Personal Health Privacy Notice

Use this link to see the Business Privacy Notice.

This is the Personal Health Information (PHI) Privacy Notice.

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.

DATE OF NOTICE: April 14, 2003

FDS, Inc. is required by law to maintain the privacy of Protected Health Information (PHI) and to provide individuals with this Notice of our legal duties and privacy practices with respect to PHI and to abide by the terms of this notice. PHI is information that may identify you and that relates to your past, present and future physical or mental health or condition and related health care services. This Notice describes how we may use and disclose PHI to carry out payment, treatment, or other necessary health care operations and for specified reasons that are permitted by law. This notice will also describe your rights with respect to your Protected Health Information.

FDS, Inc. is required to follow the terms of this notice. Your PHI will not be used or disclosed without your written authorization, except as described in this Notice. We reserve the right to make changes to this notice from time to time as deemed necessary. We will make the new Notice effective for all PHI we maintain and will make the revised Notice available to you upon request

Your Rights Regarding Your Health Information

You may request a copy of the Notice at any time, even if you have agreed to receive the Notice electronically. To obtain a paper copy, contact the Privacy Officer.

You have the right to request additional restrictions on the use or disclosure of PHI by sending a written request to the Privacy Officer. FDS, Inc. is not required to agree to the requested restrictions.

You have the right to receive an accounting of the disclosures that have been made of your PHI after April 14, 2003 for purposes other than payment, treatment, or health care operations. The accounting will exclude certain disclosures, such as disclosures made directly to you, disclosures you authorize, disclosures to a friend or family member involved in your care and disclosures for notification purposes. To request an accounting, you must submit a written request to the Privacy Officer. The request must specify the time period for the accounting and may not be longer than six years. The first accounting you request within a 12-month period will be provided free of charge, but you may be charged for the cost of providing additional accountings. You will be notified of the cost to you at the time of the request. The right to this accounting is subject to certain other exceptions, restrictions, and limitations.

You have the right to request communication of your PHI by an alternative means or at an alternative location. To request confidential communication of PHI, you must submit a written request to the Privacy Officer. The request must state how or where you would like to be contacted. All reasonable requests will be accommodated.

Uses and Disclosures of Protected Health Information

Your Protected Health Information will be used for treatment, payment, or health care operation purposes only. We have the right to use and disclose PHI in order to operate our business. This disclosure may take place in providing, coordinating, or managing health care and its related services by one or more of our Business Associates.

Your Protected Health Information will be used and disclosed in order to obtain or provide reimbursement for services rendered. We may use your personal information to process claims for health care services you receive. We will assure that only the minimum necessary data is disclosed when obtaining payment information. PHI may be disclosed to one or several intermediaries including but not limited to: physicians, insurers, pharmacy benefits managers, claims administrators and computer switching companies.

Your Protected Health Information may be used to monitor the performance of the individuals providing our business services. This information will be used to improve the quality of the service we provide.

Some Protected Health Information is stored in electronic computer files. We back up our electronic records daily and periodically store backups off-site. We also employ other precautions to safeguard the integrity of all PHI, but in the unlikely case of a computer crash or other technological failure, we could experience data loss. Reasonable safeguards are employed to protect PHI stored on electronic media.

We may use and disclose your Protected Health Information without your authorization when the need to contact a physician or physician’s staff occurs.

We may not be able to provide health care products and services to you without the involvement of other businesses or persons, who are our Business Associates. It may be necessary for us to provide your PHI to a Business Associate so that they can carry out the activities needed in order to provide you health care products and services. Our Business Associate contracts require business associates give us their assurance that they will protect the privacy of your PHI.

We may use and disclose PHI to provide information to you or someone who has the legal right to act on your behalf (i.e. family member, other relative, close personal friend, or any person you identify as involved in your care or payment related to your care).

We may disclose to the FDA, or persons under the jurisdiction of the FDA, Protected Health Information relative to adverse events with respect to drugs, foods, supplements, product and product defects, or post-marketing surveillance information to enable product recalls, repairs, or replacements.

We may disclose PHI as authorized by and as necessary to comply with laws relating to workers’ compensation or similar programs established by law.

We may disclose PHI about you to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

We may disclose PHI to an oversight agency for activities authorized by law. These oversight activities include audits, investigations and inspections, as necessary for licensure and for the government to monitor the health care system, government programs and compliance with civil rights laws.

We may disclose PHI for law enforcement purposes as required by law or in response to a valid subpoena or other legal process. We may disclose PHI, if you are involved in a lawsuit or dispute, in response to a court or administrative order. We may also disclose PHI in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the requested PHI

We are permitted to use or disclose PHI for purposes of research when an institutional review board has reviewed the research proposal and established protocols to ensure the privacy of your information.

We may disclose PHI to a coroner or medical examiner. This may be necessary to identify a deceased person or determine the cause of death. We may also disclose PHI to funeral directors consistent with applicable law to carry out their duties.

We may disclose PHI to an organ procurement organization or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplants consistent with applicable law.

We may disclose PHI if you become an inmate of a correctional institution, to the institution or its agents when necessary for your health or the health and safety of others.

We may disclose PHI when necessary to prevent a serious threat to your health and safety or the health and safety of the public or other persons.

We may disclose PHI as required by military command authorities if you are a member of the armed forces. We may also release PHI about foreign military personnel to the appropriate military authorities.

We may release PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

We may disclose PHI to authorized federal officials so that they may provide protection to the President, other authorized persons or foreign heads of state, or conduct special investigations.

We may disclose PHI to a government authority, such as a social service or protective services agency, if we have reason to believe that you are a victim of abuse, neglect, or domestic violence. We will only disclose this type of information to the extent required by law if you agree to the disclosure, or if the disclosure is allowed by law and we believe it is necessary to prevent serious harm to you or someone else, or the law enforcement or public official who is to receive the report represents that it is necessary and will not be used against you.

FDS, Inc. will obtain your written authorization before using or disclosing PHI about you for purposes other than those provided above or as otherwise permitted or required by law. You may revoke an authorization in writing at any time. Upon receipt of written revocation, we will stop using or disclosing PHI, except to the extent that we have already taken action in reliance on the authorization.

If you have questions or would like additional information about our privacy practices, you may contact the Privacy Officer by calling 817-531-8992. If you believe your privacy rights have been violated, you can file a complaint with the Privacy Officer or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.