Privacy Practices

This practice understands that medical information about you and your health is personal. We are committed to protecting this information. This practice will create a record of the care and services you receive as a basis for planning your care and treatment, for communicating with the many healthcare professionals involved in your care, to obtain payment for services provided, as a source of information for public health officials, and to provide you with quality care while complying with certain legal requirements.

 

By law, Goodnite Sleep Solution, LLC. is required to provide you with our Notice of Privacy Practices. If you should have any questions about this Notice or to submit requests pursuant to this Notice, please contact the Practice Manager at Goodnite Sleep Solution. A copy of this Notice is available upon request. 

 

METHODS MEDICAL INFORMATION MAY BE USED AND DISCLOSED 

 

The following information describes different ways this office may use and disclose your medical information. Although examples are given, it is impossible to list every use or disclosure. 

 

For Treatment - We are permitted to use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes coordination or management with other physicians or facilities. For example, the physicians in this practice are specialists. When we provide treatment, we may request information from our referring physician as well as provide information about your diagnosis and treatment so that he may appropriately treat you for other medical conditions. 

 

For Payment - We may use and disclose information about you to bill and collect payment for service provided to you from your insurance company, Medicare, you, or other payer. For example, we may need to disclose information about you to a health plan in order for the health plan to pay your physician for the services you received. We may also need to inform your health plan about a treatment or procedure you are going to receive in order to obtain prior approval or to determine whether your plan will cover these services. 

 

For Health Care Operations - We are permitted to use and disclose medical information about you in order to efficiently operate our office and ensure all patients receive quality care. For example, your medical records or health information may be used to evaluate health care services, and the quality of your treatment. In addition, medical and billing records are audited to ensure we maintain our compliance with federal and state regulations.

 

Appointment Reminder and Other Health Related Benefits - We may use and disclose medical information about you as a reminder of an upcoming appointment, or to inform you of treatment alternatives or other health related benefits. For example, we may provide a reminder of your next appointment by telephone, voicemail/answering machine, or written notice. 

 

Text Messaging (SMS) and Email Communications – If you provide us with a mobile phone number and/or email address, you consent to receive communications from Goodnite Sleep Solution, LLC by SMS text message and/or email. These communications may include appointment reminders, equipment updates, billing notices, and other health-related information. Message frequency may vary. Standard message and data rates may apply. Reply STOP to opt-out of future messages or HELP for more information. You may also request to stop email communications by contacting our office. Please note that while we use reasonable safeguards, SMS and email communications may not always be fully secure. Goodnite Sleep Solution, LLC will not share your personal information, mobile number, or messaging consent information with third parties or affiliates for marketing or promotional purposes. For more information, please review our Privacy Practices and Terms & Conditions (www.goodnitesleepsolution.com/privacypractices and www.goodnitesleepsolution.com/termsandconditions).

 

Research or Other Qualified Personnel - We may use and disclose medical information about you for research or for management audit, financial audit, or program evaluation. You will not be directly or indirectly identified in any report of the research, audit, or evaluation. Your identity will not be disclosed in any manner. 
 

Organ and Tissue Transplants - If you have formally indicated your desire to be an organ donor or recipient, we may release medical information to organizations who handle procurement of organ eye, or tissue transplantation.
 

Coroners, Medical Examiners, and Funeral Directors - We are permitted to release information to a coroner or medical examiner to identify a deceased person or to determine the cause of death. We may also release information to funeral directors in order for the director to carry out his duty.

 

Military, Veterans, and National Security - If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may disclose your medical information for specialized governmental functions, authorized national security and intelligence activities, and for the provision of protective services for the President of the United States, other authorized government officials, or foreign heads of state. 

 

As required by Law - We will disclose medical information about you when required by federal or state law or regulations. 

 

Public Health Risks and Health Oversight - We may disclose your medical information for public health activities which may include prevention or control of disease, injury or disability, to report births and deaths, to notify a person who may have been exposed to a disease or problems with products, or to notify individuals of recalls of product they may be using. 

 

Medical information about you may be disclosed to health oversight agencies for activities authorized by law. Health oversight agencies include public and private agencies authorized by law to oversee the health care system. They may include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor government programs, eligibility or compliance, and to enforce civil rights and criminal laws. 

 

Abuse or Neglect - We will disclose medical information in order to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. State law requires physicians to report child abuse or neglect. Regulations also permit the disclosure of information to report the abuse or neglect of elders or the disabled. 

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Worker’s Compensation - Medical information about you may be disclosed to provide benefits to you for work-related injuries or illness. 

 

Lawsuits and Disputes - If you are involved in certain lawsuits or administrative disputes, we are permitted to disclose medical information about you in response to a court order or administrative order. 

