This Notice is effective as of September 22, 2022
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
To Patients of Our Clients Notice of Privacy Practices
Our Responsibilities
Alpha II, LLC is dedicated to protecting the privacy of the individuals subject of the medical healthcare claims and information that we process. We call this information Protected Health Information or “PHI.” We are required by law to maintain the privacy of this PHI and to provide you with this Notice of our legal duties and privacy practices with respect to the PHI.
This Notice of Privacy Practices describes how we may use and disclose the PHI to enable the use of medical encounter and claims data to process payments for our clients and for other purposes that are permitted or required by law. Our clients are the medical providers and certain businesses that help support medical providers. This Notice also informs of your rights to access and control your PHI. 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 condition and related health care services.
We may change the terms of our Notice at any time. The new Notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices. To request a revised Notice, you may contact our Tallahassee office and request that a revised copy be sent to you in the mail, or you may request a digital copy via email.
How We May Use and Disclose Protected Health Information
Alpha II is not the System of Record for your PHI. We do not create or modify PHI. We never talk with patients or deal directly with members or patients. Alpha II only receives and reports on PHI sent to us by or on behalf of healthcare providers. However, we may use and disclose PHI from your healthcare provider as permitted by federal and state privacy laws and regulations for the following purposes.
NOTE: Other uses and disclosures not described in this notice will only be made with your individual written authorization which can later be revoked by you.
Claim Payment Processing
We may use and disclose PHI to support our normal business functions that enable us to provide claims scrubbing services to our clients as part of their claim payment processing. These functions may include but are not limited to scrubbing healthcare claims, business management and general administrative activities. We may also disclose PHI to non-affiliated third parties where allowed by law (and as necessary) to help us fulfill our obligations to your health care provider
Assist Your Health Care Provider
We may use and disclose your PHI to assist your health care provider in connection with payment processing activities. For example, we may disclose your PHI when needed by your health care professional to determine a coding error on a claim for payment.
Business Associates
We may contract with individuals and entities (called business associates) to perform various functions on our behalf. To perform these functions or services, business associates may receive, create, maintain, use or disclose your PHI, but only after they have agreed, in writing, to safeguard your PHI.
Legal Proceedings
We may disclose your PHI in the course of certain judicial or administrative proceedings.
Law Enforcement
We may disclose your PHI for law enforcement purposes of other specialized governmental functions.
Your Rights Regarding Your Medical Information
You have the following rights with respect to your medical information:
- You may ask us to restrict certain uses and disclosures of your protected health information. Alpha II is not required to agree to any restriction except in case of a disclosure restricted under Federal Law 164.522(a)(1)(vi), but if we do, we will honor it.
- You have the right to be assured that your information will be kept confidential. Alpha II does not divulge PHI to anyone outside of normal business claim processing operations or required legal proceedings (i.e., judicial or administrative proceedings), law enforcement purposes, or for specialized governmental functions.
- You have the right to inspect and receive a copy of your PHI from our clients that provide your personal care service. Generally, you may inspect and copy your medical information processed by Alpha II through your health care provider.
- You have the right to amend your PHI through your personal health care provider.
- You have the right to receive an accounting of the disclosures of your PHI made by our operations during the last six years, except for disclosures which you authorized and certain other specific disclosure types as provided by law.
- You may request a paper or digital copy of this Notice.
- You have the right to complain to us and/or to the United States Department of Health and Human Services if you believe that we have violated your rights. If you choose to file a complaint, you will not be retaliated against in any way. To complain to us, please contact our Compliance Officer at the address and phone number provided below.
- Citizens of Switzerland, you have the right to view and correct your PHI if we have it in our possession.
If you would like further information regarding your rights or regarding the uses and disclosures of your medical information, you may contact our Compliance Officer at the address and phone number provided below.
Revision of Notice of Privacy Practices
We reserve the right to change the terms of this Notice, making any revision applicable to all the protected health information we maintain. If we revise the terms of this Notice, we will post a re-vised Notice at our office and will make paper or digital copies of the revised Notice of Privacy Practices available upon request.
References
“Standards for the Privacy of Individually Identifiable Health Information; Final Rule.” 45 CFR Parts 160 through 164. Federal Register, Vol. 65, No. 250 (December 28, 2000).
“Standards for the Privacy of Individually Identifiable Health Information; Final Rule.” 45 CFR Parts 160 through 164. Federal Register, Vol. 67, No. 157 (August 14, 2002)
“Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules Under the Health Information Technology for Economic and Clinical Health Act and the Genetic Information Nondiscrimination Act; Other Modifications to the HIPAA Rules; Final Rule.” 45 CFR Parts 160 and 164. Federal Register, Vol. 78, No. 17 (January 25, 2013 – Part II).