of Privacy Practices
Practices and Standards
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.
This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out advice, enrollment, payment, or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services.
1. Uses and Disclosures of Protected Health Information
Your PHI may be used and disclosed by your health insurance advocate, our office staff, and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operation of PA Health Advocates, and any other use required by law.
Advice: We will use your PHI to assess your overall Health Insurance needs. This could include vetting insurance drug formularies to insure a prescription is in-network and could include contacting your doctors to confirm that they participate with the coverage you seek.
Enrollment: We will use and disclose your PHI on our Third-Party quoting platforms to assemble quotes and use them as a bridge to your state's preferred platform(healthcare.gov, pennie.com, getcovered.nj.gov, etc.), medicare, or carrier systems. We may use your PHI to complete off Market Plans such as Short Term Medical, Faith-Based Plans, and Off-Exchange Major Medical plans. For example, Upon quoting, and you deciding on the plan that is prudent for you, we will use your PHI to input into a marketplace on your behalf listed as your assistor under the "Were you helped" tab.
Payment: Your PHI will be used, as needed, to provide payment to your health insurance carrier. For example, logging in to the healthcare.gov system to pay your first payment.
Healthcare Operations: We may use or disclose, as needed, your PHI in order to support the business activities of this brokerage. These activities include, but are not limited to, quality assessment activities, employee review activities, training of enrollers, licensing, and conducting or arranging for other business activities. For example, we may disclose your PHI to the marketplace as your appointed advisor to discuss plan changes or appeals updates. We may also call you by name in our lobby when we are ready for you to be seen.
We may also use or disclose your PHI in the following situations without your authorization. These situations include: as required by law, public health issues as required by law, communicable diseases, health oversight, abuse or neglect, food and drug administration requirements, legal proceedings, law enforcement, coroner request, funeral director request, criminal activity, national security, worker’s compensation. Under the law, we must make disclosures to you when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500.
Other Permitted and Required Uses and Disclosures: will be made only with your consent, authorization, or opportunity to object unless required by law.
You may revoke this authorization at any time, in writing, except to the extent that your health care practitioner or this health center has taken action in reliance on the use or disclosure indicated in the authorization.
The following is a statement of your rights with respect to your PHI.
You have the right to inspect and copy your PHI. Under federal law, however, you may not inspect or copy the following records: information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and PHI that is subject to law that prohibits access to PHI.
You have the right to request a restriction of your PHI. This means you may ask us not to use or disclose any part of your PHI for the purpose of advice, enrollment, payment, or healthcare operations. You may also request that any part of your PHI not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in the Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply.
You have the right to request to receive confidential communications from us by alternative means or at an alternative location. You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice alternatively.
You may have the right to have your advocate amend your PHI. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.
You have the right to receive an accounting of certain disclosures we have made, if any, of your PHI.
We reserve the right to change the terms of this notice and will inform you by mail of any changes. You then have the right to object or withdraw as provided in this notice.
Complaints You may complain to us or the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our health center of your complaint. We will not retaliate against you for filing a complaint.
This notice was published and became effective on August 3rd, 2017. This notice was revised on August 11th, 2020.
We are required by law to maintain the privacy of, and provide individuals with, this notice of our legal duties and privacy practices with respect to PHI. If you have any objections to the form, please ask to speak with our HIPPA Compliance Officer, Principal, Joshua Brooker, in person or by telephone at our main office number (717-400-1244).