 

Law Enforcement - If asked by a law enforcement official, we may disclose your medical information under limited circumstances to provide the information:

 

• Is in response to a court order, warrant, or subpoena,

• Pertains to a victim of crime, whether living or deceased, and we are unable to obtain the person’s agreement;

• Is released because a crime has occurred on these premises;

• Is released to locate to fugitive, missing person, or suspect. 

 

We may also release medical information about you when necessary to prevent a serious threat to your health and safety, including mental and emotional injury to you, or the health and safety of the public or another person. 

 

Inmates - If you are an inmate or under the custody of law enforcement, we may release your medical information to the correctional facility or law enforcement official. This release is permitted to allow the institution to provide you with medical treatment, to protect your health or the health and safety of others, or for the safety or security of the correctional facility. 

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YOUR RIGHTS REGARDING MEDICAL INFORMATION

 

The U.S Department of Health and Human Services created regulations intended to protect your rights as a patient as required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The following are rights regarding your medical information, which this office collects and maintains. We will not retaliate against a patient who exercise’s their rights under HIPAA. 

 

Right to Request Restrictions - You have the right to request a restriction or limitation on the medical information this office uses or discloses about your treatment, payment or health care operations. You also have the tight to request a limit on the medical information disclosed to someone who is not involved in your care or the payment for your care. We are not required to agree to your request. However, if we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment. 

 

To request restrictions you must make your request in writing to the Practice Manager. Include the following in your request (1). What information you want to limit: (2) what kind of restriction are your requesting; (3) to whom the limits apply. For example, you may request we limit disclosure to your spouse, family member’s and other relatives, or close personal friends who may or may not be involved in your care. 

 

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 to be contacted only at work or by mail. This request must be made in writing and submitted to the Practice Manager. We are required to accommodate only reasonable requests. Your request must specify how or where you wish to be contacted.

 

Right to Inspect and Copy - You have the right to inspect and copy medical information that may be used to make decisions about your care. To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing and submit to the Practice Manager. We may refuse to provide you with certain information you request to inspect or copy if the information:

 

• Includes psychotherapy notes

• Has been compiled in anticipation for use in civil, criminal, or administrative proceedings

• Is subject to or exempt from the Clinical Laboratory Improvements Amendments of 1988

• Identifies a person whose information was obtained under a promise of confidentiality. 

 

If you request a copy of your medical information, we are permitted to charge a fee. The California State Board of Medical Examiners has established these fees for the cost of copying, mailing, or summarizing your records. California law requires we provide these copies or a narrative within 15 days of your request. We will inform you when the records will be ready or if we believe access should be limited or denied. If access is denied, we will notify you in writing of this decision. 

 

We may deny your request to inspect and copy records in certain limited circumstances. IF you are denied access to medical information including psychotherapy notes, you may request that this denial be reviewed. Another licensed health care professional who was not involved in the original decision to deny access will perform this review. 

 

Right to Amend - You have the right to request an amendment of your medical information for as long as the information is maintained by this office. The request of an amendment, you must submit your request in writing along with a reason that supports your request to the Practice Manager. 

 

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 as us to amend information that:

 

• Was not created by this office, unless the person or entity that created the information is no longer available to make the amendment;

• Is not part of the medical information kept by this office;

• Is part of the information you would not be permitted to inspect or copy;

• Is accurate and complete. 

 

We will respond to your request in writing within 60 days. However, if we refuse to allow an amendment, you are permitted to include a statement about the information in your medical record. If your amendment is accepted, we will work with you to notify other designated individuals of this amendment. 

 

Right to Accounting Disclosures - You have the right to request an accounting of disclosures. This is a list of disclosures made of your medical information for the purposes other than treatment, payment, or health care operations, or disclosures made per a signed authorization by you or our representative. Other limitations may apply as well. 

 

You must submit your request in writing to the Practice Manager. The first accounting of disclosures within any 12-month period will be free of charge. We are permitted to charge a reasonable fee for any additional requests within the same period. You will be notified of the cost involved so that you may withdraw or modify your request before any charge is incurred. 

 

Complaints if you believe your privacy rights have been violated; you may file a complaint with the Practice Manager. You may also send written complaints to the Office for Civil Rights, U.S. Department of Health and Human Services. The Office of Civil Rights may be contacted. 

 

Changes to Our Notice - This office reserves the right to change our practices, policies and procedures and to make the new provisions effective for all protected health information we maintain. Should any change be made, a revised Notice of Privacy Practices will be posted in the office and made available to you upon your request. This Notice of Privacy Practices is effective 9-4-2016.