Privacy Policy
THIS NOTICE IS INTENDED TO DESCRIBE HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND/OR DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.
If you have any questions regarding this notice, please contact the Compliance Officer at Cocoon Care Management, LLC, 3839 Flatlands Ave Suite 208 – Brooklyn, NY 11234 or call 855-262-6660 or email [email protected].
1. Understanding your Health Record/Information
Each time you visit a hospital, physician, or each time a healthcare professional visits your home a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnosis, treatment and a plan for future care or treatment. This information often referred to as your health or medical record, serves as a basis for planning your care and treatment and serves as a means of communication among the many health professionals who contribute to your care. Understanding what is in your record and how your health information is used helps you to ensure its accuracy, better understand who, what, when, where and why others may access your health information, and make more informed decisions when authorizing disclosure to others.
2. Your Rights
Unless otherwise required by law, your health record is the physical property of the healthcare practitioner or facility that compiled it, but the information belongs to you. You have the right to:
Request in writing a restriction on certain uses and disclosures of your information. Cocoon Care Management is not required to agree to comply with your requested restriction and may say “no” if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Request in writing amendments (corrections to any information that you think is incorrect or incomplete) to your health record, either clinical or demographic. We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Inspect and request in writing an electronic or paper copy of your health record. We will provide a copy or a summary of your health information, usually within our request. We may charge a reasonable, cost-based fee.
Obtain an accounting of disclosures of your health information for six years prior to the date of your request. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
Request confidential communications of your health information by alternative means or at alternative locations. We will say “yes” to all reasonable requests.
Get a copy of this Notice of Privacy Practices.
Revoke your authorization to use/disclose health information in writing at any time, except to the extent that Cocoon Care Management has already taken action in reliance thereon.
File a Complaint. If you have questions and would like additional information, you may contact the Compliance Officer at Cocoon Care Management. If you believe your privacy rights have been violated, you may also file a complaint with the NYS Department of Health at 212-417-5888. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. There will be no retaliation for filing a complaint.
3. Your Choices
For certain health information, you can tell Cocoon Care Management your choices about what we share. If you have a clear preference for how we share your information in the situations described below, tell us what you want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to:
Share information with your family, close friends, or others involved in your care. Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friends or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care.
Share information in a disaster relief situation.
Contact you for fundraising efforts. In the case of fundraising, we may contact you for fundraising efforts, but you can tell us not to contact you again.
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we never share your information unless you give us written permission:
-
Marketing purposes
-
Sale of your information
Cocoon Care Management does not (i) create or manage a hospital directory, or (ii) create or maintain psychotherapy notes.
4. Our Uses and Disclosures
We will use your health information for treatment:
Information obtained by the assessment professional will be recorded in your record and used to determine the course of treatment that should work best for you. Members of your healthcare team will then record the actions they took, their observations and education provided. We will also provide other practitioners involved with your care with copies of various reports that should assist them in treating you as well as enabling your physician to provide orders for your care.
We will use your health information for payment:
Your information will be used and shared to bill and obtain payment for services provided. A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, services provided, and supplies used. Outside collection agencies may also be utilized.
We will use your health information to run our agency:
We may use and disclose health information in order to facilitate regular healthcare operations, to provide quality care to all patients, and to contact you when necessary.
Examples include quality assessment and improvement activities, case management and care coordination, employee training and evaluation, accreditation, certification, licensing or credentialing activities, review and auditing, compliance programs, business planning and development, patient satisfaction surveys, and emergency and disaster planning.
Business Associates:
There may be some services provided through contracts with Business Associates. Examples may include therapy services, laboratory tests, supplies, and audit services. When these services are contracted, we may disclose some or all your health information to our Business Associate so they can perform the business we’ve asked them to do. To protect your health information, we require the Business Associate to safeguard your information.
Other permitted uses include public health activities, research, workers’ compensation, law enforcement, oversight, responding to legal actions, organ and tissue donation, medical examiners/funeral directors, and as otherwise required by law.
Use and disclose information to other providers, including affiliated providers, to avail you of certain healthcare items or services, including care management services (“Healthcare Services”). We can use or share health information, including PHI and disclose it to (i) Cocoon Care Management’s Coordinator, (ii) such of its employees/independent contractors as Cocoon may select, and (iii) other providers, including providers affiliated with Cocoon Care Management, in connection with the Healthcare Services, including without limitation, to determine whether you are an appropriate candidate for Healthcare Services and to obtain payment for the same.
5. Our Responsibilities
Cocoon Care Management is required by law to maintain the privacy and security of your protected health information.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it.
Cocoon Care Management will not disclose your health information other than as described in this document without your written authorization. If you or your representative authorizes Cocoon Care Management to use or disclose your health information, you may revoke such authorization in writing at any time.
6. Notice of Privacy Practices Availability
This notice will be prominently posted in the office and on our website. Patients will be provided a hard copy.
7. Changes to the Terms of This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.