2024 Archdiocese of Atlanta / Lay Employee Quick Guide - Flipbook - Page 48
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Right to an Accounting of Disclosures. Except for limited circumstances as defined by HIPAA, you have the
right to request an “accounting of disclosures” made by the Plan. Some, but not all, of the exceptions include where the
disclosure was made by the Plan for treatment, payment, or health care operations, where the disclosure was made to you or
your personal representative or to family, friends, and relatives involved in your care, or where the disclosure was made
pursuant to your authorization or was incidental to a disclosure otherwise permitted or required. To request an accounting
of disclosures, you must submit a written request to the Contact Office designated at the end of this Notice. Your request
must state a time period which may not be longer than six years and may not include dates before April 14, 2003. The first
accounting that you request within a 12 month period will be free. For subsequent requests within the 12-month period,
you may be charged for the costs of providing the accounting. If a cost will be charged, you will be notified in advance and
given an opportunity to withdraw or modify your request for a subsequent accounting in order to avoid or reduce the fee.
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Right to Request Restrictions. You have the right to request a restriction or limitation on the protected health
information that the Plan may use or disclose about you for treatment, payment or health care operations. You also have the
right to request a limit on the protected health information that the Plan can disclose about you to someone who is involved
in your care or the payment for your care, like a family member, relative, or friend. Except as provided below, the Plan is
not required to agree to your request. We will comply with any restriction request if: (1) except as otherwise required by
law, the disclosure is to the Plan for purposes of carrying out payment or health care operations (and is not for purposes of
carrying out treatment); and (2) the protected health information pertains solely to a health care item or service for which
the health care provider involved has been paid out-of-pocket in full. If the Plan does agree to a request for restriction or
limitation, the Plan can still disclose the information if you are in need of emergency treatment. You must request
restrictions in writing and send them to the Contact Office designated at the end of this Notice. In your request, you must
advise the Plan of (1) what information you want to limit; (2) whether you want to limit use, disclosure, or both; and (3) to
whom you want the limits to apply. A restriction that the Plan has agreed to can be terminated as allowed by HIPAA.
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Right to Request Confidential Communications. You have the right to request that you receive communication
from the Plan by alternative means or at alternative locations. The Plan does not have to agree to your request unless the
Plan believes it is reasonable, you clearly state that the confidential communication is necessary to avoid endangering you,
your request continues to allow the Plan to collect premiums and pay claims, and you specify an alternative address or other
method of contact. To request confidential communications, you must make your request in writing to the Contact Office
designated at the end of this Notice.
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Right to be Notified of a Breach. You have the right to be notified in the event that the Plan (or a Business
Associate) discovers a breach of unsecured protected health information.
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Right to a Copy of This Notice. You have the right to request a paper copy of this notice. To obtain a paper copy,
contact the Contact Office designated at the end of this Notice.
Changes to This Notice
The Plan is required to abide by the terms of this Notice, but it reserves the right to change the Notice. The Plan reserves the
right to make the revised or changed notice effective for protected health information it already has about you as well as any
information it creates, receives, or maintains after the Plan revises or changes the Notice. The Plan will promptly distribute a
copy of a revised Notice whenever there is a material change to the uses or disclosures, your rights, the Plan’s legal duties, or
other of the Plan’s privacy practices stated in the Notice. A changed Notice will be promptly distributed by mail, electronically
as allowed by HIPAA, or in any other manner reasonably expected to reach you, as the law may allow. If the Plan has a
website, it will post a copy of the current Notice there.
Complaints
If you believe the Plan has violated your privacy rights, you may file a complaint with the appropriate Contact Office
designated at the end of this Notice. You may also file a complaint with the Secretary of the Department of Health and Human
Services. The Plan encourages you to first file a complaint with the appropriate Contact Office shown below so that the Plan
will have an opportunity to address your concerns. HIPAA prohibits entities that are covered by HIPAA from intimidating,
threatening, coercing, discriminating against, or taking any retaliatory action against individuals for exercising any right the
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