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. Wells Health Care, LLC is required by law to maintain the privacy of your Protected Health Information (PHI), to provide you with this Notice of our legal duties and privacy practices, and to follow the terms of the Notice currently in effect.
How We May Use and Disclose Your Health Information
We may use and disclose your PHI, without your written authorization, for the following purposes:
- Treatment — to provide, coordinate, and manage your health care with our nurses, therapists, aides, physicians, and other providers involved in your care.
- Payment — to bill and obtain payment for services from MassHealth, Medicare, insurers, or other responsible parties.
- Health Care Operations — for quality assessment, staff training, care coordination, accreditation, and administrative activities.
- As Required by Law — including public health activities, reporting of abuse or neglect, health oversight, judicial proceedings, and to avert a serious threat to health or safety.
Other uses and disclosures will be made only with your written authorization, which you may revoke at any time in writing.
Your Rights Regarding Your Health Information
- The right to inspect and obtain a copy of your health information.
- The right to request an amendment of information you believe is incorrect or incomplete.
- The right to an accounting of certain disclosures we have made.
- The right to request restrictions on certain uses and disclosures.
- The right to request confidential communications by alternative means or at an alternative location.
- The right to a paper copy of this Notice upon request.
Our Responsibilities
We are required to maintain the privacy of your PHI, provide you this Notice of our duties and privacy practices, notify you following a breach of unsecured PHI, and abide by the terms of the Notice currently in effect. We reserve the right to change this Notice and to make the revised Notice effective for information we already have as well as information we receive in the future.
How to File a Privacy Complaint
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer using the contact information below, or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be penalized or retaliated against for filing a complaint.
Privacy Officer
Please direct questions or complaints regarding this Notice or your health information to our Privacy Officer at the contact information below.
Contact Us
If you have questions about this hipaa notice of privacy practices, please contact us:
Wells Health Care, LLC
435 Shrewsbury Street, Suite #4, Worcester, MA 01604
Phone: (508) 556-1040 • Fax: (508) 519-0292
Email: [email protected]