life Recovery Center reserves the right to change the terms of this Notice and to make the new provisions effective for all PHI it maintains. Should Life Recovery Center change this Notice, Life Recovery Center will promptly:

  • Post the revised Notice in its facility

  • Make copies of the revised Notice available upon request through our patient portal, through agency staff, and on our website

  • Post the revised notice on its website

 

Life Recovery Center will not use or disclose your health information without your consent or authorization, except as described in this Notice or as otherwise required by law.

 

LIFE RECOVERY CENTER MAY USE AND DISCLOSE PHI ABOUT YOU WITHOUT YOUR CONSENT OR AUTHORIZATION IN THE FOLLOWING CIRCUMSTANCES:

In general, Life Recovery Center is required by law to obtain your written consent or authorization prior to using or disclosing your PHI that does not identify you as a substance abuser or a patient of the substance abuse services. However, there are exceptions to this requirement.

 

TREATMENT: Within Life Recovery Center, employees, students, and consultants involved in your case, treatment, or habilitation may exchange PHI as necessary for the purpose of carrying out their responsibilities in serving you. Upon specific request, your PHI may be released to the physician or psychologist who referred you to Life Recovery Center. A professional at Life Recovery Center may disclose your PHI, as necessary, to another physician or health care provider who provides you with emergency medical services.

 

NEXT OF KIN: In addition, Life Recovery Center may disclose the fact of your admission or discharge to your next of kin, if the next of kin or the responsible professional determines that such disclosure is in your best interest. If you have next of kin who is substantially involved with your care, upon his or her request, Life Recovery Center shall provide these kin with information relating to your admission and discharge from Life Recovery Center, any decision on your part to leave Life Recovery Center against medical advice, and referrals and appointment information for treatment after discharge after Life Recovery Center notifies you that such information was requested.

 

BUSINESS ASSOCIATES: Life Recovery Center also may disclose your PHI to providers of support services who have entered into Business Associates Agreements with Life Recovery Center. Life Recovery Center provides some services through contracts with “Business Associates.” For example, Life Recovery Center may provide certain diagnostic tests through a third party, or it may contract with a copy service to make copies of medical records. These entities constitute Business Associates of Life Recovery Center; when the hospital contracts for these services, Life Recovery Center may disclose your PHI to a Business Associate including a subcontractor that acts on behalf of the Business Associate so that it can perform the function(s) Life Recovery Center has contracted with them to do and bill you or third-party payor for services rendered. To protect your PHI, Life Recovery Center requires the Business Associate to appropriately safeguard your information in accordance with a written agreement.

 

OTHER PERMITTED USES AND DISCLOSURES: In addition, Life Recovery Center may use or disclose PHI that does not identify you as a substance abuser or a patient of substance abuse services without your written consent or authorization as follows:

  • To an internal client advocate as necessary to fulfill his or her monitoring and advocacy functions

  • To disclose an advance instruction to a physician, psychologist or other qualified professional when such disclosure is necessary to give effect to or provide treatment in accordance with the advance instruction

  • To State or Federal governmental agencies, when there is a reason to believe that you may be eligible for financial benefits through the government agency, to establish such financial benefits

  • To the state for certain purposes of research and evaluation, or for conducting general research or audits

  • For the purposes of alerting others to an imminent danger to you, or another’s health or safety, or if there is a likelihood of the commission of a felony or violent misdemeanor, or to communicate with appropriate law enforcement in the event of your escape from Life Recovery Center

  • To an attorney, upon your request or the request of your legally responsible person

  • As required by law – for example, when a court orders disclosure or when child abuse or neglect is suspected

  • For purposes of filing a petition for involuntary commitment or a petition for an adjudication of incompetence and the appointment of a guardian

  • As required by state law when you are a defendant in a criminal case, or to the court and counsel involved in any commitment or other court hearings you face

