Notice of Privacy Practices

This Notice of Privacy Practices applies only to care and recommendations you receive through Synergy Healthcare USA LLC (SHC) at your place of employment under the federal law known as HIPAA that protects the privacy of your health information.  

 

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE READ IT CAREFULLY.

 

Effective Date: starts with enrollment in Synergy Healthcare USA LLC program at your place of employment

 

A. WE MUST PROTECT HEALTH INFORMATION ABOUT YOU

We must protect the privacy of personal health information (sometimes called “PHI” for short) about you that can be identified with you. PHI includes information about your past, present, or future health. This notice explains how we can use and disclose PHI about you and give you some examples. This Notice also explains your privacy rights and how you can file a complaint if you believe these rights have been violated.

 

We must follow this Notice. We may change this Notice and make the changes that apply to PHI we already have if we:

• Post the new notice in our website at www.synergyhealthcare.com.

• Make copies of the new notice available if someone asks for it through your Nurse Advocate or calling our office directly at 980-505-8401.

 

B. HOW WE CAN USE AND DISCLOSE PHI ABOUT YOU.

 

1. When We Can Use and Disclose PHI About You Without An Authorization. We may use and disclose PHI about you without your authorization in the following ways:

 

a. To provide healthcare treatment to you.

We use and share PHI with others to provide and coordinate your healthcare treatment. For example, the laboratory will need to provide us with any specimen results. Your PHI would also be provided to any physician to whom we make a referral on your behalf. 

 

b. For healthcare operations. We may use and share PHI to perform business activities that we call “healthcare operations” (such as using a national laboratory to run tests on samples obtained from you by our on-site assessment team) to help us improve the quality of care we provide and reduce healthcare costs. We may also use PHI to review our services or evaluate the performance of the people taking care of you. 

 

c. To remind you about appointments. We may use and/or disclose PHI to remind you about an appointment you have with us.

 

d. To tell you about treatment options. We may use and/or disclose PHI to tell you about treatment options that may interest you. For example, if you have diabetes, we may tell you about nutritional services that might help you.

 

g. To our business associates. We provide some services through other businesses we call business associates. We may give business associates health information about you so they can do the job we asked them to do. For example, we provide information to the national laboratory that runs our specimen samples. 

 

2. When We May Use And Disclose PHI About You Without An Authorization Or An Opportunity To Object. In some situations, we may use and/or disclose PHI about you without your authorization or an opportunity to object. These situations include when the use or disclosure is:

 

a. When it is required by law.

 

b. For public health activities. We may disclose PHI about you for public health activities. These activities generally include disclosing PHI in order to:

• Prevent or control disease, injury or disability

• Report births and deaths

• Report child and disabled adult abuse or neglect

• Report reactions to medicine or problems with medical products

• Tell people that a medical product they are using has been recalled

c. For health oversight activities. We may disclose PHI about you to a state or federal health oversight agency that is authorized by law to oversee our operations.

 

d. For a legal proceeding. We may disclose PHI about you if a judge orders us to.

 

e. For law enforcement purposes. We may disclose PHI about you to report certain types of wounds, physical injuries or criminal conduct on our property.

 

f. To avoid a serious threat to health or safety. We may disclose health information if it is necessary to protect the health and safety of you, the public or someone else.

 

3. When You Can Object To A Use Or Disclosure. Unless you tell us not to, we may use or share your PHI:

 

a. To people involved in your care. We may share PHI with family members or others identified by you, who are involved in your care. 

 

C. OTHER USES AND DISCLOSURES. In any situation other than those listed above, we will ask for your written authorization before we use or disclose your PHI. If you sign a written authorization allowing us to disclose PHI, you can cancel it later. Your cancellation must be in writing, and we will not disclose PHI about you after we receive your cancellation.

 

D. YOUR PRIVACY RIGHTS. You have the following rights about the health information we maintain about you. If you want to exercise your rights, you must notify us in writing regarding one or more of the following four topics listed below. Your letter should be mailed to: Privacy Officer, c/o Synergy Healthcare USA LLC, P.O. Box 1069, Denver, NC 28037.

 

1. Right to Ask for Restrictions. You have the right to ask us to limit the ways we use and disclose your PHI for treatment or healthcare operations. You also have the right to ask us to limit the health information we share about you to someone involved in your care. Your request must be in writing. We do not have to agree to your request if it conflicts with one of the legally required disclosure items found in section 2(a) – 2(f) above. But, we do have to agree if you ask us not to disclose PHI to your health plan or for our healthcare operations if the PHI is about an item or service you paid for, in full, out-of-pocket. Even if we agree, your restrictions may not be followed in some situations such as emergencies or when disclosure is required by law.

 

2. Right to Ask for Different Ways to Communicate with You. You have the right to ask us to contact you in a certain way or at a certain location. For example, you can ask us to only contact you at your work phone number. If your request is reasonable, we will do what you ask. 

 

3. Right to See and Copy PHI. You have the right to see and get a copy of the health information about you. You must sign a special form called an authorization. We may charge you a fee if you have asked for a copy of records. We can deny your request in some situations. If we deny your request, we will notify you in writing and explain how you can ask for a review of the denial.

 

4. Right to Ask for an Accounting of Disclosures. If you ask in writing, you can get a list of some, but not all, the disclosures we made of your health information. For example, the list will not include disclosures made for treatment, payment, healthcare operations or disclosures you specifically authorized. You may ask for disclosures made in the last six (6) years. We cannot give you a list of any disclosures made before April 14, 2003. If you ask for a list of disclosures more than once in 12 months, we can charge you a reasonable fee.

 

F. YOU MAY FILE A COMPLAINT ABOUT OUR PRIVACY PRACTICES. If you think we have violated your privacy rights, or you want to discuss our privacy practices, you can contact the Synergy Healthcare USA LLC Privacy Officer at 980-505-8403 or P.O. Box 1069, Denver, NC 28037.