KLARITY, LLC NOTICE OF PRIVACY PRACTICES
This notice describes how medical information about you may be used and disclosed and how you can get access to the information. Please review it carefully.
Our Legal Duty
We are required by applicable federal and state law to maintain the privacy of your Protected Health Information (PHI). We are also required to give you this Notice about our privacy practices, our legal duties, and your rights concerning your health information. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect immediately and will remain in effect until we replace it.
Commitment to Your Privacy
Klarity, LLC (dba Klarity Clinic or “KC”) is committed to protecting the confidentiality of its patients’ medical information. This Notice describes how KC may use your medical information within KC, and how we may disclose it to others outside of KC. This Notice also describes your rights concerning your own medical information. Please review it carefully and contact us should you have questions.
Use and Disclosure of Your Medical Information
Treatment
KC may use your medical information to provide you with medical services and supplies. KC may also disclose your medical information to others who require such information to treat you. These may include, but are not limited to: doctors, physician assistants, nurses, and medical transportation providers, as well as others involved in your care, as deemed medically appropriate. For example – your physician may be allowed to have access to your KC medical record to assist in your follow-up care. KC may also use your medical information to contact you to remind you of an upcoming appointment, to inform you about possible treatment options or alternatives, or to advise you about health-related services available to you.
Family Members and Others Involved in Your Care
KC may disclose your medical information to a family member or friend who is involved in your medical care, or to someone who helps to pay for your care. If you do not want KC to disclose your medical information to family members or others, please inform KC staff members assigned to your care. You may modify this list at any time.
Payment
KC may use and disclose your medical information to secure payment for the medical services and supplies provided to you. For example – your health plan or health insurance company may ask to see parts of your medical record before they will reimburse KC for your treatment.
Healthcare Operations
KC may use and disclose your medical information if it is necessary to improve the quality of care provided to patients or to assist in the day to day operations of KC. Your medical information may be used to conduct quality improvement activities, to obtain an audit, accounting or legal services, or to conduct business management and planning. For example – KC staff members may look at your medical record to evaluate whether KC personnel, your doctors, or other health care professionals performed satisfactorily.
Research
KC may use or disclose your medical information for research projects, such as studying the effectiveness of a treatment you received. These research projects must go through a special process that protects the confidentiality of your medical information.
Required by Law
Federal, state or local laws may require KC to disclose patients’ medical information.
Public Health
KC may report certain medical information for public health purposes. KC also may need to report a patient’s issues with medications or medical products to the Food and Drug Administration (“FDA”), or may notify patients of recalls of products they are using.
Public Safety
KC may disclose medical information for public safety purposes in limited circumstances. We may disclose medical information to law enforcement officials in response to a search warrant or a grand jury subpoena. We may also disclose medical information to assist law enforcement officials in identifying or locating a person, to prosecute a crime of violence, to report deaths that may have resulted from criminal conduct, or to report criminal conduct at KC. We may disclose your medical information to law enforcement officials and others to prevent a serious threat to the health or safety of an individual or the community.
Health Oversight Activities
Klarity, LLC may disclose medical information to a government agency that oversees KC or its personnel, and requires medical information to monitor KC’s compliance with state and federal laws.
Military, Veterans, National Security and Other Government Purposes
If you are a member of the armed forces, KC may release your medical information as required by military command authorities or to the Department of Veterans Affairs. KC may also disclose medical information to federal officials for intelligence and national security purposes or for presidential protective services.
Judicial and Administrative Proceedings
KC may disclose medical information in any judicial or administrative proceeding if ordered to do so by a court, or if KC receives a subpoena or a search warrant. You will receive advance notice about this disclosure in most situations, so that you will have a chance to object to sharing your medical information.
Information with Additional Protection
Certain types of medical information have additional protection under state or federal law. Medical information about evaluation and treatment for a serious mental illness or addiction is treated differently than other types of information. KC is required to get your permission before disclosing that information to others in many circumstances.
Disclosure Accounting
You have the right to receive a list of instances in which we, or our business associates, disclosed your health information for purposes other than treatment, payment, healthcare operations and/or certain other activities. If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests.
Other Uses and Disclosures
If KC wishes to use or disclose your medical information for a purpose that is not discussed in this Notice, KC will seek your permission. Permission granted to KC may be rescinded at any time, unless KC has already acted on your permission to use or disclose the information. To revoke your permission, please notify KC in writing at [email protected].
Your Rights
Right to Request Your Medical Information
Patients have a right to review their own medical information and receive a copy of that information. The law requires KC to keep the original record. This includes your medical record, your billing record, and other records we use to make decisions about your care. Medical information that is available electronically may be obtained in that format. If you request a copy of your information, you may be charged for KC’s costs to copy the information. You will be notified in advance of any applicable fee. Patients may review their record at no cost.
Right to Request Amendment
If you examine your medical information and believe that the information is erroneous or incomplete, you may ask us to amend your record. Your request must be in writing and provide an explanation for why the information should be amended. We may deny your request under certain circumstances.
Right to Obtain a List of Certain Disclosures
You have the right to request a list of many of the disclosures KC makes of your medical information. The first list will be provided to you free of charge, but you may be charged a fee for any additional lists requested during the same year. You will be notified in advance of any applicable fees.
Right to Request Restrictions
You have the right to ask KC not to make use of or disclose your medical information in seeking reimbursement for care or to operate KC. You may require a restriction on the disclosure of your medical information to a health plan, where that information is associated with an item or service for which you paid out-of-pocket. Otherwise, KC is not required to agree to your request. If we do agree, we will comply with that agreement. To request a restriction, please contact KC and describe your request in detail.
Right to Request Confidential Communication
You have the right to ask KC to communicate with you in a way that you will feel is more confidential. For example – you may ask us not to call your home, but to communicate only by mail. At the time of admission or upon registration, you may orally request confidential communications. Otherwise, you must submit a request in writing. You have the right ask to speak with your health care providers in private, outside the presence of others.
Right to a Paper Copy
If you have received this Notice electronically, you have the right to a paper copy at any time. You may download a paper copy of the Notice from our website, or you may obtain a paper copy of the Notice at any KC facility.
Changes to This Notice
From time to time, KC may change its practices concerning how it uses or discloses patient medical information, or how KC will implement patient rights concerning their information. KC reserves the right to change this Notice and to make the provisions in our new notice effective for all medical information we maintain. A revised Notice of Privacy Practices will be published for any further changes to these practices. Copies of KC’s current Notice of Privacy Practices may be obtained by contacting KC or by visiting our website.
Health Care Providers Covered by This Notice
This Notice of Privacy Practices applies to KC and its personnel. KC may share your information with other providers for treatment purposes, to be reimbursed for treatment, or to conduct health care operations. Our health care providers will follow this Notice for information they receive about you from KC. Other health care providers may follow different practices at their own offices or facilities.
Concerns or Complaints
Please inform us of any problems or concerns you have with your privacy rights, or how KC uses or discloses your medical information. If you have a concern, please contact KC at [email protected] or call 844-552-7489. If KC cannot resolve your concern, you may also file a complaint with the federal government. We will not penalize you or retaliate against you in any way for the filing of a complaint.
If You Have Questions
KC is required by law to give you this Notice and to follow the terms of the Notice that are currently in effect. If you have any questions about this Notice, or have further questions about how KC may use and disclose your medical information, please contact KC’s Privacy Administrator at [email protected] or call 844-552-7489.