  • To Life Recovery Center counsel, or counsel for an employee of Life Recovery Center, if such information is relevant to litigation, to the operations of Life Recovery Center, or to the provision of services by Life Recovery Center

  • To the Department of Corrections, upon request, if the Department has determined that you need treatment for mental illness or developmental disability

  • To disclose PHI regarding communicable diseases, as discussed below

  • As necessary to comply with other State or Federal law, including disclosure to the State and/or Federal Department of Health and Human Services as necessary, for a determination that Life Recovery Center is compliant with the federal privacy standards

 

ALCOHOL AND DRUG ABUSE RECORDS: If you receive substance abuse services from Life Recovery Center, federal law generally requires that Life Recovery Center cannot disclose PHI that would identify you as a substance abuser or a patient of substance abuse services without your written consent. There are some exceptions to this requirement. Life Recovery Center may use or disclose PHI that would identify you as a substance abuser or a patient of substance abuse services without your consent or authorization as follows:

 

  • Within Life Recovery Center for activities related to the provision of substance abuse diagnosis, treatment, or referral for treatment

  • AS permitted by a court order

  • To medical personnel in a medical emergency

  • To qualified personnel for research, audit, or program evaluation

  • To comply with State law mandating the reporting of suspected child abuse or neglect

  • To communicate with law enforcement personnel about a crime or threatened crime on the premises of Life Recovery Center or against Life Recovery Center personnel

 

COMMUNICABLE DISEASES: If you have one of several specific communicable diseases (for example, tuberculosis, syphilis, or HIV/AIDS), Life Recovery Center will treat PHI about your disease as confidential and will disclose such PHI without your written consent only in limited circumstances as permitted or required by law. Life Recovery Center may use or disclose PHI about your disease without your consent or authorization as follows:

  • To health care personnel providing medical care to you

  • As necessary to protect public health

  • As permitted by a subpoena or court order

  • To local or State health directors, upon request

  • As otherwise permitted or required by laws specifically addressing the release of information or records related to HIV/AIDS

 

Life Recovery Center may use or disclose PHI about you without your consent in the following circumstances:

TREATMENT: Life Recovery Center may use and disclose your PHI to provide, coordinate, or manage your health care and related services, including the disclosure of your PHI to health care providers outside of Life Recovery Center. For example, Life Recovery Center may use and disclose your PHI when referring you to another health care provider. Life Recovery Center also may disclose your PHI to individuals who may be involved in your medical care after you leave Life Recovery Center. For example, if you are referred to a counselor or psychiatrist for follow-up treatment at Life Recovery Center.

PAYMENT: Life Recovery Center may use and disclose your PHI to bill and collect payment for treatment and services provided to you. For example, Life Recovery Center may share your PHI with your health plan(s) in order to request coverage and obtain approval prior to providing services to you (in non- emergency situations).

 

Life Recovery Center may send a bill to you or to third party payor, and this bill may include PHI such as your diagnosis, treatment received, and list of supplied used. Life Recovery Center may share portions of your PHI, as necessary, with billing departments, collection agencies, insurance companies, and other health care providers.

 

NOTE: You do have the right to restrict the uses and disclosures of PHI to health plans if you have paid for services out of pocket in full.

 

HEALTH CARE OPERATIONS: Life Recovery Center may use and disclose PHI to perform business activities i.e. “health care operations.” These health care operations enable Life Recovery Center to improve the quality of care that it provides. For example, members of Life Recovery Center, medical staff, its risk manager, and other team members may use PHI to assess the care and outcomes in your case, to continually improve the quality and effectiveness of health care services provided. Life Recovery Center also may use your PHI in order to provide training programs for its employees to resolve grievances within the organization or review and evaluate the skills and qualifications of health care providers who are treating you.

