Notice of Privacy Practices


CAYABA CARE

 1575 N 52nd St. #801, Philadelphia, PA 19131

www.cayabacare.com 

 (267) 668-2256

NOTICE OF PRIVACY PRACTICES

During your treatment with  OnCall Health of NJ, PC d/b/a Cayaba Care (“Cayaba Care”), doctors, nurses, and other caregivers may gather Protected Health Information about your medical history and your current health in order to carry out treatment, payment, health care operations, and for other purposes that are permitted or required by law. This Notice of Privacy Practices explains how that information may be used and shared with others. It also explains your privacy rights regarding this kind of information. The terms of this Notice apply to health information created or received by Cayaba Care. We are required by law to make sure that medical information that identifies you is kept private, give you this Notice of our legal duties and privacy practices with respect to medical information about you, and follow the terms of the Notice that is currently in effect.

How We May Use and Disclose Your Health Information

The following categories describe different ways that we may use and disclose health information. For each category of uses or disclosures, we will explain what we mean and provide 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 health information will fall within at least one of the categories.

  • For Treatment: We may use your information to provide, coordinate, and manage your care and treatment. For example, a Cayaba Care physician may share your medical information with another health care provider for a consultation or a referral.

  • For Payment: We may use and disclose medical information about your health in order to bill and collect payment from you, an insurance company, or another third party, for treatment and services provided to you by Cayaba Care. For example, we may need to give your health plan information about treatment you received with Cayaba Care so your health plan will pay us or reimburse you for the treatment. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

  • Health Care Operations: We may use and disclose medical information about you for Cayaba Care’s health care operations. Health care operations include the use and disclosure of information that is necessary to run Cayaba Care and to make sure that all of our patients receive quality care. For example, we may use medical information to:
  • Review and improve the quality, efficiency and cost of our treatment and services,
  • Conduct business planning and business management,
  • Evaluate and improve the skills, qualifications and performance of our healthcare providers taking care of you,
  • Cooperate with outside organizations that assess the quality of care we provide and evaluate, certify, or license healthcare providers, and
  • Comply with this Notice and with applicable laws.

  • Fundraising: Occasionally, Cayaba Care may use limited information (your name, address, and the dates you were seen for medical services) to let you know about fundraising or other charitable events. You have the right to request that we not send you information about fund-raising. If you would prefer that Cayaba Care not notify you about fundraising events, please notify the Privacy Officer.

  • Individuals Involved in Your Care or Payment of Your Care: Cayaba Care may share health information with a family member, relative, friend, or individual identified by you, which is directly relevant to the involvement that person has in your care or for the payment of your care. We may, for example, provide limited medical information to allow a family member to pick up a prescription for you. Generally, we will get your written consent prior to making disclosures about you to family or friends. If you are able to make your own health care decisions, Cayaba Care will ask your permission before using your medical information for these purposes. If you are unable to make health care decisions, Cayaba Care will disclose relevant medical information to family members or other responsible people if we feel it is in your best interest to do so, including in an emergency. We will comply with additional state law confidentiality protections if you are a minor and receive treatment for pregnancy, drug and/or alcohol abuse, communicable disease, or mental health.

  • To Business Associates: Some services are provided by or to Cayaba Care through contracts with business associates. Examples include Cayaba Care’s attorneys, management service company, consultants, collection agencies, and accreditation organizations. We may disclose information about you to our business associate so that they can perform the job we have contracted with them to do. To protect the information that is disclosed, each business associate is required to sign an agreement to appropriately safeguard the information and not to redisclose the information unless specifically permitted by law.

  • De-identified Health Information. We may use your health information to create “de-identified” information that is not identifiable to any individual in accordance with HIPAA. We may also disclose your health information to a business associate for the purpose of creating de-identified information, regardless of whether we will use the de-identified information.

Special Situations When Your Medical Information May Be Released:

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Please note that we do not create or manage a hospital directory.

There are a variety of circumstances in which your health information will be used and/or disclosed, without your prior consent or authorizations. These circumstances include the following:

  • As Required by Law: Cayaba Care will disclose medical information about you when we are required to do so by federal, state or local law.

