Legal
This publication of this Notice of Privacy Practices (“Notice”) is required by the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). It describes how the Diabetes Prevention and Weight Loss program that Fruit Street Health, P.B.C. provide (collectively, “Fruit Street”, “we,” “us,” or “our”) may use and disclose your “Protected Health Information,” which is defined as information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition; related health care services; or related to the past, present, or future payment for the provision of health care to you.
HIPAA requires us to adhere by the terms of this Notice of Privacy Practices. We may change the terms of our notice at any time and those revised terms will apply to your Protected Health Information. You acknowledge receipt of this Notice by accepting our Terms & Conditions Terms & Conditions for using the Services provided by Fruit Street.
As set out in our Privacy Policy, you have agreed to our Privacy Policy by use of the Services.
1. Your Protected Health Information may be used and disclosed by Fruit Street and its business associates (collectively, “Fruit Street”) as defined in our Privacy Policy, and by others outside Fruit Street that are involved in your care and treatment for the purpose of providing health care services to you.
2. Examples of usage of your Protected Health Information includes, but is not limited to, the following:
Payment: Your Protected Health Information may be used to obtain payment for your health care services from third parties.
Support Operational Activities: Including, but not limited to, quality assessment activities, review activities, training, licensing, and conducting or arranging for other business activities.
Sharing with Business Associates: We may share your Protected Health Information with “business associates” or other third parties that perform billing and healthcare services for Fruit Street. We have in place business associates agreements that protect the privacy of your Protected Health Information.
Disclosure Required By Law: Such use or disclosure will be made in compliance with the law and you will be notified by us of such use.
Public Health: We may disclose your Protected Health Information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information.
Health Oversight: Similarly, we may disclose Protected Health Information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.
Law Enforcement: We may disclose Protected Health Information, so long as applicable legal requirements are met, for law enforcement purposes.
Threat to Public Safety: Consistent with applicable federal and state laws, we may disclose your Protected Health Information if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
Information Not Personally Identifiable: We may use or disclose your Protected Health Information in ways that do not personally reveal your identity.
3. By using the Services, you consent to our use of Protected Health Information as described herein both retrospectively and prospectively.
INSPECTION OF PROTECTED HEALTH INFORMATION AND RESTRICTIONS ON ITS USE
4. You have the right to inspect and copy your Protected Health Information subject to applicable legal restrictions. You may inspect and obtain a copy of your Protected Health Information as long as we maintain it.
5. You have the right to request a restriction on the use or disclosure of your Protected Health Information. This means you may ask us not to use or disclose any part of your Protected Health Information for the purposes of treatment, payment or healthcare operations. If Fruit Street believes it is in your best interest to permit use and disclosure of your Protected Health Information, however, your Protected Health Information will not be restricted.
6. You have the right to request to receive confidential communications of your Protected Health Information from Fruit Street by alternative means or at an alternative location and we will accommodate reasonable requests.
ELECTRONIC COMMUNICATIONS
7. You may always contact us at start@fruitstreetclinic.com and choose to communicate with us electronically. However, we warn you that we can make no guarantee that the email will be or will remain encrypted during the data transfer, and that there may be some level of risk that the information in the email could be read by a third party. By communicating with us via email, and, especially by making a request(s) to receive your information via unencrypted email, you acknowledge that you are aware that email is not a secure method of communication, and that you agree to the risks.
COMPLAINTS
8. You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our Privacy Contact of your complaint by delivering your complaint to the following address:
Complaints
Fruit Street Health, P.B.C.
5601 Bridge Street
Suite 300, Office 353A,
Fort Worth, 76112