 

MINIMUM NECESSARY STANDARD: When using or disclosing your PHI or when requesting your PHI from another entity, Life Recovery Center will make reasonable efforts not to use, disclose, or request more than the minimum amount of PHI necessary to accomplish the intended purpose of the use, disclosure or request, taking into consideration practical and technological limitation. However, the minimum necessary standard will not apply in the following situations:

  • Disclosures to or requests by a health care provider for treatment

  • Uses or disclosures made to you

  • Uses or disclosures made pursuant to an authorization

  • Disclosures made to the Secretary of the US Department of Health and Human Services

  • Uses or disclosures that are required by law

  • Uses or disclosures that are required for Life Recovery Center' compliance with legal regulations

 

YOUR RIGHTS UNDER THE FEDERAL PRIVACY STANDARDS

Although your health records are the physical property of the healthcare provider who completed them, you have certain rights regarding the information contained therein.

You have a right to request restrictions on uses and disclosures of your health information by submitting a request in writing. The right to request does not extend to certain uses or disclosures permitted or required by law, such as uses or disclosures for public health activities. In those cases, you do not have the right to request restriction. Life Recovery Center is not required to agree to your requested restriction. However, if Life Recovery Center does agree to restriction, it will comply with the restriction unless the information is needed to provide emergency treatment to you, or the disclosure is otherwise required under federal regulations.

 

You have the right to request how and where Life Recovery Center contacts you about PHI. For example, you may request that Life Recovery Center contact you at your work address or phone number. Your request must be in writing. Life Recovery Center is required to accommodate all reasonable requests.

 

You have the right to obtain a paper copy of this Notice at any time by contacting the facility Privacy Official. Life Recovery Center will provide a copy of this Notice no later than the date you first receive treatment at the facility, except in emergency situations, and then Life Recovery Center will provide the Notice to you as soon as reasonably practical after the emergency treatment situation.

 

You have the right to inspect a copy of your PHI upon submission of a written request. Again, this right is not absolute and in certain situations, Life Recovery Center can deny access – for example, if a licensed health care professional believes that access to such information could cause harm to your physical or mental well-being.

 

You do not have a right of access to the following:

  • Psychotherapy notes. These include notes that are recorded in any medium by a mental health professional documenting or analyzing a conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of your medical record

  • Information compiled in reasonable anticipation of or for use in civil, criminal, or administrative actions or proceedings

  • Protected Health Information (PHI) that is subjected to the Clinical Laboratory Improvement Amendments of 1988 (“CLIA”), 42 U.S.C. Section 263a, to the extent that the provision of access to the individual would be prohibited by law

  • Information obtained from someone other than a healthcare provider under a promise of confidentiality and the access requested would be reasonably likely to reveal the source of the information

 

In other situations, the provider may deny you access, but if it does, the provider must provide you with an opportunity to have the denial reviewed by another licensed professional within 60 days of the denial. These “reviewable” grounds for denial include:

  • Licensed healthcare professional has determined, in the exercise of professional judgment, that the access is reasonably likely to endanger the life or physical safety of the individual or another person

  • Protected Health Information makes reference to another person (other than a healthcare provider) and a licensed healthcare provider has determined, in the exercise of professional judgment, that providing access is reasonably likely to cause substantial harm to such other person

  • The request is made by the individual’s personal representative and a licensed healthcare professional has determined, in the exercise of professional judgment, that providing access to such personal representative is reasonably likely to cause substantial harm to the individual or another person

If Life Recovery Center denies you access to your PHI, Life Recovery Center will explain why and what your rights are, including how to seek review. If Life Recovery Center grants you access to you PHI, Life Recovery Center will give you instructions on any additional steps, if needed, for you to have access to the information. Life Recovery Center reserves the right to charge a reasonable fee for making copies of the requested PHI.

