NOTICE OF PRIVACY PRACTICES
Effective Date: February 25, 2011
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
BOSTON’S COMMUNITY MEDICAL GROUP IS REQUIRED BY LAW TO PROTECT MEDICAL INFORMATION ABOUT YOU
We are committed to protecting medical information about you and that identifies you. This medical information may be information about health care provided to you and or payment for health care provided to you.
We are required by law to provide you with this Notice of Privacy Practices explaining our legal duties and privacy practices with respect to medical information. We are only allowed to use and disclose medical information in the manner that is described in this Notice.
We reserve the right to make changes and to make the new Notice effective for all medical information we maintain. If we make changes to the Notice, we will have copies of the new Notice available upon request through our Privacy Officer at the address below or on our website.
The rest of this Notice will:
- Describe how we may use and disclose medical information about you;
- Explain your rights with respect to medical information about you; and
- Describe how and where you may file a privacy-related complaint.
If you have questions about the information in this Notice, please contact:
Boston’s Community Medical Group
Attention: Privacy Officer
1 BMC Place
Dowling North, Suite 5108
Boston, MA 02118
WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU IN CERTAIN CIRCUMSTANCES
This section of our Notice explains how we may use and disclose medical information about you in order to provide health care, obtain payment for that health care, and operate our business efficiently. This section also mentions several other circumstances in which we may use or disclose medical information about you. For more information about any of these uses or disclosures, or about any of our privacy policies, procedures or practices, contact our Privacy Officer at 617-638-7034.
For Treatment: We may use and disclose medical information to provide, coordinate or manage your health care and related services. This may include communicating with other health care providers regarding your treatment and coordinating and managing your health care with others.
Example: You are being discharged from a hospital. Our Nurse Practitioner, PCP or PA may disclose your medical information to a home health agency to make sure you get the services you need after discharge from the hospital.
For Payment: We may use and disclose your medical information about you to obtain payment for health care services that you received.
Example: Our billing service, on our behalf, submits a claim for health care services to your insurance company. The claim may contain information that identifies you, your diagnosis and the treatment or supplies you received. They may use the medical information to process the claim for payment and we may disclose the medical information to your insurance company when we seek payment for services that you received.
For Healthcare Operations: We may use and disclose your medical information to perform a variety of business activities that allow us to coordinate the benefits you are entitled to under your health plan. For example, we may use or disclose your medical information in performing the following activities:
- Review and evaluate the skills, qualifications, and performance of health care providers taking care of you.
- Review and improve the quality, efficiency and cost of care that BCMG provides to you and our other patients.
- Cooperating with other organizations that assess the quality of the care of others including government agencies and private organizations.
- Mail information containing your medical information to the address you have provided.
Example: We may use your medical information as well as medical information from other patients to develop an educational program to help patients recognize early symptoms of a particular disease.
Persons Involved in Your Care: We may disclose your medical information to a relative, close personal friend or any other person you identify if that person is involved in your care and the information is relevant to your care.
We may also use or disclose your medical information to a relative, another person involved in your care or possibly a disaster relief organization (such as the Red Cross) in an emergency if we need to notify someone about your location or condition.
You may ask us at any time not to disclose your medical information to persons involved in your care. We will agree to your request and will not disclose the information except in certain limited circumstances such as emergencies or if the patient is a minor.
Example: If you ask us to share your health information with your spouse we will disclose your medical information to him or her.
Required by Law: We will use and disclose your medical information whenever we are required by law to do so. For example, Massachusetts law requires us to report suspected abuse to the Disabled Persons Protection Commission or to Elder Abuse and Protective Services. We will comply with any state and other applicable laws regarding these disclosures.
Federal Government Uses and Disclosures : When permitted by law, we may use or disclose your medical information without your permission for various activities by the federal government. In other words, the government has determined that under certain circumstances (as described below), it is so important to disclose health information that it is acceptable to disclose health information without the individual’s permission. We will only disclose your medical information in the following circumstances when we are permitted to do so by law. Below are descriptions of the activities recognized by law. For more information on these types of disclosures, contact BCMG’sPrivacy Officer at 617-638-7034.
- Threat to health or safety: We may use or disclose your medical information if we believe it is necessary to prevent or lessen a serious threat to health or safety
- Public health activities: We may use or disclose your medical information for public health activities. Public health activities require the use of health information for various activities, including, but not limited to, activities related to investigating diseases, reporting child abuse and neglect, monitoring drugs or devices regulated by the Food and Drug Administration, and monitoring work related illnesses or injuries. For example, if you have been exposed to a communicable disease, we may report it to the State and take other actions to prevent the spread of the disease.
- Abuse, neglect or domestic violence: We may disclose your medical information to a government authority if you are an adult and we believe that you may be a victim of abuse, neglect or domestic violence.
- Health oversight activities: We may disclose your medical information to a health oversight agency which is an agency responsible for overseeing the health care system or certain government programs.
- Court proceedings: We may disclose your medical information in response to a court order.
- Law enforcement: We may disclose your medical information to a law enforcement official for specific law enforcement purposes. For examples, we may disclose limited health information about you to a police officer if the officer needs the information to help find or identify a missing person.
