Notice of Privacy Practices

EFFECTIVE DATE

This Notice of Privacy Practices (“Notice”) is effective March 30, 2021.

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.

CONTACT PERSON

Bridge Diagnostics, LLC’s Chief Compliance Officer is the contact person for all issues and complaints regarding your health information and privacy rights. If you have any questions or concerns about this Notice, please contact the Chief Compliance Officer at:

U.S. Mail and Overnight Delivery:

Bridge Diagnostics ATTN: Jessenia Cornejo

110 Theory, Suite #150, Irvine, CA 92617

 

Toll-Free Number: (800) 803-1611

Email: Compliance@bridgediagnostics.com

WHO WILL FOLLOW THIS NOTICE

This Notice describes the privacy practices described in health information privacy practices followed by the members of Bridge’s workforce.

YOUR HEALTH INFORMATION

Health information that Bridge has may include information received or created by Bridge, may be in the form of written or electronic records or spoken words, and may include information about your health history, test results, related billing activity, and any similar types of health-related information about you. We will refer to all of this information throughout this Notice as “Your Health Information.”

 

This Notice provides a summary of the ways we may use and disclose health information about you, and describes your rights and our obligations regarding the use and disclosure of that information.

USES AND DISCLOSURES OF HEALTH INFORMATION

We use, share and disclose information in a number of ways connected to your treatment, payment for your care, and our health care operations. We also use, share, and disclose information as permitted or required by law, as listed below. Not every use or disclosure in a category will be listed in this Notice, but, all of the ways we may use and disclose information will fall within one or more of these categories.

 

 

Uses and Disclosures that Do Not Require Your Authorization

We may use and disclose Your Health Information:

• Treatment: To provide you with care and share it with other professionals who are treating you, including doctors, therapists, and other health care professionals. For example: We may give your treating healthcare professionals your Bridge lab results so he/she can interpret and properly diagnosis and treat your medical condition.
• Payment: So that the lab testing services you receive at Bridge can be billed to you and payment collected from you, your insurance company, or other third party responsible to pay for your care. For example: We give information about you to your health plan so it will pay for your services.
• Health Care Operations: To run our practice, improve your care, and contact you when necessary. For example: We may use Your Health Information to evaluate internally the performance of our laboratory services.  
• To Avert a Serious Threat to Health or Safety: When we believe disclosure is necessary to prevent or lessen a serious and imminent threat to the health and safety of you or others.
• To Comply with the Law: When required to do so by federal, state, or local law including with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.
• Research: In very limited circumstances, usually when an institutional review board reviews the research project for privacy protections and most of the time, we will ask for your permission before sharing it for medical research.
• Military and National Security: To the military and to authorized federal officials for national security and intelligence purposes or in connection with providing presidential protective services.
• Worker’s Compensation: In response to a worker’s compensation claim you may file. These programs provide benefits for work-related injuries or illness.
• Public Health Activities: To an authorized public health authority or person to protect public health and safety or to prevent or control disease, injury, or disability, and vital events (such as birth or death); assist with the public health surveillance, investigations, and interventions; report adverse events and product defects; and help with product recalls.
• Health Oversight Activities: To health oversight agencies for audits, investigations, or licensure or disciplinary actions.
• In Response to Legal Action: To respond to court or administrative orders, subpoenas, discovery requests, and other lawful processes.
• Law Enforcement: To law enforcement officials in limited circumstances for certain law enforcement purposes including as required by law; for reporting of certain types of injuries; as required by a court order, subpoena, warrant, summons, or similar process; and, in limited situations, about a person who is a victim of a crime.
• Upon Death: To coroners, funeral directors, organ donation organizations, or medical examiners, as authorized by law, for purposes of identifying a deceased person, determining cause of death, or their other duties. We may disclose Your Health Information about you to funeral directors, as permitted by law, as necessary for them to carry out their duties.

·          Correctional Facilities: To a correctional facility if you are an inmate.

·          Information Not Personally Identifiable and Limited Data Sets: As information that is not generally identifiable in which certain identifiers (such as your name and address) are removed.

·          To Report Abuse, Neglect, or Domestic Violence: To government authorities authorized to receive reports of abuse, neglect, or domestic violence, including child abuse.

·          To Contractors: To contractors who perform activities on behalf of Bridge. We require these contractors to protect the privacy, security, and confidentiality of the information.

We may disclose Your Health Information with the Secretary of the Department of Health and Human Services for purpose of determining Bridge’s compliance with any of the HIPAA rules.

Your Choices

For certain health information, you can tell us your choices about what we share.

