LifeScope, a Division of E4 Health, Inc.
Notice of Privacy Practices – effective April 14, 2003
THIS NOTICE DESCRIBES HOW HEALTH CARE AND PSYCHOLOGICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. IT IS OUR LEGAL DUTY TO PROVIDE YOU WITH THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
At LifeScopeEAP (LIFESCOPE), the privacy and confidentiality of your personal information is very important to us. We would like to provide you with specific information on our privacy practices and a detailed description of how we may use and disclose your Protected Health Information (PHI). The Notice of Privacy Practices is presented here. A more detailed (and updated, when necessary) notice can be viewed on our website (www.LifeScopeEap.com
) or obtained by calling (800-227-2195).
The Notice describes how LIFESCOPE may use and disclose your PHI to carry out payment activities (when necessary); to facilitate referrals to EAP and health care providers when that will help your ongoing care; and to conduct health care operations, such as record keeping and activities for quality assurance; and to perform other activities that are permitted or required by law. It also contains information about your rights to access and control your PHI.
We are required by law to maintain the privacy of your PHI. Most of our uses and disclosures of your PHI are for coordinating treatment and community resource referrals and for health care operations. We may also use or disclose your PHI as permitted and required by law.
LIFESCOPE may use or disclose your protected health information (PHI) for specific treatment, payment and health care operations purposes with your consent.
Treatment is when the EAP provides, coordinates or manages your behavioral health care. An example of treatment would be when we consult with, or make a referral to, another health care provider, such as your family physician or another psychotherapist.
Paymentis when LIFESCOPE pays a contracted affiliate counselor for counseling services provided.
Health Care Operations are activities that relate to the performance and operation of the EAP practice. Examples of health care operations are quality assessment and improvement activities, business-related matters, such as audits and administrative services, and case management and care coordination. This applies to activities within the EAP office, such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.
In most cases, we will choose to follow state privacy laws which can provide individuals with greater privacy protections. If a state law that we follow requires that we not use or disclose PHI, then we may not use or disclose that information according to the applicable state law.
You have the following rights regarding your PHI:
· You have the right to request that we restrict the PHI we use or disclose about you for health care operations and referrals.
· If you believe that a disclosure of all or part of your PHI may endanger you, you may request that we communicate with you in an alternate manner or at an alternate location.
· Generally, you have the right to inspect and copy your PHI that is contained in a ‘designated record set.’
· If you believe that your PHI is incorrect or incomplete, you may request that we amend your information.
You may complain to LIFESCOPE if you believe that we have violated your privacy rights. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services. For any questions or complaints you may call the Privacy Officer at: 800-227-2195.
WHEN AUTHORIZATION IS NEEDED
The purpose of an Authorization is to protect your privacy and confidentiality. LIFESCOPE may use or disclose PHI for purposes outside of treatment coordination, payment and health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits disclosures of specific PHI. In those instances when LIFESCOPE is asked for information for purposes outside of treatment coordination and health care operations, we will obtain an authorization from you before releasing this information.
You may revoke all such authorizations of PHI at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that LIFESCOPE has already used and relied on that authorization.
USES AND DISCLOSURES WITH NEITHER CONSENT NOR AUTHORIZATION
LIFESCOPE may use or disclose PHI without your consent or authorization in the following circumstances:
- Child Abuse: If we have reasonable cause to believe that a minor child is at risk of harm due to physical or emotional injury resulting from abuse, sexual molestation or from neglect, LIFESCOPE must immediately report such condition to the Department of Social Services or Department of Children, Youth and Families, or the relevant child protective agency in your state.
- Adult and Domestic Abuse: If LIFESCOPE has reasonable cause to believe that an elderly person (age 60 or older) is suffering from or has died as a result of abuse, we must immediately make a report to the state’s Department of Elder Affairs, or other relevant state overseeing agency.
- Serious Threat to Health or Safety: If you communicate to LIFESCOPE an explicit threat to kill or inflict serious bodily injury upon an identified person and you have the apparent intent and ability to carry out the threat, we must take reasonable precautions. These may include warning the potential victim, notifying law enforcement, or arranging for your hospitalization. We must also do so if we know you have a history of physical violence and we believe there is a clear and present danger that you will attempt to kill or inflict bodily injury upon an identified person. If you present a danger to yourself and refuse to accept appropriate treatment, we can take action for you to be committed to a hospital and may contact members of your family or other individuals to assist in protecting you. If such a situation arises, LIFESCOPE will make every effort to fully discuss it with you before taking any action and we will limit our disclosure to what is necessary.
- Worker’s Compensation: If you file a worker’s compensation claim, your records relevant to that claim will not be confidential to entities such as your employer, the insurer and the Division of Worker’s Compensation.
- Judicial or Administrative Proceedings: If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment and the records thereof, such information is privileged under state law and will not be released without written authorization from you or your legally-appointed representative, or a court order. The privilege does not apply when you are being evaluated for a third party or where the evaluation is court-ordered. You will be informed in advance if this is the case.
- Health Oversight: If a government agency is requesting the information for health oversight activities, LIFESCOPE may be required to provide it for them.
- Lawsuits: If a client files a complaint or lawsuit against us, LIFESCOPE may disclose relevant information regarding that client in order to defend ourselves.
No PHI or information about your specific contact with, and use of, the LifeScope EAP will be given to your company/organization or anyone in your company/organization without your written and specific authorization (except as described above, such as if you or someone else may be in serious danger).