- Coroners and others: We may disclose your medical information to a coroner, medical examiner or funeral director or to organizations that help with organ, eye and tissue transplants.
- Worker’s compensation: We may disclose your medical information in order to comply with workers’ compensation laws.
- Research organizations: We may use or disclose your medical information to research organizations if the organization has satisfied certain conditions about protecting the privacy of your medical information.
- Certain government functions: We may use or disclose your medical information for certain government functions, including but not limited to military and veterans’ activities and national security and intelligence activities.
Other than the uses and disclosures described above, we will not use or disclose health information about you without the authorization (or signed permission) of you or your personal representative. In some instances, we may wish to use or disclose health information about you and we may contact you to ask you to sign an authorization form. In other instances, you may contact us to disclose medical information and we will ask you to sign an authorization form.
If you sign a written authorization allowing us to disclose medical information about you, you may later revoke (or cancel) your authorization in writing. If you would like to revoke your authorization, you may write us a letter revoking your authorization. If you revoke your authorization, we will follow your instructions except to the extent that we have already relied upon your authorization to disclose your medical information.
You Have Rights with Respect to Medical Information About You
You have certain rights with respect to medical information about you. This section of the Notice will briefly describe each of these rights. If you would like to know more about your rights, please contact the Privacy Officer at 617-638-7034.
Right to a Copy of this Notice: You have a right to have a paper copy of our Notice of Privacy Practices at any time. If you would like to have a copy of our Notice, contact the Privacy Officer at 617-638-7034.
Right to Access to Inspect and Copy: You have the right to inspect (see or review) and receive a copy of your medical information that Boston’s Community Medical Group maintains. If we maintain your medical records in an Electronic Health Record system, you may obtain an electronic copy of your medical records. You may also instruct us in writing to send an electronic copy of your medical records to a third party. If you would like to inspect or receive a copy of medical information about you, you must provide us with a request in writing.
We may deny your request in certain circumstances. If we deny your request, we will explain the reason for doing so in writing. We will inform you in writing if you have the right to have the decision reviewed by another person.
We may be able to provide you with a summary or explanation of the information. Contact the Privacy Officer for more information on these services.
Right to Have Medical Information Amended: You have the right to have us amend, correct or supplement your medical information that we maintain. If you believe that we have information that is either inaccurate or incomplete, we may amend the information to indicate the problem and notify others who have copies of the inaccurate or incomplete information. If you would like us to amend information, you must provide us with a request in writing and explain why you would like us to amend the information.
We may deny your request to amend, correct or supplement your medical information in certain circumstances. If we deny your request, we will explain our reason for doing so in writing. You will have the opportunity to send us a statement explaining why you disagree with our decision to deny your amendment request and we will share your statement whenever we disclose the information in the future.
Right to an Accounting of Disclosures we have Made: You have the right to receive an accounting (which means a detailed listing) of disclosures we have made for the previous six (6) years. If you would like to receive an accounting, you may send us a letter requesting an accounting or contact our Privacy Officer at 617-638-7034.
Right to Request Restrictions on Uses and Disclosures: You have the right to request that we limit the use and disclosure of your medical information for treatment, payment and health care operations. Under federal law, Boston’s Community Medical Group must agree to your request and comply with your requested restriction(s) if:
- Except as otherwise required by law, the disclosure is to a health plan for purpose of carrying out payment of health care operations (and is not for purposes of carrying out treatment); and,
- The medical information pertains solely to a health care item or service for which the health care provider involved has been paid out of pocket in full.
Once we agree to your request, we must follow your restrictions, except if the information is necessary for emergency treatment. You may cancel the restrictions at any time by writing to us. In addition, we may cancel a restriction at any time as long as we notify you of the cancellation and continue to apply the restriction to information collected before the cancellation.
Right to Request an Alternative Method of Contact: You have the right to request to be contacted at a different location or by a different method. For example, you may prefer to have all written information mailed to your work address rather than to your home address.
We will agree to any reasonable request for alternative methods of contact. If you would liketo request an alternative method of contact, you must provide us with a request in writing.
You may File a Complaint About our Privacy Practices
If you believe your privacy rights have been violated or if you are dissatisfied with our privacy policies or procedures, you may file a written complaint either with us or with the federal government.
BCMG will not take any action against your or change the treatment of you in any way if you file a complaint.
To file a written complaint with us, you may bring your complaint directly to the Privacy Officer or may mail it to the following address:
Boston’s Community Medical Group
Attention: Privacy Officer
1 BMC Place
Dowling North, Suite 5108
Boston, MA 02118
To file a written complaint with the federal government, please use the following contact information:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201
Toll-Free Phone: (800) 368-1019
TDD Toll-Free: (800) 537-7697
If you have any questions, please contact the Privacy Officer at the address listed above.
Boston’s Community Medical Group
1 BMC Place, Dowling North, Suite 5108, Boston, MA 02118
Phone: 617.638.7062 | Fax: 617-638-7075 | TTY: 617-638-7053 | Toll Free: 800-442-0520