This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully. At Rover Analytics we respect the privacy and confidentiality of your protected health information. We are sincere in our promise to ensure the confidentiality of your information in a responsible and professional manner. We also are required by law to maintain the privacy of your protected health information, provide you with this notice and abide by the terms of this notice. Should any of our privacy practices change, we reserve the right to change the terms of this notice and to make the new notice effective for all protected health information we maintain. Once revised, we will notify you that a change has been made and post the notice on our Web site. You may also request the new notice be mailed to you. This notice explains how we use information about you and when we can share that information with others. It also informs you about your rights. Finally, this notice provides you with information about exercising these rights.
How We Use or Share Information
We use protected health information and may share it with others as part of your employer-sponsored health plan, and our business operations. The following are ways we may use or share information about you:
We may share your information with individuals who perform business functions for us, including your employer’s Benefit Advisor/Insurance Broker. We will only share your information if there is a business that needs to do so and if our business partner agrees to protect the information.
We may share your information with your doctors or hospitals to help them provide medical care to you. For example, if you are in the hospital, we may give them access to any medical records sent to us by your doctor.
We may use or share your information with others to help manage your health care. For example, we might talk to your doctor to suggest a disease management or wellness program that could help improve your health.
To give you information about alternative wellness programs or about health related products and services that you may be interested in. For example, we sometimes send out newsletters that let you know about “healthy living” alternatives such as smoking cessation or weight loss programs.
There are also state and federal laws that may require us to release your health information to others. We may be required to provide information to others for the following reasons:
We may have to give information to law enforcement agencies. For example, we are required to report when we believe there has been child abuse or neglect or domestic violence.
We may be required by a court or administrative agency to provide information because of a search warrant or subpoena.
We may report health information to public health agencies if we believe there is a serious health or safety threat.
We may report health information on job-related injuries because of requirements of your state worker compensation laws.
We may report information to the Food and Drug Administration. They are responsible for investigation or tracking of prescription drug and medical device problems.
We may have to report information to state and federal agencies that regulate us, such as the U.S. Department of Health and Human Services, Oregon Insurance Division and the Washington Office of Insurance Commissioner.
If we use or disclose your information for any reasons other than the above, we will first get your written permission. If you give us written permission and change your mind you may revoke your written permission at any time. We will honor the revocation except to the extent that we have already relied on your permission.
NOTE: If we disclose information as a result of your written permission it may be re-disclosed by the receiving party and may no longer be protected by state and federal privacy rules. However, federal or state law may restrict re-disclosure of additional information such as HIV/AIDS information, mental health information, genetic information and drug/alcohol diagnosis, and treatment or referral information.What Are Your Rights
You have certain rights with respect to your protected health information. These include:
• You have the right to ask us to restrict how we use or disclose your information for treatment, or health care operations. You also have the right to ask us to restrict information we may give to persons involved in your care. While we may honor your request for restrictions, we are not required to agree to these restrictions.
You have the right to submit special instructions to us regarding how we send plan information to you that contains protected health information. For example, you may request that we send your information by a specific means (for example, U.S. mail only) or to a specified address. We will accommodate reasonable requests by you as explained above. We may require that you make your request in writing.
You have the right to inspect and obtain a copy of information that we maintain about you in a designated record set. However, you may not be permitted to inspect or obtain a copy of information that is:
o Contained in psychotherapy notes;
o Compiled in reasonable anticipation of, or for use in a civil criminal or administrative action or proceeding;
Additionally, in certain other situations, we may deny your request to inspect or obtain a copy of your information. If we deny your request, we will notify you in writing and will provide you with a right to have the denial reviewed.
We may require that your request be made in writing. We will respond to your request no later then 30 days after we receive it. If the information you request is not maintained or accessible to us on-site, we will respond to your request no later than 60 days after we receive it. If we need additional time, we will inform you of the reasons for the delay and the date that we will be able to complete action on your request.
If you request a copy, we will charge you a reasonable fee based on copying and postage costs.
• You have the right to ask us to amend information we maintain about you in a designated record set. We may require that your request be in writing and that you provide a reason for your request. We will respond to your request no later than 60 days after we receive it. If we are unable to act within 60 days, we may extend that time by no more than an additional 30 days. If we need to extend this time, we will notify you of the delay and the date by which we will complete action on your request.
If we make the amendment, we will notify you that it was made, and we will obtain your agreement to have us notify the relevant persons you have identified with whom the amendment needs to be shared. We will notify these persons, including their business associates, of the amendment.
If we deny your request to amend, we will notify you in writing of the reason for the denial. The denial will explain your right to file a written statement of disagreement.
Exercising Your Rights
You have a right to receive a paper copy of this notice upon request at any time.
If you have any questions about this notice or our privacy practices, please contact us at 971-268-6001 or send us an email at: email@example.com. If you believe your privacy rights have been violated, you may file a complaint with us by writing Appeals & Grievances at:
Attn: Appeals and Grievance Dept.firstname.lastname@example.org
You may also notify the Office of Civil Rights, U.S. Department of Health and Human Services of your complaint. We will not take any action against you for filing a complaint. You may contact the Office of Civil Rights at:
Office for Civil Rights
U.S. Department of Health and Human Services 200 Independence Avenue, S.W.
OCR Hotlines-Voice: 1-800-368-1019 E-mail: email@example.com
For more information about uses and disclosers of member information, including uses and disclosures required by law, please refer to our Notice of Privacy Practice.