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Effective March 6, 2024

Notice of Privacy Practices

How health information is used and disclosed, and the individual rights that apply to it.

Overview

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

About This Notice

This Notice applies to healthcare services furnished through ClearToStart clinical-clearance services and the VitalCheck Doctors In Your Office program by participating licensed healthcare providers, and to VitalCheck Wellness, Inc. when it acts as a healthcare provider, covered entity, or business associate in connection with those services.

VitalCheck Wellness helps arrange appointments at workplaces, patient service centers, other designated locations, and through telemedicine, and provides administrative services and technology to participating healthcare providers. Clinical services — including tuberculosis screening, antibody titers, vaccinations, physical examinations, and drug screening completed through ClearToStart — are furnished by the licensed provider responsible for your care. This Notice describes how the applicable provider and VitalCheck Wellness may use and disclose protected health information and explains your rights.

Your Rights

Get an Electronic or Paper Copy of Your Medical Record

  • You may ask to inspect or receive an electronic or paper copy of your medical record and other health information maintained about you.
  • We generally will 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 Medical Record

  • You may ask us to correct health information that you believe is incorrect or incomplete.
  • We may deny the request in circumstances permitted by law, but we will explain the denial in writing, generally within 60 days.

Request Confidential Communications

  • You may ask us to contact you in a particular way, such as at a home or office number, or to send mail to a different address.
  • We will accommodate reasonable requests.

Ask Us to Limit What We Use or Share

  • You may ask us not to use or disclose certain health information for treatment, payment, or healthcare operations. We are not required to agree and may deny a request if it could affect care or is otherwise not feasible.
  • If you pay in full out of pocket for a healthcare item or service, you may ask us not to disclose information about that item or service to your health plan for payment or healthcare operations. We will agree unless disclosure is required by law.

Get a List of Disclosures

  • You may request an accounting of certain disclosures made during the six years before your request, including who received the information and why.
  • The accounting will not include disclosures for treatment, payment, or healthcare operations and certain other disclosures excluded by law. One accounting in a 12-month period is free; a reasonable cost-based fee may apply to 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.

Choose Someone to Act for You

A person with medical power of attorney, a legal guardian, or another authorized personal representative may exercise your rights. We will verify that person's authority before acting.

File a Complaint

  • You may complain to us if you believe your privacy rights have been violated by contacting the Privacy Office listed at the end of this Notice.
  • You may also file a complaint with the United States Department of Health and Human Services Office for Civil Rights at 200 Independence Avenue SW, Washington, DC 20201; by calling 1-877-696-6775; or through hhs.gov/ocr/privacy/hipaa/complaints.
  • 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 disclose. Tell us if you have a clear preference in the situations below.

  • Disclosing information to family, close friends, or others involved in your care or payment for care.
  • Disclosing information in a disaster-relief situation.
  • Including information in a facility directory when applicable.

If you cannot tell us your preference, such as when you are unconscious, we may disclose information when we believe it is in your best interest. We may also disclose information when needed to lessen a serious and imminent threat to health or safety.

We will obtain your written authorization before using or disclosing PHI for marketing when authorization is required, selling PHI, or disclosing most psychotherapy notes. You may revoke an authorization in writing, except to the extent action has already been taken in reliance on it.

Federal or state law may provide additional protection for genetic information, mental-health information, substance-use-disorder records, sexual-assault information, sexually transmitted disease information, HIV or AIDS information, and other sensitive records. We will follow the more protective law where it applies.

How We May Use and Disclose Health Information

Treatment

We may use health information and disclose it to professionals involved in your care, including to coordinate services, referrals, testing, and follow-up.

Payment

We may use and disclose health information to bill and collect payment from health plans, employers or program sponsors where authorized, and other responsible payers.

Healthcare Operations and Program Administration

We may use and disclose health information to operate the program and participating practices, improve care, conduct quality assessment, train personnel, manage records and communications, support credentialing and compliance, prevent fraud, and perform other healthcare operations. Business associates that receive PHI for these functions must protect it as required by law and contract.

Health Information Exchange

Where permitted, we and participating providers may use a health information exchange or similar network to obtain or disclose information for treatment, payment, healthcare operations, and other lawful purposes. Applicable consent and opt-out rights will be honored.

Other Uses and Disclosures Permitted or Required by Law

We may use or disclose health information without written authorization when HIPAA or another law permits or requires it, including for:

  • Public-health and safety activities, including disease reporting, product recalls, adverse-event reporting, and preventing or reducing a serious threat.
  • Reporting suspected abuse, neglect, or domestic violence as permitted or required by law.
  • Health-oversight activities such as audits, inspections, investigations, and licensing.
  • Research approved or permitted under applicable legal safeguards.
  • Organ and tissue donation and transplantation activities.
  • Coroners, medical examiners, and funeral directors.
  • Workers' compensation and similar programs.
  • Law-enforcement purposes and judicial or administrative proceedings when legal requirements are met.
  • Specialized government functions, including military, national-security, protective-service, and correctional-institution activities.
  • Compliance with the law and with requests from the United States Department of Health and Human Services concerning HIPAA compliance.

Other uses and disclosures not described in this Notice will be made only with your written authorization unless otherwise permitted or required by law.

Our Responsibilities

  • We are required by law to maintain the privacy and security of protected health information.
  • We will notify affected individuals following a breach of unsecured PHI when notice is required by law.
  • We must follow the duties and privacy practices described in the Notice currently in effect.
  • We will not use or disclose information other than as described here unless you authorize the use or disclosure in writing or another law permits or requires it.

Changes to This Notice

We may change this Notice and make the revised terms apply to PHI already maintained as well as information received in the future. The current Notice will be available upon request and posted on the applicable website. The effective date of the Notice in effect at the time of a use or disclosure controls.

Contact Information

For questions, requests, or complaints concerning this Notice, contact:

VitalCheck Wellness, Inc.
Attn: Privacy Office and Compliance
241 West 37th Street, Suite 402
New York, New York 10018
Email: privacy.office@getvitalcheck.com
Telephone: (800) 828-0730

Also see: Privacy Policy · Terms of Use