NOTICE OF HIPAA PRIVACY PRACTICES OF
MEDEASE TECHNOLOGIES, INC d/b/a DOCSPACE

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

During your treatment through the DocSpace portal, your doctor and other authorized personnel may gather information about your health, treatment, and payment for services. This notice explains how that information may be used and shared with others. It also explains your privacy rights regarding this kind of information. We will not use or disclose your information without your written authorization (permission) except as described in this notice. The terms of this notice apply to health information created or received by your treatment provider through the DocSpace portal.

DocSpace is committed to protecting patient privacy. We are required by law to provide you with this Notice of Privacy Practices and to (1) make sure that medical information that identifies you is kept private (2) give you this notice of our legal duties and privacy practices with respect to medical information about you (3) follow the terms of the notice that is currently in effect and (4) notify you in the event there is a breach of any unsecured protected health information about you.

We reserve the right to revise or amend this Notice at any time. Any revision or amendment to this Notice will be effective for all of your records that we created or maintained in the past and for any of your records that we may create or maintain in the future. You may request a copy of our most current Notice at any time.

I.When We May Use and Disclose Your Medical Information With Your
Written Authorization

  • With your authorization – For any purpose other than the ones described below, we may use or disclose your health information only when you have given us your written authorization.
  • Highly confidential information – There are additional protections for certain confidential health information, which may require a special authorization. For example: diagnosis, prognosis or treatment for alcohol or drug dependency, HIV testing or results
  • Marketing – We will obtain your written authorization before using your health information to send marketing materials.

** DocSpace will never sell your medical information **

II.When We May Use and Disclose Your Medical Information Without Your
Written Authorization

  • Treatment: Your Protected Health Information (PHI) may be used by staff members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. For example, results of laboratory tests and procedures will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members.
  • Payment: Your PHI may be used to seek payment from sources of insurance coverage such as an automobile or health insurer, or from credit card companies that you may use to pay for services. For example, your health plan may request and receive information on dates of service, the services provided, and the medical condition being treated.
  • Health Care Operations: Your PHI may be used as necessary to support the day-to-day activities and management of DocSpace. For example, information on the services you received may be used to support budgeting and financial reporting, and activities to evaluate and promote quality.
  • Law Enforcement: Your PHI may be disclosed to law enforcement agencies to support government audits and inspections, to facilitate law enforcement investigations, and to comply with government mandated reporting.
  • Public Health Reporting: Your PHI may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the state’s public health department.
  • Appointment Reminders, Check-In and Results: DocSpace may use and disclose your PHI to contact you and remind you of an appointment. We may leave a voice message or text message, or notify you through our portal or phone application to remind you of an appointment for results of certain tests but will leave the minimum amount of information necessary to communicate this information.
  • Treatment Options and Health-Related Benefits and Services: We may use and disclose your PHI to inform you of treatment options or alternatives as well as certain health-related benefits or services that may be of interest to you. In addition, we use and disclose your PHI to describe health-related products or services (or payment for such products or services) provided through your plan or to offer information on other services available to you.
  • Disclosures to Family or Friends: We may disclose your PHI to individuals involved in your care or treatment or responsible for payment of your care or treatment, if you authorize us to disclose your PHI to these individuals. If you are incapacitated, we may disclose your PHI to the person named in your Durable Power of Attorney for Health Care or your personal representative (the individual authorized by law to make health-related decision for you). In the event of a disaster, your PHI may be disclosed to disaster relief organizations to coordinate your care and/or to notify family members or friends of your location and conditions.
  • Public Health Reporting: We may disclose and may be required by law to disclose your PHI for certain public health purposes. With permission, we may provide proof of immunizations to a school that requires a patient’s immunization record prior to enrollment or admittance of a student if you have informally agreed to the disclosure for yourself or on behalf of your legal dependent.
  • Lawsuits and Disputes: We may disclose your PHI in response to a court or administrative order, subpoena, request for discovery, or other legal processes. In the absence of a court order, disclosure of PHI can only be given with patient’s authorization. Your information may also be disclosed if required for our legal defense in the event of a lawsuit related to your treatment.
  • Deceased Patients: We may disclose your PHI to a medical examiner or coroner to identify a deceased individual or to identify the cause of death. In addition, we may disclose PHI necessary for funeral directors to fulfill their responsibilities, or for a lawsuit related to your death. Your health information remains protected until fifty (50) years after your death.
  • Serious Threats to Health or Safety: We may use and disclose your PHI when necessary to reduce or prevent a serious threat to your health and safety or the heath and safety of another individual or the public. This includes disclosures of your condition to an emergency contact during your session in the event of an emergency.
  • Workers’ Compensation: We may disclose your necessary portion of your PHI that are deem necessary for worker’s compensation in compliance with worker’s compensation laws. This information may be reported to your employer and/or your employer’s representative in the case of an occupational injury or illness.
  • Minors: If you are a minor, we may disclose your PHI to your parent or guardian unless otherwise prohibited by the law.
  • Special Circumstances: We may use and disclose your medical information in these Special circumstances:
    • Organ and tissue donation
    • Health oversight activities (as required or allowed by law)
    • National security and intelligence activities
    • Research
    • Business Associates

III.Your Rights Regarding Your Medical Information

Right to inspect and copy your health information – You may request access to your health information to review or request copies of the information. This usually includes medical and billing records maintained by DocSpace.

Right to request restrictions on the use or disclosure of your health information – You have the right to request restrictions on the use or disclosure of your medical record to your health plan for payment or health care operations if you have paid in full for the treatment out-of-pocket. This request must be in writing and identify what information you want to limit, how you want to limit the use and/or disclosure, and to whom you want the limits to apply.

Right to request to correct or amend your health information – You may ask us to correct your health information. We will consider all requests and may deny your request for legitimate reasons, for example, if we determine that the record is accurate and complete. To request a correction, you must send the request in writing and identify what information needs to be correct and why.

Right to request confidential communications – You can request that we communicate with you about medical matters in a certain way. Please be sure to let us know your wishes so we can note this request in your chart.

Right to be notified of a breach – We will notify you in the event of a breach of your protected health information.

Right to a paper copy of this notice – You have the right to receive a paper copy of this notice and may ask for a copy at any time.

IV.Changes to this Notice

We reserve the right to change this notice and to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. If the terms of this notice are changed, DocSpace will provide you with a revised notice upon request.

IV.Complaints or Questions

If you believe your privacy rights have been violated you may file a complaint with us by notifying the Office of Civil Rights. We will not retaliate against you for filing a complaint.