  • To Avert a Serious Threat to Health or Safety: Cayaba Care may use and disclose your health information 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 or reduce the threat.

  • Health Oversight Activities: Cayaba Care may disclose your health information to a federal or state health oversight agency for oversight activities authorized by law. These oversight activities include, for example, government audits, investigations, inspections, and licensure activities. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

  • Public Health Risks: Cayaba Care may disclose your health information to appropriate government authorities for public health activities. These activities generally include the following:
  • Preventing or controlling disease, injury or disability.
  • Reporting births and deaths.
  • Reporting child abuse or neglect, or abuse of a vulnerable adult.
  • Reporting reactions to medications or problems with products.
  • Notifying people of recalls of products they may be using.
  • Notifying a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition. 
  • Reporting to the FDA as permitted or required by law, or
  • Supporting public health surveillance and combat bioterrorism.

  • Law Enforcement: We may release health information to a law enforcement official for certain law enforcement purposes. For example, we may disclose your health information to report a gunshot wound. However, if you request treatment and rehabilitation for drug dependence from us, your request will be treated as confidential, and we will not disclose your name to any law enforcement officer unless you consent. 

  • Lawsuits and Disputes: In the course of any judicial or administrative proceeding, we may disclose your health information in response to a court or administrative order, subpoena, discovery request, or other lawful process. 

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

  • Organ and Tissue Donation: We may release health information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation. 

  • Specialized Government Functions: We may disclose health information about you if it relates to military and veterans’ activities, national security and intelligence activities, protective services for the President, and medical suitability determinations of the Department of State. 

  • Workers’ Compensation: We may release your health information for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.

  • Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release your health information to the correctional institution or law enforcement official. This release is required: (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; and (3) for the safety and security of the correctional institution.

Situations Where We Will Never Share Your Information Without Written Permission:

We will not disclose or use your Protected Health Information in the situations listed below without first obtaining written authorization to do so. In addition to the uses and disclosures listed below, other uses not covered in this Notice will be made only with your written authorization. If you provide us with authorization, you may revoke it at any time by submitting a request in writing:

  • Psychotherapy Notes: Cayaba Care will not use or disclose psychotherapy notes without your written consent.

  • Marketing and Sale of Private Medical Information: Cayaba Care will not use or disclose your private medical information for marketing purposes, nor will we sell your private medical information for marketing purposes without your written consent.

  • Research: Under certain circumstances permitted by Federal Law, Cayaba Care may use and disclose medical information about you for research purposes. This can be done either with your specific, written authorization or when the study has been reviewed for privacy protection by an Institutional Review Board or Privacy Board before the research begins. In some cases, researchers may be permitted to use information in a limited way to determine whether the study or the potential participants are appropriate. We will make a good faith effort to obtain your consent or refusal to participate in external research, as required by law, prior to releasing any identifiable information about you to external researchers.

  • As Required By Privacy Law: The confidentiality of substance use disorder and mental health treatment records as well as HIV-related information maintained by us is specifically protected by state and/or federal law and regulations. Generally, Cayaba Care may not disclose such information unless you consent in writing, the disclosure is allowed by a court order, or in other limited, regulated circumstances.

  • Contact: With your prior written consent, Cayaba Care will contact you via call or text message, on the telephone number we have on file, in order to coordinate your care. You can revoke this consent at any time by replying STOP to any text message, or by calling Cayaba Care at (267) 668-2256.

  • Breach Notification: You will be notified in writing by Cayaba Care within 60 days if we become aware of any violation of HIPAA privacy rules resulting in the acquisition, unauthorized access, or use or disclosure of your private medical information if that information is not protected by government approved security measures.

Your Rights Regarding Your Protected Health Information:

You have the following rights regarding the health information we maintain about you:

  • Right to Inspect and Copy Protected Health Information: Pursuant to your written request, you have the right to inspect and copy your Protected Health Information in paper or electronic format. Under federal law, you may not inspect or copy the following types of records: psychotherapy notes, information compiled as it relates to civil, criminal, or administrative action or proceeding; information restricted by law; information related to medical research in which you have agreed to participate; information obtained under a promise of confidentiality; and information whose disclosure may result in harm or injury to yourself or others. We have up to 30 days to provide the Protected Health Information and may charge a fee for the associated costs.

