Our Privacy Policy
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Payment
For purposes of this policy, the term "payment" generally means the activities undertaken by the agency to obtain or provide reimbursement for the provision of health care. Some examples of payment activities involving the use or disclosure of protected health information are:
- disclosing the consumer's protected health information to a health insurance plan to determine whether it will provide coverage for the consumer's treatment;
- disclosing the consumer's protected health information to obtain pre-approval before providing a treatment or service, such as admitting the consumer to the agency for a particular type of surgery; and
- disclosing the consumer's protected health information to his or her health insurance plan to obtain reimbursement after the agency has treated the consumer.
Uses and disclosures of protected health information for the agency' payment purposes are subject to the HIPAA Privacy Regulations' "minimum necessary" standard.
Health Care Operations
For purposes of this policy, the term "health care operations" generally refers to those general business and administrative functions of the agency that are required in order to operate and perform its health care functions. Some examples of uses and disclosures of protected health information for health care operations are:
- uses and disclosures of protected health information for quality assurance and utilization review purposes;
- uses and disclosures of protected health information for education and training of students and other trainees;
- uses and disclosures of protected health information to recommend possible treatment options or alternatives, or health-related benefits or services, that may be of interest to the consumer;
- uses and disclosures of protected health information for legal services, business planning, and other business management and general administrative activities; and
- uses and disclosures of protected health information to raise funds for the benefit of the agency.
Uses and disclosures of protected health information for the agency's health care operations are subject to the HIPAA Privacy Regulations' "minimum necessary" standard.