You have the right to request in writing amendment of your PHI. Life Recovery Center may deny your request if:

  • Life Recovery Center did not create the record unless you provide a reasonable basis to

  • believe the originator of the PHI is no longer available to act on the requested amendment

  • The records are not available for your access, as discussed above in number 4

  • The record is accurate and complete

  • The PHI that is the subject of your request is not maintained by or for Life Recovery Center

 

If Life Recovery Center denies your request for amendment, Life Recovery Center will notify you why and how you can submit a written statement disagreeing with the denial (which may be rebutted by Life Recovery Center) and how you can complain to Life Recovery Center about the denial.

If Life Recovery Center grants the request, Life Recovery Center will make the correction and distribute the correction to those who need it and those you identify to Life Recovery Center that you want to receive the corrected information.

 

You have the right to obtain an accounting of certain disclosures by Life Recovery Center of your PHI during the six years prior to the date of your request. However, Life Recovery Center does not need to provide an accounting for:

  • Disclosures to persons involved in the individual’s care or disclosures for other notification purposes as provided in Section 164.510 of the HIPAA Privacy Rules (uses and disclosures requiring an opportunity for the individual to agree or to object, including notification to family members, personal representatives, or other persons responsible for the care of the individual, of the individual’s location, general condition or death)

  • National security or intelligence purposes under Section 164.512 (k)(2) (disclosures not requiring consent, authorization, or an opportunity to object, see Chapter 16)

  • Correctional institutions or law enforcement officials under Section 164.512 (k)(5) (disclosures not requiring consent, authorization, or an opportunity to object)

  • Disclosures of PHI made prior to the compliance date, April 14, 2003

  • Disclosures of PHI made to carry out treatment, payment or health care operations

  • Disclosures of PHI made to you about your own PHI

  • Disclosures of PHI incidental to a permissible disclosure

  • Disclosures of PHI made pursuant to your written authorization

 

Life Recovery Center must respond to the request for accounting within 60 days of the request by providing the accounting or by granting itself a one-time 30-day extension in which to provide the accounting. The accounting will include:

  • Date of each disclosure

  • Name and address, if known, of the organization or person who received the protected health information

  • A brief statement of the purpose of the disclosure that reasonably informs you of the basis for the disclosure or, in lieu of such statement, a copy of the written request for disclosure where permitted by law

The first accounting in any 12-month period is free. Thereafter, Life Recovery Center reserves the right to charge a reasonable retrieval and copying fee.

You have the right to revoke your consent or authorization to use or disclose health information in accordance with the instructions on the consent or authorization form, except to the extent that we have already acted in reliance on the consent or authorization.

 

Life Recovery Center is required to notify you and obtain your authorization for the following uses and disclosures:

  • Any uses and disclosures for marketing purposes

  • Any uses and disclosures that constitute the sale of PHI

  • Most uses and disclosures of Psychotherapy notes (as described in number 4)

  • Other uses and disclosures not described in this notice Pursuant to 45 C.F.R. 160 and 164;

 

You have the right to be notified in the event of a breach of PHI. A “Breach” is defined as “the acquisition, access, use or disclosure of PHI in a manner not permitted under subpart E of this part which compromises the security or privacy of PHI.” Any “acquisition, access, use or disclosure of PHI in a manner not permitted under subpart E is presumed to be a breach unless the covered entity or Business Associate, as applicable, demonstrates that there is a low probability that the PHI has been compromised based on a risk assessment.”

 

HOW TO REPORT A PROBLEM

You have the right to complain to Life Recovery Center by notifying the designated Privacy Officer, 8150 Madison Avenue, Indianapolis, IN 46227; phone 317.887.3290 x0, or e-mail recovery@liferecoverycenter.net. Life Recovery Center will not retaliate against you for filing a complaint. You may also complain to the Secretary of Health and Human Services at 1-877-696-6775, 200 Independence Avenue SW, Washington, DC 20201 if you believe your rights to privacy have been violated.

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Life Recovery Center's treatment programs are certified by the Indiana FSSA Department of Mental Health and Addiction, the Indiana Coalition Against Domestic Violence, and the Indiana Problem Gambling Awareness Program. 

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