This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
If you have any questions about this notice or if you need more information, please contact our Privacy Officer at 603-668-6688.
About This Notice
Certain information contained in the record of your medical care generated by a hospital, physician, or other healthcare provider is referred to as Protected Health Information. Protected Health Information includes your name, address, and other identifying data, as well as information about your health and the health services that you may receive or have already received. This notice describes the privacy practices of Corflex Global. It applies to all Protected Health Information about you that is maintained by Corflex Global, including any such information that is maintained on paper, electronically, or verbally spoken. This notice serves to tell you how Corflex Global may use and disclose the information that has been collected and what rights you have with respect to your medical information.
How We May Use or Disclose Your Protected Health Information
Corflex Global is permitted to use and disclose your medical information in accordance with federal and state regulations. The Health Insurance Portability and Accountability Act (HIPAA) is a set of Federal Regulations which safeguard the privacy and security of your Protected Health Information and establishes certain rights with respect to your Protected Health Information. At times, State or other regulations may afford more protection or provide additional patient rights that exceed the regulations outlined under HIPAA. In these and all other applicable cases, Corflex Global will abide by the most stringent of the regulations as they pertain to Protected Health Information, including obtaining your prior written authorization, as required, before any such information is disclosed to a third party.
The following set of categories outlines the different ways in which Corflex Global uses and discloses Protected Health Information. Not every use and disclosure is explicitly listed. However, all permitted uses and disclosures of Protected Health Information that are allowable under the law fall within one of these categories.
• For Treatment. Corflex Global may use or disclose your Protected Health Information in an effort to provide the most comprehensive treatment and service and to better manage and coordinate your care. We may disclose medical information to many health professionals who are involved in taking care of you.
• For Payment. Corflex Global may use and disclose your Protected Health Information so that we can bill for treatment and services that were provided to you in order to collect payment from you, a health plan, or a third party. This use and disclosure of information may include actions that your health insurance provider may undertake before it approves or pays for healthcare services. For example:
– We may share medical information with your health plan that is required by the plan to determine whether the services that you request are eligible to be covered by your health plan.
– We may share medical information with your health plan and reviewing services to determine medical necessity.
• For Health Care Operations. We may use and disclose Protected Health Information for activities that Corflex Global engages in to operate its business. These activities are used and performed by Corflex Global and in some cases third-party contractors, to run our programs and ensure that all of our patients receive the best care. For example, we may use your Protected Health Information to:
– Perform quality assessment and quality improvement activities
– Peer review, including evaluating practitioner performance
– Credentialing, licensing and training programs
– Business planning and development
• We may disclose Protected Health Information of children, who are considered to be minors, to their parents or legal guardians unless such disclosure in prohibited by law.
Special Situations: How We May Use and Disclose Your Protected Health Information Without Your Consent, Authorization, or Opportunity to Agree or Object Verbally
Under certain circumstances, Corflex Global may use or disclose your Protected Health Information without your authorization or any other type of permission from you. These circumstances are as follows:
• As Required By Law. We will disclose Protected Health Information about you when required to do so by federal, state, or local law.
• Threat to Health or Safety. We may use and disclose Protected Health Information about you when necessary to prevent a serious threat to your health and safety, the health and safety of another person, or the health and safety of the public. In doing so, however, Corflex Global would only disclose such information to parties able to help prevent the threat.
• Business Associates. We may disclose Protected Health Information to our business associates who perform functions on our behalf or who provide a service to Corflex Global. All of our business associates are obligated, under federal and state law as well as written agreement, to protect the privacy and security of your Protected Health Information.
• Workers’ Compensation. We may disclose Protected Health Information about you to Workers’ Compensation or similar programs that provide benefits for work-related injuries and illness.
• Public Health Activities and Risk. We may disclose your Protected Health Information for public health activities. These activities generally include:
– To prevent and control disease, injury or disability
– To report births and deaths
– To report child abuse and neglect
– To report problems with medications and other medical products
– To notify the correct parties of recalls of medications and products they may be using
– To notify a person who may have been exposed to a disease and/or may be at risk of contracting and spreading the disease and condition
• Abuse, Neglect, and Domestic Violence. We may disclose Protected Health Information to the appropriate governmental authority if, based on our professional judgment, we believe a patient is the victim of abuse, neglect, or domestic violence. We will only make this disclosure when the patient agrees
or when it is required by law.
• Data Breach Notifications. We may disclose Protected Health Information to provide legally required notices of unauthorized access or disclosure of your Protected Health Information.
• For Lawsuits and Disputes. Corflex Global may disclose Protected Health Information in the event that a court or administrative order is received. We may also disclose Protected Health Information in response to a subpoena, discovery request, or other legal process from someone Involved in the dispute. Protected Health Information will only be released after efforts have been made to inform you of the request and an order protecting the information has been given. Corflex Global may also disclose your Protected Health Information to defend ourselves in the event of a lawsuit.
• To Law Enforcement. We may disclose Protected Health Information to law enforcement pursuant to a court order, subpoena, warrant, summons, administrative request, or similar legal process to assist in locating or identifying a suspect, fugitive, victim, witness, missing person, or stopping a possible crime.
• Coroners, Medical Examiners, and Funeral Directors. We may release Protected Health Information to coroners, medical examiners, and funeral directors so that they can carry out their duties.
