000c American Health Network Privacy Policy

Privacy Notice (pdf) | Privacy Notice (Spanish) (pdf)

The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

For Treatment.

• We may use your medical information to provide you with treatment or services.
• We may disclose your medical information to doctors, nurses, technicians, medical students, or other personnel who are involved in taking care of you.
• For example, a doctor treating you for pneumonia may need to know if you have diabetes because diabetes may slow the healing process. Different departments may share medical information about you in order to coordinate the different things you need. We also may disclose medical information about you to people outside American Health Network who may be involved in your medical care.

For Payment.

• We may use and disclose your medical information to bill and collect payment for treatment and services provided to you.

For example, we may give your health information to your insurance company about treatment you received so they will pay us or reimburse you. We may also tell your insurance about treatment you are going to receive to obtain prior approval or find out whether they will pay for the treatment.

For Health Care Operations.

• We may use and disclose medical information about you for our business operations. These uses and disclosures are necessary to run American Health Network and make sure that all of our patients receive quality care.
• For example, we may use medical information to review our treatment and services and to evaluate our performance.
• We may combine medical information about many patients to decide what additional services we should offer, what services are not needed, and whether certain new treatments are effective.
• We may disclose information to doctors, nurses, technicians, medical students, and other personnel for review and learning purposes.
• We may remove information that identifies you so others may use it to study health care and health care delivery without learning the identities of the specific patients.

Business Associates. We contract with outside organizations, called business associates, to perform some of our operational tasks on our behalf. Examples would include billing agencies or a copy service we use when making copies of your health record. When these services are performed, we disclose the necessary health information to these companies so that they can perform the tasks we have asked them to do and so that we can bill you or your third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.

Appointment Reminders. We may use and disclose your medical information to remind you of appointments, annual exams, or prescription refills.

Treatment Alternatives. We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you. For example, this may include specific brand name or over-the-counter pharmaceuticals.

Health-Related Benefits and Services. We may use and disclose medical information to tell you about health-related benefits or services. For example, this may include a new heart care program that we offer.

Individuals Involved in Your Care or Payment for Your Care. Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your health information that directly relates to that person's involvement in your health care or payment related to your care. If you are unable to agree or to object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. Finally, we may use or disclose your health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals directly involved in your health care.

Research. Under certain circumstances, we may use and disclose medical information about you for research purposes.

• For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another, for the same condition. All research projects, however, are subject to a special approval process. Before we use or disclose medical information for research, the project will have been approved through a research approval process, but we may, however, disclose medical information about you to people preparing to conduct a research project, for example, to help them look for patients with specific medical needs.

To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.

Military and Veterans. If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.

Workers' Compensation. We may release medical information about you for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Public Health Risks. We may disclose medical information about you for public health activities. These activities generally include the following:

• to prevent or control disease, injury or disability;
• to report births and deaths;
• to report reactions to medications or problems with products;
• to notify people of recalls of products they may be using;
• to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
• to notify the appropriate government authority if we believe a patient has been the victim of abuse or neglect. We will only make this disclosure when required or authorized by law.

Health Oversight Activities. We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute.

Law Enforcement. We may release medical information if asked to do so by a law enforcement official:

• In response to a court order, subpoena, warrant, summons or similar process;
• To identify or locate a suspect, fugitive, material witness, or missing person;
• About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person's agreement;
• About a death we believe may be the result of criminal conduct;
• In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.

Coroners, Medical Examiners and Funeral Directors. We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients to funeral directors as necessary to carry out their duties.

National Security and Intelligence Activities. We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Protective Services for the President and Others. We may disclose medical information about you to authorized federal officials so they may provide protection to the President, or to other authorized persons.

Inmates. The rights listed in this Notice will not apply to inmates of a correctional institution.

• Right to Inspect and Obtain a Copy. You have the right to inspect and have a copy of medical information that may be used to make decisions about your care. This includes medical and billing records, but does not include psychotherapy notes (if applicable).

To inspect and have a copy of medical information that may be used to make decisions about you, you must submit your request in writing to the Office Records Supervisor (ORS). If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. We have a reasonable time-period to make a response to your request.

We may deny your request to inspect and have a copy in some limited circumstances. If you are denied access to your medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by AHN will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

• Right to Request an Amendment. If you feel that medical information we have about you is incorrect you have the right to request an amendment (a change to your record).

To request an amendment, your request must be made in writing and submitted to the ORS. In addition, you must provide a reason that supports your request.

We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

• Was not created by us, unless the person or entity that created the information is no longer available to make the amendment to those records not created by us;
• Is not part of the medical information kept by American Health Network;
• Is not part of the information which you would be permitted to inspect and copy; or
• AHN believes is accurate and complete.

• Right to an Accounting of Disclosures. You have the right to request an "accounting of disclosures." This is a list of people who saw your records who you did not specifically authorize. For example, if we have to respond to a legal request for your records.

To request this list or accounting of disclosures, you must submit your request in writing to the ORS. Your request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

• Right to Request Restrictions on Uses and Disclosures of Medical Information. You have the right to request a restriction or limitation on how we use your medical information. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a procedure that you had performed in our office. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide emergency treatment. Use the AHN form: "PATIENT REQUEST FOR RESTRICTION ON USES AND DISCLOSURES OF RECORDS." In your request you must tell us: (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
• Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.

To request confidential communications, you must make your request in writing to your AHN doctor's office. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted. This request should be made on the AHN PATIENT INFORMATION COLLECTION FORM.

• Right to a Paper Copy of This 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 have agreed to receive this Notice electronically, you are still entitled to a paper copy of this Notice.

American Health Network is required to and will abide by the terms of this Notice. We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current Notice in all American Health Network patient facilities. The Notice will contain the effective date. In addition, each time you register or are seen for treatment or health care services at an AHN facility we will make a copy of the current Notice available to you.

If you believe your privacy rights have been violated, you may file a complaint with American Health Network or with the Secretary of the Department of Health and Human Services. To file a complaint, contact the AHN Privacy Officer at (317) 580-6306 (American Health Network, 10333 N. Meridian Street, Suite 450, Indianapolis, IN 46290, Attn: Privacy Officer). All complaints must be submitted in writing and must be filed within 180 days of the time you became aware or should have been aware of the violation.

YOU WILL NOT BE PENALIZED FOR FILING A COMPLAINT.

OTHER USES OF MEDICAL INFORMATION

Other uses and disclosures of medical information not covered by this Notice or law will be made only with your written permission. If you provide us permission to use or disclose medical information, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. American Health Network is unable to take back any disclosures we have already made with your permission, and we are required to retain our records of the care that we provided to you.

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