Notice of AIS Healthcare’s Patient Privacy Practices
For our patients: This notice describes how AIS Healthcare uses and discloses your health information, and how you can get access to this information. Please review it carefully.
How AIS Healthcare uses your health information
Here are the typical ways that AIS Healthcare uses or shares your health information:
- To treat you: We can use your health information and share it with other professionals who are treating you.
- To run our organization: We can use and share your health information to run our company, improve your care and contact you when necessary.
- To bill for your services: We can use and share your health information to bill and receive payment from health plans or other entities.
- To do research: We may use or share your information for health research.
- To comply with the law: We will share information about you if state or federal laws require it, including with the U.S. Department of Health and Human Services if it wants to see that we are in compliance with federal privacy law.
- To respond to organ and tissue donation requests: We may share health information about you with organ procurement organizations.
- To work with a medical examiner or funeral director: We may share health information with a coroner, medical examiner or funeral director when an individual passes away.
- To address workers’ compensation, law enforcement and other government requests: We may use or share health information about you for workers’ compensation claims, for law enforcement purposes or with a law enforcement official, with health oversight agencies for activities authorized by law or for special government functions such as military, national security and presidential protective services.
- To respond to lawsuits and legal actions: We may share health information about you in response to a court or administrative order, or in response to a subpoena.
We can also share health information about you to prevent disease, help with product recalls, report adverse reactions to medications, report suspected abuse, neglect or domestic violence, or to reduce a serious threat to anyone’s health or safety. For more ways we can use or share your health information, see https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html.
Please note: Your state’s law may be different than federal privacy law. Please call AIS Healthcare’s compliance department or email us at firstname.lastname@example.org if you have any questions about state law.
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy.
- We will not use or share your information other than as described without your written permission.
For more information, see: http://hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of This Notice
We can change the terms of this notice and those changes will apply to all information we have about you. The new notice will be available upon request.
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you exercise your rights.
Get an electronic or paper copy of your medical record.
- You may ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this by calling 877.443.4006.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record.
- You may ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this by calling 877.443.4006.
- We may say “no” to your request, but we will tell you why in writing within 60 days.
Request confidential communications.
- You may ask us to contact you in a specific way (for example, calling an office phone number instead of a home phone number) or to send mail to a different address.
- We will say “yes” to all reasonable requests.
Ask us to limit what we use or share.
- You may ask us not to use or share certain health information for treatment, payment or our operations.
- We are not required to agree to your request, and we may say “no” if it will affect your care.
- If you pay for a service or healthcare item out-of-pocket in full, you may ask us not to share that information for the purpose of payment or our operations with your health insurer.
- We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information.
- You may ask for a list (accounting) of the times we’ve shared your health information for six years prior to that date you ask, who we shared it with and why.
- We will include all the disclosures except for those about treatment, payment and healthcare operations and certain other disclosures (such as any you have asked us to make). We will provide one accounting a year for free, but will charge a reasonable, cost-based fee if you ask for another within 12 months.
Get a copy of this privacy notice.
- You may ask for a paper copy of this notice at any time, even if you have agreed to receive the notices electronically. We will provide you with a paper copy promptly.
Choose someone to act for you.
- If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights and make choices about your health information.
- We will make sure the person has this authority and may act for you before we take any action.
File a complaint if you feel your rights are violated.
- To report a complaint regarding the services you receive, please call toll-free 844.731.8139.
- You may complain if you feel we have violated your rights. You may call our helpline or make a report through our website (aiscaregroup.com). You will be given a verbal or written confirmation your report was received within 5 calendar days.
- You may file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 877.696.6775 or visiting http://hhs.gov/ocr/privacy/hipaa/complaints/.
- We will not retaliate against you for filing a complaint.
- Please review your state-specific complaint process.
If you have any questions about this policy, please contact AIS Healthcare at:
AIS Healthcare™ Headquarters
18451 Dallas Parkway, Suite 150
Dallas, TX 75287
P: 601.988.1700 | 877.443.4006
This document was last updated on December 16, 2019.