Notice of Privacy Practices
About This Notice
The Fearless Kind is strongly committed to protecting your health information. This Notice of Privacy is provided to you to describe how we may use and disclose your protected health information (PHI) to carry out treatment, payment or healthcare operations and for other purposes that are permitted or required by law.
This Notice also describes your rights and our duties with respect to your protected health information. “Protected health information” is information about you that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services
The Fearless Kind “we” are providers of addiction and mental health services. More specifically, we are a licensed Alcohol and Drug Abuse Facility in the State of Nevada. We create and maintain treatment records that contain individually identifiable health information about you. These records are generally referred to as “medical records” or “mental health records,” and this notice, among other things, concerns the privacy and confidentiality of those records and the information contained therein.
Confidentiality of Alcohol and Drug Abuse Patient Records
The confidentiality of alcohol and drug abuse patient records maintained by this program is protected by federal law and regulations. Generally, the program may not say to a person outside the program that a patient attends the program, or disclose any information identifying a patient as an alcohol or drug abuser unless:
- The patient consents in writing;
- The disclosure is allowed by a court order; or
- The disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or program evaluation
Violation of the federal law and regulations by a program is a crime. Suspected violations may be reported to appropriate authorities in accordance with federal regulations.
Federal law and regulations do not protect any information about a crime committed by a patient either at the program or against any person who works for the program or about any threat to commit such a crime.
Federal laws and regulations do not protect any information about suspected child abuse or neglect from being reported under State law to appropriate state or local authorities.
Source: “Confidentiality of Alcohol and Drug Abuse Patient Records” Code of Federal Regulations, 2000. 42 CFR, chapter I, part 2,
How we may use and disclose your PHI
For Treatment and healthcare operations
We may use and disclose your protected health information on an as needed basis within The Fearless Kind and to an entity that has direct administrative control over the Company to provide, coordinate, or manage your health care treatment and any related services. For example, your protected health information may be shared among The Fearless Kind personnel involved in your care. With your written consent, we may disclose to your physician protected health information to assist him/her in providing treatment to you while participating in or upon discharge from the program.
We may use and disclose your protected health information for internal health care operation purposes. For example, members of the treatment staff, the utilization review coordinator, the quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the treatment and service we provide.
With your written consent, we may use and disclose your protected health information so that the treatment and health care services you receive may be billed to you, your insurance company, a government program, or third-party payors. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services, we recommend for you, such as pre-qualifying your eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities.
We may disclose your protected health information to medical personnel in a medical emergency and to medical personnel of the Food and Drug Administration (FDA) who assert a reason to believe that your health may be threatened by an error in the manufacture, labeling, or sale of a product under FDA jurisdiction
We may disclose your protected health information in the course of a judicial proceeding in response to an order of a court in conformity with federal regulations.
Auditors and Evaluators
We may disclose your protected health information, for purposes of performing an audit, investigation or evaluation, to any Federal, State, or local governmental agency in which we are required by State or Federal law; or a quality improvement organization performing a utilization or quality control review.
We may disclose your protected health information to researchers when their research has been approved by an institutional review board or any research in which you have consented, in writing, to be a participant. Protocols must be established to ensure the privacy of your protected health information and to otherwise satisfy federal regulatory requirements.
Abuse or Neglect
We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect, elder abuse or neglect, or abuse or neglect to an individual who cannot advocate for themselves (e.g., person with a disability). In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.
We may disclose your protected health information to report a crime committed by you either at the program or against any person who works for the program or about any threat to commit such a crime.
We may disclose your protected health information should it be brought to our attention that you intend to cause harm or are a direct threat to yourself or others.
For Data Breach Notification Purposes
We may use or disclose your protected health information to provide legally required notices of unauthorized access to or disclosure of your health information.
Required Uses and Disclosures
By law, we must make disclosures to you and when required by the Secretary of the U.S. Department of Health and Human Services to investigate or determine our compliance with the requirements of HIPAA.
1. Breach of Protected Health Information: Should there be a breach in confidentiality, you have the right to be notified.
2. Right to Inspect and Copy: You have the right to look at and obtain a copy of your protected health information contained in your electronic health record and billing record. All requests must be submitted in writing. If you request a copy of your information, whether in electronic or paper form, we may charge you a reasonable fee for the costs of copying, mailing or other costs incurred by us in complying with your request. Under federal law, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and protected health information that is subject to law that prohibits access to protected health information. Depending on the circumstances, we may deny your request to inspect and/or copy your protected health information. A decision to deny access may be reviewable.
3. Right to Request Restrictions: You may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care. To request a restriction on who may have access to your protected health information, you must submit a written request.
4. Right to Request Confidential Communication: You have the right to request confidential communication from us by alternative means. All requests must be submitted in writing. We reserve the right to deny unreasonable requests, while maintaining compliance with State and Federal laws.
5. Right to Notice: You have the right request this Notice by paper or electronic copy. All requests must be submitted in writing.
6. Right to Request Amendment: You may request an amendment of your protected health information contained in your medical and billing records that The Fearless Kind uses for making decisions about you, for as long as we maintain the protected health information. You may request an amendment by submitting to the Executive Body a written request which includes the reason(s) that support your request. In certain cases, we may deny your request for an amendment. If we deny your request for an amendment, 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.
7. Right to an Accounting of Disclosures: You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. This right applies to disclosures for purposes other than treatment, payment or healthcare operations as described in this Notice. It excludes disclosures we may have made to you or to family members or friends involved in your care to whom you have provided written consent for disclosure of such information.
Changes to this Notice
We reserve the right to change this Notice at any time.
Right to Voice Concerns
You reserve the right to voice concerns or issue complaints to The Fearless Kind and to the Secretary of the U.S. Department of Health and Human Services if you believe your privacy rights may have been violated either by me or by those who are employed by The Fearless Kind.
You may file a complaint with the Company by simply providing us in writing that specifies the manner in which you believe the violation occurred, the approximate date of such occurrence, and any details that you believe will be helpful to the company.
We can be reached through the following:
- Phone: (702) 780-0822
- Email: firstname.lastname@example.org
- Fax: (702) 447-8771
- Address: PO Box 13833 Las Vegas, NV 89112
We will not retaliate against you in any way for filing a complaint with me or with the Secretary. Complaints to the Secretary must be filed in writing. A complaint to the Secretary can be sent to U.S Department of Health and Human Services.