Notice of Privacy Practices
Hearth, Inc.
1640 Washington Street, Boston, MA 02118
617-369-1550
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
Privacy
Hearth is required by state and federal law to maintain the privacy of your protected health information (PHI). PHI includes any identifiable information about your physical or mental health, the health care you receive, and the payment for your health care.
Hearth is required by law to provide you with this notice to tell you how PHI may be used and disclosed and to inform you of your privacy rights. Hearth must follow the privacy practices as set forth in its most current Notice of Privacy Practices.
This notice refers only to the use/disclosure of PHI. IT does not change existing law, regulations and policies regarding informed consent for treatment.
Changes to This Notice
Hearth may change its privacy practices and the terms of this notice at any time, Changes will apply to PHI that Hearth already has, as well as PHI that Hearth receives in the future. The most current privacy notice will be posted in Hearth facilities and programs, and on the Hearth website (www.hearth-home.org), and will be available on request. Every privacy notice will be dated.
How Does Hearth use and Disclose PHI?
Hearth may use/disclose your PHI internally for treatment, payment and health care operations without your authorization. Otherwise, your written authorization is needed unless an exception listed in this notice applies.
Uses/Disclosures Relating to Treatment, Payment and Health Care Operations
The following examples describe some, but not all, of the uses/disclosures that are made for treatment, payment and health care operations.
- For treatment - Consistent with its’ regulations and policies, Hearth may use/disclose PHI to doctors, nurses, service providers and other persons (e.g., interpreters) who are involved in delivering your health care and related services. Your PHI will be used to determine your eligibility for Hearth services, to assist in developing your action and/or service plan and to conduct periodic reviews and assessments. Your PHI may be shared with other health care professionals and providers to obtain prescriptions, lab work consultations and other items needed for your care.
- To obtain payment – Consistent with the restrictions set forth in its regulations and policies, Hearth may use/disclose your PHI to bill and collect payment for your health care services. Hearth may release portions of your PHI to the Medicaid or Medicare program or to a third party payer to determine if they will make a payment, to get prior approval and/or to support any claim or bill.
- For health care operations – Hearth may use/disclose PHI to support activities such as program planning, management and administrative activities, quality assurance, receiving and responding to complaints, compliance programs (e.g. Medicaid), audits, training and credentialing of health care professionals, and certification and accreditation (e.g. EOEA).
Appointment Reminder
Hearth may use PHI to remind you of an appointment or to provide you with information about treatment alternatives or other health related benefits and services that may be of interest to you.
Use/Disclosures Requiring Authorization
Hearth is required to have a written authorization from you or from your personal representative with the legal authority to make health care decisions on your behalf, for uses/disclosures beyond treatment, payment and health care operations unless an exception listed below applies. You may cancel an authorization at any time, if you do so in writing. A cancellation will stop future uses/disclosures except to the extent Hearth has already acted based upon your authorizations.
Exceptions
- For guardianship or commitment proceedings when Hearth is a party
- For judicial proceedings if certain criteria are met
- For protection of victims of abuse or neglect
- For research purposes, following strict internal review
- If you agree verbally or otherwise, Hearth may disclose limited amount of PHI for the following purpose:
- Clergy—Your religious affiliation may be shared with clergy
- To family and friends—Hearth may share information directly related to their involvement in your care, or payment for your care
- To correctional institutions—if you are an inmate for federal and state oversight activities such as fraud investigations, usual incident reporting, and protection and advocacy activities
- For specialized government functions such as government benefit programs relating to eligibility and enrollment
- To avoid a serious and imminent threat to public health or safety
- For public health activities such as tracking diseases and reporting vital statistics
- Upon death—to funeral directors and organ banks
Your Rights
You, or a personal representative with legal authority to make health care decisions on you behalf, have the right to:
- Request that Hearth use a specific address or telephone number to contact you.
- Obtain, upon request, a paper copy of this notice or any revision of this notice, even if you agreed to receive it electronically.
- Inspect and copy PHI that may be used to make decisions about your care. Access to your records may be restricted in limited circumstances. If you are denied access, in certain circumstances, you may request that the denial be reviewed. Fees may be charged for copying and mailing.
- Request additions or corrections to your PHI.
- Receive a list of individuals who received your PHI from Hearth (excluding disclosures that you authorized or approved, disclosures made for treatment, payment and healthcare operations and some required disclosures).
- Ask that Hearth restrict how it uses or discloses your PHI.
These requests must be made in writing.
To Contact Hearth or to File a Complaint
If you want to obtain further information about Hearth’s privacy practices, or you feel your privacy rights have been violated, or you want to file a complaint, you may contact a Hearth Site or Program Director. If you are unsure of who to contact, please call Hearth's main number: 617-369-1550.
You also may contact Hearth’s Privacy Officer, Dawn Matchett, for more information or assistance with filing a complaint. Dawn can be reached at 617-369-1554.
No one may retaliate against you for filing a complaint or for exercising your rights as described in this notice.