This document contains important information regarding your rights as well as Cayaba Care's responsibilities.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE READ CAREFULLY.
State Notice on Privacy Practices
When it comes to handling your personal health information, we follow state laws, which are sometimes stricter than the federal HIPAA privacy law. This notice explains your rights and our duties under state law. Your state may give you additional rights to limit sharing your health information. Please call our care team at 267-668-2256.
Your Personal InformationYour nonpublic (private) personal information (PI) identifies you. You have the right to see and correct your PI. We may collect, use and share your PI as described in this notice. Our goal is to protect your PI because your information can be used to make judgments about your health, finances, character, habits, hobbies, reputation, career and credit. We may get your PI from others, such as hospitals, insurance companies, or other doctors. We may also share your PI with others outside our company — without your approval, in some cases. But we take reasonable measures to protect your information. If an activity requires us to give you a chance to opt out, we'll let you know. Further, we will tell you how you can let us know you don't want your PI used or shared for an activity you can opt out of.
HIPAA Notice on Privacy Practices
We keep the health and financial information of our current and former patients private as required by law, accreditation standards and our own rules. We're also required by federal law to give you this notice to explain your rights and our legal duties and privacy practices.
Your Protected Health Information
There are times we may collect, use and share your Protected Health Information (PHI) as allowed or required by law, including the HIPAA Privacy rule. Here are some of those times:Payment:
We collect, use and share PHI to get payment for the medical care you receive from us or share information with the doctors, clinics, and others who bill us for your care.Health care operations:
We collect, use and share PHI for your health care operations.Treatment activities:
We collect, use and share PHI to provide the care, medicine, and services you need or to help doctors, hospitals, and others get you the care you need.
Examples of ways we use your information:-We may share PHI with other doctors or your hospital so that they may treat you.-We may use PHI to review the quality of care and services you get.-We may use PHI to help you with services for conditions like asthma, diabetes or traumatic injury.-We may use publicly and/or commercially available data about you so you can get available health services.-We may use your PHI to create, use or share de-identified data as allowed by HIPAA.-We may also use and share PHI directly or indirectly with health information exchanges for payment, health care operations and treatment. If you don't want your PHI to be shared in these situations, contact our care team at 267-668-2256
Sharing your PHI with you:
We must give you access to your own PHI. We may also contact you about treatment options or other health-related benefits and services. We may also send you reminders about routine medical checkups and tests.You may get emails that have limited PHI, such as appointment reminders. We'll ask your permission before we email you.
Sharing your PHI with others:
In most cases, if we use or share your PHI outside of treatment, payment, operations or research activities, we have to get your okay in writing first. We must also get your written permission before:-Using your PHI for certain marketing activities.-Selling your PHI.-Sharing any psychotherapy notes from your doctor or therapist.We may also need your written permission for other situations not mentioned above. You always have the right to cancel any written permission you have given at any time. You have the right and choice to tell us to:-Share information with your family, close friends or others involved with your current treatment or payment for your care.-Share information in an emergency or disaster relief situation.If you can't tell us your preference, for example in an emergency or if you're unconscious, we may share your PHI if we believe it's in your best interest. We may also share your information when needed to lessen a serious and likely threat to your health or safety.
Cayaba Care participates with one or more secure health information organization networks (each, an "HIO"), including an HIO called "HealthShare Exchange of Southeastern Pennsylvania, Inc., ("HSX"), which makes it possible for Cayaba Care to share your Health Information electronically through a secure connected network.
Cayaba Care may share or disclose your Health Information to HSX and other secure HIOs, including HIOs contracted with the Commonwealth of Pennsylvania, and even HIOs in other states.
Other health care providers, including physicians, hospitals and other health care facilities, that are also connected to the same HIO network as Cayaba Care can access your Health Information for treatment, payment and other authorized purposes, to the extent permitted by law.
You have the right to "opt-out" or decline to participate in having Cayaba share your health information through these aforementioned health information organization networks.
If you choose to opt-out of data-sharing through HIOs, Cayaba Carewill no longer share your Health Information through an HIO network, however it will not prevent how your information otherwise is typically accessed and released to authorized individuals in accordance with the law, including being transmitted through other secure mechanisms (i.e., by fax or an equivalent technology).Other reasons we may use or share your information:
We are allowed, and in some cases required, to share your information in other ways — usually for the good of the public, such as public health and research. We can share your information for these specific purposes:-Helping with public health and safety issues, such as-Preventing disease-Helping with product recalls-Reporting adverse reactions to medicines-Reporting suspected abuse neglect, or domestic violence-Preventing or reducing a serious threat to anyone's health or safety-Doing health research.-Obeying the law, if it requires sharing your information.-Responding to organ donation groups for research and certain reasons.-Addressing workers' compensation, law enforcement and other government requests, and to alert-Responding to lawsuits and legal actions.