  • Right to Amend: You have the right to request that Cayaba Care makes amendments to the Protected Health Information we have on file for you, if you believe that it is inaccurate or incomplete. Your request for an amendment must be submitted in writing and detail what information is inaccurate and why. Please note that a request for an amendment does not necessarily indicate the information will be amended.

  • Right to an Accounting of Disclosures: You have the right to receive an accounting of disclosures of your Protected Health Information. An “accounting” being a list of the disclosures that we have made of your information. The request can be made for paper and/or electronic disclosures and will not include disclosures made for the purposes of treatment; payment; health care operations; notification and communication with family and/or friends; and those required by law.

  • Right to Request Restrictions: You have a right to request that Cayaba Care restricts and/or limits the information we disclose to others, such as family members, friends, and individuals involved in your care or payment for your care. You also have the right to limit or restrict the information we use or disclose for treatment, payment, and/or health care operations. Your request must be submitted in writing and include the specific restriction requested, whom you want the restriction to apply, and why you would like to impose the restriction. Please note that our practice/your physician is not required to agree to your request for restriction with the exception of a restriction requested to not disclose information to your health plan for care and services in which you have paid in full out-of-pocket.

  • Right to Request Confidential Communications: You have a right to request confidential communications from us by alternative means or at an alternative location. For example, you may designate we send mail only to an address specified by you which may or may not be your home address. You may indicate we should only call you on your work phone or specify which telephone numbers we are allowed or not allowed to leave messages on. You do not have to disclose the reason for your request; however, you must submit a request with specific instructions in writing.

  • Right to Obtain an Electronic Copy of Medical Records: You have the right to request an electronic copy of your medical record for yourself or to be sent to another individual or organization when your Protected Health Information is maintained in an electronic format. We will make every attempt to provide the records in the format you request; however, in the case that the information is not readily accessible or producible in the format you request, we will provide the record in a standard electronic format or a legible hard copy form. Record requests may be subject to a reasonable, cost-based fee for the work required in transmitting the electronic medical records.

  • Right to a Summary of your Protected Health Information: You have the right to request only a summary of your Protected Health Information if you do not desire to obtain a copy of your entire record. You also have the option to request an explanation of the information when you request your entire record.

  • Right to Receive Notice of a Breach: In the event of a breach of your unsecured Protected Health Information, you have the right to be notified of such breach.

  • Right to a Paper Copy of This Notice: Even if you have agreed to receive an electronic copy of this Privacy Notice, you have the right to request we provide it in paper form. You may make such a request at any time.
  • Additional Rights Under New Jersey Law: New Jersey law may further limit Cayaba Care’s uses and disclosures of your PHI. This includes AIDS/HIV-related information, venereal disease information, genetic information, tuberculosis information, mental/behavioral health information, psychotherapy notes, certain drug and alcohol treatment information and certain information related to the emancipated treatment of a minor (e.g., when the minor seeks emancipated treatment for pregnancy or treatment related to the minor's child or a sexually transmitted disease). In these cases, Cayaba Care will abide by the most stringent of the regulations as they pertain to PHI, including obtaining your prior written consent, if required, before any such information is disclosed to a third party. 

Our Responsibilities

  • 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 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.

Changes to the Terms of this Notice

The effective date of this Notice is May 13, 2022, and it has been updated effective May 13, 2022. We reserve the right to change the terms of this Notice, and the changes will apply to all information we have about you. The new Notice will be available upon request, in our office, and on our website.

Complaints or Questions

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. To file a complaint with Cayaba Care, or to ask a question about this Notice, contact:

Privacy Officer

Name: Kit Dobyns

E-mail: Privacy@cayabacare.com

Phone: (267) 668-2256

All complaints must be submitted in writing. You will not be penalized for filing a complaint.