NOTICE OF PRIVACY PRACTICES
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.
Effective Date: March 8, 2012
Federal privacy regulations implemented by the government under
the Health Insurance Portability and Accountability Act of 1996
(HIPAA) went into effect April 14, 2003. These regulations require
our office to maintain the privacy of your medical information and
provide you with a Privacy Notice. This Notice describes how your
personal medical information may be used and/or disclosed by
MedExpress Urgent Care to carry out treatment, payment, or health
care operations and for other purposes that are permitted or
required by law. It also describes how you can obtain access and
control of this information. The privacy regulations also require
our office to obtain your acknowledgement of receipt of this
notice. Please take this privacy notice home with you for your
records. If you have any questions, please feel free to ask a
PROTECTED HEALTH INFORMATION (PHI):
PHI refers to any patient information relating to treatment,
diagnosis, or payment that identifies a person.
USES AND DISCLOSURES OF PHI:
MedExpress uses PHI when employees within the organization
share, examine, or analyze a patient's medical information.
MedExpress discloses PHI upon the release, transfer, or granting of
access of PHI to other external persons or facilities. Except for
the following circumstances, MedExpress will not release your PHI
without your written authorization.
MedExpress will use and/or disclose your PHI to provide medical
services, coordinate medical care, and/or help manage your health
care and other medical services. MedExpress may also disclose PHI
to external persons or facilities that will be involved in your
Your PHI will be used and/or disclosed, as needed, to help
obtain payment for your services. These uses are often required to
obtain payment from third parties. Many services require prior
authorization, and your PHI may be disclosed to obtain insurance
authorization for such services before they are rendered.
Health Care Operations:
Your PHI may be used and/or disclosed, as needed, to aid in the
everyday administration of MedExpress. In order to provide you and
your family with quality care, MedExpress may use your PHI for
quality control reviews, internal investigations, performance
reviews, training of new employees, and for other health-related
activities. MedExpress may also use and/or disclose your PHI to
provide information to you.
Continuation of Treatment:
MedExpress may use and/or disclose your PHI to ensure
continuation of care by checking on your progress or notifying you
of received test results.
MedExpress may use and/or disclose your PHI to inform you of
various treatment options or programs that may be of benefit to
Medical Benefit Services:
MedExpress may use and/or disclose your PHI to inform you of
various medical benefit services in the community that may be of
use to you.
Certain aspects and components of our services may be performed
through contracts with outside persons or organizations, such as
auditing, billing, legal services, etc. At times, it may be
necessary for us to provide your PHI to one or more of these
outside persons or organizations who assist us with our Health Care
Operations. In all cases, these business associates are required to
appropriately safeguard the privacy of your information.
OTHER PERMITTED/ REQUIRED USES & DISCLOSURES:
MedExpress may use and/or disclose your PHI in the following
situations without your authorization:
Requirements of federal, state, or local law
Public safety issues that require notification to the proper public
Issues of national security or military activity
Health oversight agencies
Court-ordered legal proceedings
Correctional institutions at which a patient may be an inmate
Approved research projects
Coroners, organ donation services, and funeral directors
Change in ownership of MedExpress Urgent Care
The Food & Drug Administration
PERMITTED USES & DISCLOSURES THAT MAY BE USED WITH YOUR
AUTHORIZATION & OPPORTUNITY TO OBJECT:
MedExpress may use and/or disclose your PHI with your
authorization in certain situations. You have the opportunity to
authorize or object to the use and/or disclosure of all, or part,
of your PHI in the following situations:
If an emergent situation exists where it is impossible to obtain
your consent for PHI uses and/or disclosures, MedExpress will make
every effort to obtain consent once the emergent situation is
MedExpress will not use and/or disclose your PHI to any outside
marketing agencies without your written authorization. If the
marketing is to result in direct or indirect payment to MedExpress
by a third party, we will state this on the authorization form you
MedExpress utilizes a sign-in sheet to help employees determine
who is to be seen and in what order they will be seen. Once your
information is retrieved by a MedExpress employee, your PHI will be
removed from the sign-in sheet. If you object to leaving your PHI
on the sign-in sheet, please inform a MedExpress employee.
Other Persons Involved in Your Care:
MedExpress may disclose your PHI to notify a family member or
another responsible person of your care or condition. You will be
given the opportunity to agree or object to the disclosure of this
PHI before we will communicate with other persons involved in your
If you authorize MedExpress to use or disclose protected health
information about you, you may revoke that permission in writing at
any time and we will no longer use or disclose PHI about you for
the reasons covered by your authorization. Please understand that
we are unable to take back any uses or disclosures we have already
made with your permission and that we are required to retain our
records of the medical treatment or other services we have provided
YOUR RIGHTS REGARDING YOUR PHI:
You have the right to inspect and obtain a copy of your PHI in
your designated record set.
This designated record set includes any records that MedExpress
Urgent Care may have about you that are used for making medical
treatment decisions. Under federal law, you may not inspect a copy
of psychotherapy notes, information being used in anticipation of
legal proceedings, or PHI that is otherwise prohibited. In
addition, you have a right to access your PHI in electronic format,
where it is available.
You have the right to request restrictions be placed on certain
uses and/or disclosures of your PHI.
You may ask us not to use and/or disclose part of your PHI for
treatment, payment, or health care operations. You may also request
that any part of your PHI not be disclosed to any of your family
members. You must state the specific restriction request, and to
whom it applies. Please submit these requests in writing to the
Center Manager. MedExpress has the right not to agree with your
request in most circumstances. However, you have the right to
require restrictions on disclosures of your PHI to a health plan
where you paid out of pocket, in full, for items or services and
MedExpress is required to honor this request.
You have the right to receive confidential communications from
us by alternative means or at an alternative location.
Please notify the Center Manager in writing of this request.
You have the right to request a listing of certain disclosures
MedExpress Urgent Care has made of your PHI.
Please request an accounting list from the Center Manager.
You have the right to request amendments be made to your
Please submit requests to the Center Manager.
You have a right to receive a copy of this Privacy Notice.
Please request a copy from the Center Manager.
MedExpress has the right to change the terms of this
MedExpress will inform you of any changes made to this Privacy
Notice. MedExpress will post a copy of the current Privacy Notice
on the MedExpress website, www.medexpress.com. The Privacy Notice
will state the effective date in the top left corner.
You have a right to be notified of certain Breaches.
In the event of any Breach of unsecured PHI, MedExpress will
fully comply with all legal requirements for breach notification,
which will include notification to you of any impact a Breach may
have had on you and/or your family members(s) and will inform you
of the actions MedExpress has undertaken to minimize any impact the
Breach may or could have on you and/or your family member(s).
Please contact the Center Manager or Privacy Officer at
304-225-2500 if you have questions or need assistance regarding
If you feel your rights have been violated and/or that
MedExpress has not followed this Privacy Notice, you may file a
complaint. Please contact the Center Manager or Privacy Officer at
304-225-2500. In addition, you may file a complaint with the
Secretary of the Department of Health and Human Services. You will
not be retaliated against for making a complaint.