• If you are an inmate of a correctional institution or under custody of law enforcement, we may disclose your Protected Health Information to an authorized party if it is necessary for (1) the institution to provide you with healthcare; (2) to protect the health and safety of others, (3) or to protect the health and safety of law enforcement and the institution.
Your Rights Regarding Your Protected Health Information
You have the following rights, subject to certain limitations, regarding your Protected Health Information:
• Right to Request Restrictions. You have the right to ask Corflex Global to limit the Protected Health Information we use or disclose about you for treatment, payment, or other healthcare services. You may also request that any part of your Protected Health Information not be released to family members or friends who may be involved in your care or for notification purposes as described in this Notice. Your request must state the specific restriction requested and to whom you want the restriction to apply. Corflex Global is not required to agree to a restriction that you may request. If your health care provider believes it is in your best interest to permit use and disclosure of your protected health information, your protected health information will not be restricted. If Corflex Global does agree to the requested restriction, we may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment.
• Out-of-Pocket Payments. If you make a payment in full at the time of, or prior to, receiving an item or service from Corflex Global, you have the right to request that your Protected Health Information with respect to that item or service not be disclosed to your Health Plan. We will honor your request as long as financial obligations are met.
• Right to Request Confidential Communications. You have the right to request that Corflex Global contact and communicate with you only in certain ways to preserve your privacy and Protected Health Information. For example, you may request that we only contact you by mail at a specific address or via your home phone number and not workplace number. We will accommodate every reasonable request.
• The Right To Inspect and Copy. You have the right of access to inspect and copy your Protected Health Information that may be used to make decisions regarding your treatment and plan of care. Corflex Global will make every reasonable attempt to provide you with access to your medical information within thirty (30) days of your request if the records are stored on site. We also reserve the right to charge a reasonable and cost-based fee for the costs of copying, mailing, and other supplies and resources associated with your request. We may deny your request in certain circumstances. If Corflex Global does deny your access, you have a right to appeal the denial and have the denial reviewed by a licensed healthcare professional that is not directly related to the denial.
• Right to Request Amendments. If you feel that the Protected Health Information we have about you is incorrect, inaccurate, or incomplete, you may ask us to amend that information. You have the right to request this amendment as long as the information is kept by us and for our records. A request for amendment must be made in writing. In certain cases, we may deny your request for amendment. If we deny your request, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.
• Right to Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is the list of disclosures we made of the Protected Health Information about you. This list will not include the following:
– Disclosures for treatment, payment, or other health care operations.
– Disclosures made to you, or pursuant to your written authorization.
– Disclosures for our facility directory.
The right to receive this information is subject to certain exceptions, restrictions, and limitations. Corflex Global will provide you with an accounting of certain disclosures made by Corflex Global of your medical information during the six (6) years prior to your request, but no earlier than April 14, 2003. Corflex Global will generally provide you with your accounting within sixty (60) days of your request. Your request will be filled at no cost to you once every twelve (12) months. For each subsequent accounting of disclosures, Corflex Global will notify you in advance of the cost and give you an opportunity to continue or withdraw your request.
• Paper Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time, even if you agreed to receive this notice electronically. If you have obtained this notice electronically, you may obtain a paper copy by asking any Corflex Global Employee or by contacting Corflex Global’s Privacy Officer at (603)688-6688.
How to Exercise Your Rights
To exercise any of your rights described in this notice, please send your request, in writing, to Corflex Global’s Privacy Officer at the address listed below. We may ask that you fill out a form that we will provide to you.
Attn: Privacy Officer
669 East Industrial Park Drive
Manchester, NH 03109
Corflex Global’s Duties and Responsibilities
• Legal Duties. Corflex Global is required by law to satisfy the following duties:
– Maintain the privacy of Protected Health Information.
– Provide you with a notice of our legal duties and privacy practices with respect to Protected Health Information.
– In the event of a breach of your unsecured Protected Health Information, Corflex Global will provide written or other notification in accordance with federal and state law.
• Terms of this Notice. We are required by law to abide by the terms in the notice currently in effect.
• Changes to this Notice. We reserve the right to change this notice. We reserve the right to make the changed notice effective for Protected Health Information we already have about you as well as information we may gather in the future. We will post a clear copy of our current notice in each of our regions/facilities as well as the home page of our internet site containing the effective date of the notice. A current notice will be made available at the time you receive services from Corflex Global.
If you believe your privacy or any of your rights as described in this notice have been violated, you may file a complaint with Corflex Global and/or the U.S. Department of Health and Human Services Office for Civil Rights. To file with Corflex Global, please contact Corflex Global’s Privacy Officer at 603-668-6688. You may also file your privacy complaint with Corflex Global by submitting your written complaint to:
Attn: Privacy Officer
669 East Industrial Park Drive
Manchester, NH 03109
To file a complaint with the U.S. Department of Health and Human Services, you may visit the website of the Office of Civil Rights at www.hhs.gov/ocr/privacy.
You will not be retaliated against for filing a complaint. Corflex Global may not threaten, intimidate, coerce, harass, discriminate against, or take any other retaliatory action against any individual or other person for filing a complaint.
Other Uses of Your Medical Information
Other uses of Protected Health Information not covered in this notice or under the laws that apply to us will be made only with your written authorization. If you provide us with your written authorization to use or disclose Protected Health Information, you may revoke that authorization at any time in writing. If you revoke your authorization, we will no longer disclose Protected Health Information subject to the authorization, however, the revocation will not apply to disclosure previously made with your permission.
Effective Date: 02/18/2015