Opportunity to Agree or Object

In the situations below, you have both the right and choice to tell us to:

 

• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation

 

If you are not able to tell us your preference, for example if you are unconscious, then we may go ahead and share information about you if we believe it is in your best interest.

 

For all other categories, you can tell us your choices about what we share.

 

Your Authorization

For uses and disclosures not described above, we will need your permission or authorization, including in the situations below where we never share your information unless you give us written permission:

 

• Marketing purposes
• Sale of information
• Most sharing of psychotherapy notes, if we have such information.

 

If you sign an authorization, then you may take it back (or revoke it) at any time, although this will not affect information that we used and disclosed in reliance on the authorization. Usually this must be in writing.

 

Situations involving Fundraising

We may not use or disclose PHI for fundraising purposes without valid authorization, unless the information disclosed is limited to general information and is only shared with a Business Associate or institutionally related foundation for the purpose of raising funds for Bridge’s benefit, in which case, we may contact you for fundraising efforts, but you can tell us not to contact you again.

 

SENSITIVE CONDITIONS

Certain other types of health information have additional protections under state or other federal law. For example, health information about HIV/AIDS, sexually transmitted diseases, mental health, genetic testing, and substance use disorder is treated differently from other types of health information. These categories of information generally will not be disclosed without your authorization (except in certain situations).

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have the following rights regarding Your Health Information maintained by Bridge. To exercise any of these rights, please contact our Chief Compliance Officer at the contact information provided above.

·          Right to See and Copy: You may ask to see or get a paper or electronic copy of Your Health Information about you or a summary of the information. You must submit your request in writing. We may charge a reasonable fee based on our cost. Sometimes we may say no to your request, and we will tell you why. If we say no, then you may ask for a review in many situations.

 

We may deny your request to inspect or obtain copies of Your Health Information in certain limited circumstances. If you are denied copies of or access to health information that we keep about you, you may ask that our denial be reviewed. If the law gives you a right to have our denial reviewed, we will select a licensed health care professional to review your request and our denial. The person conducting the review will not be the person who denied your request, and we will comply with the outcome of the review.

 

• Right to Ask for Changes: You may ask us to change or amend Your Health Information. You must submit your request in writing and provide a reason to support the request. We may say no in certain situations, and we will tell you why.

 

We may deny your request if you ask us to amend information that:

We did not create, unless the person or entity that created the information is no longer available to make the amendment.

Is not part of the health information that we keep.

You would not be permitted to inspect and copy.

Is accurate and complete.

 

• Right to Get a List of Whom We Have Shared Information With: You may ask us for a list (accounting) of times we have shared Your Health Information for the six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, health care operations, and certain other disclosures (such as any you asked us to make). Your first accounting is free, but we may charge you a reasonable cost-based fee if you ask for another within 12 months.

 

• Right to Ask for Limits on Information We Use and Share: You may ask us to limit the way we use or share Your Health Information in certain situations. Most of the time, we are not required to agree to a request, and we may say “no” if it would affect your care. If you pay for a health care service or item in full out-of-pocket, then we will agree to restrict disclosures to a health plan for payment or health care operations. We will honor your limits unless there is an emergency or unless a law requires us to share that information.

 

• Right to Ask for Different Communications: You may ask us to communicate with you about medical matters a certain way or at a certain location. For example, you may ask that we only contact you at work or by mail. We will not ask you the reason for your request. We will try to accommodate all reasonable requests.

Your request must be in writing and specify how or where you wish to be contacted.

 

• Right to Receive this Notice: We are providing you with the right to receive a copy of this Notice. We will continue to post this Notice on our website while it still applies and you may request a copy. You may ask us to give you a copy of this Notice at any time.

 

• Right to Have Someone Act for You: You have the right to have a personal representative make decisions about Your Health Information, such as by giving someone a health care power of attorney. We will make sure the person has this authority and can act for you before we take any action.

CHANGES TO THIS NOTICE

We reserve the right to change this Notice anytime. We can have the new Notice apply to all Your Health Information we have about you as well as any health information we create or receive in the future. We will post the current Notice on our website. The new Notice will have a revision date in the top right hand corner.

COMPLAINTS

• If you believe your rights have been violated, you may file a complaint with our Chief Compliance Officer at the contact information provided above.
• You can also 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 1-877-696-6775, or visiting  www.hhs.gov/ocr/privacy/hipaa/complaints/ .
• We will not retaliate against you for filing a complaint.

BRIDGE’S RESPONSIBILITIES

• We are required by law to: maintain the privacy and security of Your 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 of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.