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.
PlushCare of California, Inc., P.C. d/b/a PlushCare (“PlushCare”) is committed to protecting your privacy and understands the importance of safeguarding your medical information. We are required by federal law to maintain the privacy of health information that identifies you or that could be used to identify you (known as “Protected Health Information” or “PHI”). We also are required to provide you with this Notice of Privacy Practices (“Notice”), which explains our legal duties and privacy practices, as well as your rights, with respect to PHI that we collect and maintain. We are required by federal law to abide by the terms of this Notice currently in effect. However, we reserve the right to change the privacy practices described in this Notice and make the new practices effective for all PHI that we maintain. Should we make such a change, you may obtain a revised Notice by calling our office and requesting a revised copy be sent in the mail, or accessing our website at http://www.plushcare.com/.
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION
A. Routine Uses and Disclosures of Protected Health Information
We are permitted under federal law to use and disclose PHI, without your written authorization, for certain routine uses and disclosures, such as those made for treatment, payment, and the operation of our business. The following are examples of the types of routine uses and disclosures of PHI that we are permitted to make. While this list is not exhaustive, it should give you an idea of the routine uses and disclosures we are permitted to make.
B. Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Object
We may use or disclose your PHI in the following situations without your authorization or providing you the opportunity to object.
C. Uses and Disclosures That May Be Made Either With Your Agreement or the Opportunity to Object
Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, orally or in writing, your PHI that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We may use or disclose your PHI to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location or general condition.
California law provides that we may disclose such information to a family member, other relative, domestic partner, a close personal friend, or any other person identified by you.
D. Wellness Plan Participation.
If you participate in a voluntary employer or group health plan wellness program that engages PlushCare to administer the laboratory and biometric collection, we may without your consent, share your PHI with third-party entities involved in the provision of wellness, health promotion or similar services on behalf of the employer or group health plan. The services provided by these entities may include, but are not limited to, health clinic administration, disease management programs, health coaching, diabetes management , consulting and prevention. You may be contacted directly from these service providers. Please note this section D, only applies to employees of employers or participants of group health plan sponsoring wellness programs and where PlushCare has been engaged to organize and administer onsite and/or at-lab laboratory testing as part of that program.
E. Uses and Disclosures of Protected Health Information Based upon Your Written Authorization
YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU
You have certain rights regarding your PHI, which are explained below. You may exercise these rights by submitting a request in writing to our Privacy Officer.
A. You have the right to inspect and copy your PHI. If you would like to see or copy your PHI that is contained in a designated record set (e.g., medical and billing records), we are required to provide you access to such PHI for inspection and copying within 30 days after receipt of your request (with up to a 30-day extension if needed). We may charge you a reasonable fee to cover duplication, mailing and other costs incurred by us in complying with your request. In addition, there are situations where we may deny your request for access to your PHI. For example, we may deny your request if we believe the disclosure will endanger your life or that of another person. Depending on the circumstances of the denial, you may have a right to have this decision reviewed.
Under California law, we must permit you or your representative to inspect your medical records during business hours within five (5) working days after receipt of a written request by you or your representative.
California law further provides that you or your representative are entitled to copies of all or any portion of your patient records upon presenting a written request specifying the records to be copied, together with a fee to defray the cost of copying, that shall not exceed twenty-five cents ($0.25) per page or fifty cents ($0.50) per page for records that are copied from microfilm and any additional reasonable clerical costs incurred in making the records available. We are required to ensure that the copies are transmitted within fifteen (15) days after receiving the written request. We may choose to prepare a summary of your medical record rather than allowing access to the entire record, in which case we must make the summary of the record available to you within ten (10) working days (with up to a 20-day extension if needed) from the request date.
B. You have the right to request a restriction of your PHI. This means you may ask us not to use or disclose any part of your PHI for purposes of treatment, payment or health care operations. You may also request that any part of your PHI not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice. Your request must state the specific restriction requested and to whom you want the restriction to apply. We are not required to agree to a restriction that you may request, except we must agree not to disclose your PHI to your health plan if the disclosure (1) is for payment or health care operations and is not otherwise required by law, and (2) relates to a health care item or service which you paid for in full out of pocket. If we agree to the requested restriction, we may not use or disclose your PHI in violation of that restriction unless it is needed to provide emergency treatment.
C. You have the right to request to receive confidential communications from us by alternative means or at an alternative location. We will accommodate reasonable requests. We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact.
D. You have the right to amend your PHI. This means you may request an amendment of your PHI in our records that is contained in a designated record set (e.g., medical and billing records) for as long as we maintain the PHI. We will respond to your request within 60 days (with up to a 30-day extension if needed). We may deny your request if, for example, we determine that your PHI is accurate and complete. If we deny your request, we will send you a written explanation and allow you to submit a written statement of disagreement.
E. You have the right to receive an accounting of certain disclosures that we have made of your PHI. You have the right to receive an accounting of certain disclosures we have made, if any, of your PHI. This right only applies to disclosures for purposes other than treatment, payment or health care operations as described in this Notice. It also excludes disclosures we may have made to you, your family members or friends involved in your care. The right to receive this information is subject to certain exceptions, restrictions and limitations. You must specify a time period for the accounting, which may not be longer than 6 years and cannot include any date before April 14, 2003. You may request a shorter timeframe. You have the right to one free request within any 12-month period, but we may charge you for any additional requests in the same 12-month period. We will notify you about any such charges, and you are free to withdraw or modify your request in writing before any charges are incurred. We will respond to your request within 60 days (with up to a 30-day extension if needed).
F. You have the right to obtain a paper copy of this Notice from us. You have the right to receive a paper copy of this Notice upon request. You may ask us to give you a copy of this Notice at any time.
G. You have the right to be notified if you are affected by a breach of unsecured PHI.
H. You have the right to opt out of receiving fundraising communications from us. We may contact you for fundraising purposes. You have the right to opt out of receiving these communications by emailing us at [email protected]]. We will not condition treatment or payment on your choice of receipt of fundraising communications.
If you believe that we have violated your privacy rights, you may file a complaint with us by notifying our Privacy Officer in writing at the following address:
PlushCare of California, Inc.
650 5th Street Suite 405
San Francisco, California 94107
You have the right to file a complaint with the US Department of Health & Human Services (HHS). We will not retaliate against you in any way for filing a complaint. You may also submit your complaint to the Secretary.
This notice is effective on August 29th, 2019 and last updated on April 19th, 2021.