HIPAA Notice of Privacy Practices

Who this notice covers

This notice applies to People Check LLC and its healthcare operations, including People Check Services, People Check Occupational Health and Direct Primary Care, and Austin Primary Care, located at 101 5th Street SE, Suites D, G, and J, Barberton, Ohio 44203. It applies to our healthcare professionals, staff, trainees, volunteers, and others who are permitted to use or disclose health information on our behalf. These locations and workforce members may share health information with one another for treatment, payment, and healthcare operations as permitted by law.

Your rights

When it comes to your health information, you have certain rights. This section explains those rights and some of our responsibilities.

Get an electronic or paper copy of your record

• You may ask to see or receive an electronic or paper copy of your medical record and other health information we maintain about you.
• We will ordinarily provide a copy or summary within 30 days. We may charge a reasonable, cost-based fee as permitted by law.

Ask us to correct your record

• You may ask us to correct health information you believe is inaccurate or incomplete.
• We may deny the request in certain circumstances, but we will explain the reason in writing, generally within 60 days.

Request confidential communications

You may ask us to contact you in a specific way—for example, at a particular telephone number—or to send mail to a different address. We will agree to reasonable requests.

Ask us to limit what we use or share

• You may ask us not to use or share certain information for treatment, payment, or healthcare operations. We are not always required to agree, particularly if the restriction could affect your care.
• If you pay for a healthcare item or service completely out of pocket, you may ask us not to share information about that item or service with your health plan for payment or healthcare operations. We will agree unless the law requires disclosure.

Get a list of disclosures

You may ask for an accounting of certain disclosures of your health information made during the six years before your request. The accounting generally does not include disclosures for treatment, payment, or healthcare operations and certain other disclosures. One accounting in a 12-month period is free; we may charge a reasonable, cost-based fee for additional requests.

Get a copy of this notice

You may request a paper copy of this notice at any time, even if you agreed to receive it electronically. We will provide one promptly.

Choose someone to act for you

If you have given someone medical power of attorney, or if someone is your legal guardian or otherwise legally authorized to act for you, that person may exercise your rights. We will verify the person’s authority before acting.

File a complaint

You may complain to us if you believe your privacy rights have been violated by contacting our Privacy Officer using the information at the end of this notice. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by visiting hhs.gov/hipaa/filing-a-complaint, calling 1-877-696-6775, or writing to 200 Independence Avenue SW, Washington, DC 20201. We will not retaliate against you for filing a complaint.

Your choices

For certain health information, you may tell us your preferences about what we share. Tell us what you want us to do, and we will follow your instructions when the law gives you that choice.

• You may choose whether we share relevant information with family members, close friends, or others involved in your care or payment for your care.
• You may choose whether we share information in a disaster-relief situation.
• If you are unable to communicate your preference, we may share information when we believe it is in your best interest or when needed to lessen a serious and imminent threat to health or safety.

We will not use or disclose your health information for marketing, sell your health information, or disclose most psychotherapy notes without your written authorization, except as otherwise permitted by law. If we ever contact you for fundraising, you may tell us not to contact you again.

How we typically use or share your health information

Treat you

We may use your health information and share it with other professionals who are treating you. For example, we may provide information to a specialist involved in your care.

Run our organization

We may use and share your information to operate the practice, improve care, train staff, conduct quality activities, and contact you when necessary. For example, we may review records to evaluate the quality of our services.

Bill for services

We may use and share your information to bill and obtain payment from health plans, employers, workers’ compensation programs, or other responsible parties. Direct Primary Care membership services generally are not billed to insurance, but other People Check services may involve billing or payment activities.

Occupational health and employer-related services

When we provide occupational health services, workplace medical surveillance, drug or alcohol testing, fitness-for-duty evaluations, or care for a work-related injury or illness, information may be disclosed to an employer, third-party administrator, testing program, government agency, or workers’ compensation entity when you authorize the disclosure or when law permits or requires it. When HIPAA requires a written notice before a workplace-related disclosure, we will provide that notice.

Other ways we may use or share information

We may use or disclose your health information for the following purposes when applicable legal requirements are met:

• Public-health and safety activities, including disease prevention, product recalls, adverse-event reporting, reporting suspected abuse or neglect, and preventing or reducing a serious threat to health or safety.
• Health research that satisfies applicable legal protections.
• Compliance with federal, state, or local law and lawful oversight by the U.S. Department of Health and Human Services.
• Organ and tissue donation requests.
• Work with a coroner, medical examiner, or funeral director.
• Workers’ compensation claims, law-enforcement purposes, health-oversight activities, and special government functions such as military or national-security activities.
• Responses to court or administrative orders, subpoenas, lawsuits, and other legal proceedings as permitted or required by law.

Additional protections

Some types of information—including certain mental-health, substance-use-disorder, HIV-related, genetic, and reproductive-health information—may receive additional protection under federal or state law. We will comply with laws that provide greater privacy protection.

To the extent we maintain substance-use-disorder patient records protected by 42 CFR Part 2, those records generally will not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your written consent or a qualifying court order and subpoena. If fundraising communications ever use Part 2 information, we will provide clear advance notice and a choice not to receive them.

Our responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will notify you 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 the notice currently in effect and provide you with a copy upon request.
• We will not use or share your information in a manner not described in this notice unless you authorize it in writing. You may revoke an authorization in writing at any time, except to the extent we have already relied on it.

Changes to this notice

We may change this notice and make the revised terms effective for all health information we maintain, including information created or received before the change. The current notice will be available in our offices, upon request, and on our website.

Privacy questions, requests, or complaints

Privacy Officer: Melissa McCoy, APRN-CNP
People Check LLC
101 5th Street SE, Suites D, G & J
Barberton, Ohio 44203
Phone: 330-848-9104
Email: customerservice@peoplecheckservices.com