We'll get your written permission before we use or share your PHI for any purpose not stated in this notice. You may cancel your permission at any time, in writing. We will then stop using your PHI for that purpose. But if we've already used or shared your PHI with your permission, we cannot undo any actions we took before you told us to stop.
Race, ethnicity and language:
We may receive race, ethnicity and language information about you and protect this information as described in this notice. We may use this information to help you, including identifying your specific needs, developing programs and educational materials and offering interpretation services. We don't share this information with unauthorized persons.
Under Federal Law, you have the right to:-Send us a written request to see or get a copy of your PHI, including a request for a copy of your PHI through email. Remember, there's a risk your PHI could be read by a third party when it's sent unencrypted, meaning regular email. So we will first confirm that you want to get your PHI by unencrypted email before sending it to you.-Ask that we correct your PHI that you believe is wrong or incomplete. If someone else, such as another doctor, gave us the PHI, we'll let you know so you can ask him or her to correct it.-Send us a written request not to use your PHI for treatment, payment or health care operations activities. We may say “no" to your request, but we'll tell you why in writing.-Request confidential communications. You can ask us to send your PHI or contact you using other ways that are reasonable. Also, let us know if you want us to send your mail to a different address if sending it to your home could put you in danger.-Send us a written request to ask us for a list of those with whom we've shared your PHI.-Ask for a restriction for services you pay for out of your own pocket: If you pay the whole bill for a service, you can ask your doctor not to share the information about that service with your health plan.
-Call our team at 267-668-2256
to use any of these rights.
How we protect information
We're dedicated to protecting your PHI, and we've set up a number of policies and practices to help keep your PHI secure and private. If we believe your PHI has been breached, we must let you know.We keep your oral, written and electronic PHI safe using the right procedures, and through physical and electronic ways. These safety measures follow federal and state laws. Some of the ways we keep your PHI safe include securing offices that hold PHI, password-protecting computers, and locking storage areas and filing cabinets. We require our employees to protect PHI through written policies and procedures. These policies limit access to PHI to only those employees who need the data to do their jobs. Employees are also required to wear ID badges to help keep unauthorized people out of areas where your PHI is kept. Also, where required by law, our business partners must protect the privacy of data we share with them as they work with us. They're not allowed to give your PHI to others without your written permission, unless the law allows it and it's stated in this notice.
Potential impact of other applicable laws
HIPAA, the federal privacy law, generally doesn't cancel other laws that give people greater privacy protections. As a result, if any state or federal privacy law requires us to give you more privacy protections, then we must follow that law in addition to HIPAA.
Calling or texting you
We, including our affiliates and/or vendors, may call or text you by using an automatic telephone dialing system and/or an artificial voice. But we only do this in accordance with the Telephone Consumer Protection Act (TCPA). The calls may be about treatment options or other health-related benefits and services for you. If you don't want to be contacted by phone, contact your provider to add your phone number to our Do Not Call list. We will then no longer call or text you.
If you think we haven't protected your privacy, you can file a complaint with us by calling 267-668-2256. You may also file a complaint with the U.S. Department 5 of Health and Human Services Office for Civil Rights by visiting hhs.gov/ocr/privacy/hipaa/complaints/
. We will not take action against you for filing a complaint.Contact informationYou may call us at 267-668-2256
to apply your rights, file a complaint or talk with you about privacy issues.
Copies and changes
You have the right to get a new copy of this notice at any time. Even if you have agreed to get this notice by electronic means, you still have the right to ask for a paper copy. We reserve the right to change this notice. A revised notice will apply to PHI we already have about you, as well as any PHI we may get in the future. We're required by law to follow the privacy notice that's in effect at this time. We may tell you about any changes to our notice through a newsletter, our website or a letter.
Effective Date of this NoticeThe most recent revision of this notice was January 25, 2021.
It's important we treat you fairly
We follow federal civil rights laws in our health programs and activities. We don't discriminate, exclude people, or treat them differently based on race, color, national origin, sex, age or disability. If you have disabilities, we offer free aids and services. If your main language isn't English, we offer help for free through interpreters and other written languages. Call your clinic for help (TTY/TDD:711).
If you think we failed to offer these services or discriminated based on race, color, national origin, age, disability, or sex, you can file a complaint, also known as a grievance. You can file a complaint through one of these ways:
-Write to Compliance Coordinator at 111 S Independence Mall E Suite 500, Philadelphia, PA 19106, or e-mail email@example.com.
-File a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights at 200 Independence Avenue, SW; Room 509F, HHH Building; Washington, D.C. 20201
-Go online at http://ocrportal.hhs.gov/ocr/portal/lobby.jsf
and fill out a complaint form http://hhs.gov/ocr/office/file/index.html
Get help in your languageOne more right that you have the right to get this information in your language for free. If you'd like extra help to understand this in another language, call the Member Services number on your ID card (TTY/TDD: 711).Aside from helping you understand your privacy rights in another language, we also offer this notice in a different format for members with visual impairments. If you need a different format, please call the Member Services number on your ID card.
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