Privacy Policy

 

Gateway to Success, Inc.
Notice of Privacy Practices

 

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.

 

At Gateway to Success, Inc. (“GTS, Inc.”), we know you value your privacy. That is why we are committed to the confidentiality and security of your health information. We maintain physical, administrative, and technical safeguards to protect against unauthorized access, use, or disclosure of your health information. We are required by law to maintain the privacy of this information and to explain our legal duties and privacy practices. GTS, Inc. applies the practices described in this notice to all health information that we maintain, including the health information of former clients. We hope this notice will clarify our responsibilities to you and give you an understanding of your privacy rights. We abide by the notice that is currently in effect. This notice is effective as of April 2012.

 

Your Rights

 

Inspection and Copies. You have the right to request an inspection or copies of the protected health information that GTS, Inc. maintains about you in a “designated record set” except for psychotherapy notes; certain information subject to the Clinical Laboratory Improvements Amendments of 1988; and information that we compiled in anticipation of, or for use in, a civil, criminal or administrative proceeding. A “designated record set” is a group of records relating to your health care, payment for your health care, or that contain information GTS, Inc. used to make a decision about you. GTS, Inc. may limit the protected health information that you can inspect or copy if we have reason to believe that is necessary to protect you or another person from harm. If we limit your right to inspect or copy, you can ask for a review of that decision. You may request a copy of the designated record set in an electronic, machine-readable format. GTS, Inc. will respect your request if the designated record set is maintained electronically and it is readily producible in the format you request. GTS, Inc. charges fees for providing copies in accordance with the laws of the State of Texas.

 

Amendment. If you believe the protected health information GTS, Inc. maintains about you in a designated record set is inaccurate or incomplete, you have the right to request an amendment to correct or complete the information. You must submit your request in writing and explain the reason for your request. If the amendment is made, we will make reasonable efforts to inform others (that you identify) and we will include the amendment in future disclosures. We may decline to amend information under certain circumstances. This is likely to occur if we did not create the original record or if the record is deemed accurate as is. If we decline to amend a record, you have the right to submit a statement of disagreement which will be attached to the record. Please be aware that GTS, Inc. may attach a rebuttal statement in response to your statement of disagreement.

 

Notice. You have the right to receive a paper copy of this notice upon request.

 

Accounting. You have the right to request a list of certain disclosures of protected health information. The list will not include disclosures made for treatment, payment, or health care operations. It also will not include disclosures made pursuant to an authorization, made prior to six years before the date of the request, incidental disclosures, disclosures made for national security or intelligence, disclosures made for facility directory purposes, disclosures to persons involved in your care or payment for your care, disclosures to correctional institutions or for law enforcement purposes, or disclosures made as part of a limited data set. The list will include the date of any accountable disclosure, a brief description of the information disclosed, and the purpose of the disclosure (provided this information is known to us). GTS, Inc. provides a list once per year at your request. If you request the list you will be charged a reasonable fee.

 

Special Handling. If you pay for your care solely out of pocket, you may ask GTS, Inc. not to disclose your care to your insurer. In addition, if you explain that you may be harmed if GTS, Inc. communicates with you in the usual way, you may request that we communicate with you in confidence. We will make every effort to accommodate your request if it is reasonable and you provide an alternative way to contact you. Furthermore, you have the right to request restrictions on GTS, Inc.’s use or disclosure of protected health information. GTS, Inc.is not required to agree to your request and we may be unable to do so. If we agree to comply with your request, we will do so except in the case of an emergency.

 

Complaints. You have the right to submit a complaint if you believe GTS, Inc. has violated your privacy rights. To submit a complaint, write to: Gateway to Success Inc., Privacy Official, P.O. Box 411338, Dallas, TX 75241 or call 214-680-2958. Be assured that we will not retaliate against you for submitting a complaint.

 

Electronic Health Information Exchange. GTS, Inc. participates in an electronic health information exchange. The exchange allows GTS, Inc.to share health information with other providers and to receive health information from other providers so that you can receive better care. You have the right to ask GTS, Inc. not to share your health information through the exchange.

 

Breach Notification. In the event that GTS, Inc. discovers an unauthorized use or disclosure of unsecured protected health information which constitutes a breach, you have the right to receive notice of the breach if it impacts protected health information maintained about you.

 

Permitted Uses and Disclosures

 

Treatment. GTS, Inc. will use and disclose protected health information to provide you care. You should be aware that the associates providing treatment may not be employees of GTS, Inc. They may be employed by others agencies but have agreed to work on the behalf of GTS, Inc. as an assessor, counselor, volunteer, and/or intern. These individuals will be charged with the protection of your health information as required by GTS, Inc.

 

Payment. GTS, Inc. will use or disclose protected health information for payment purposes, including to submit claims to payers or insurers, to determine coverage or eligibility status, and to obtain prior approval for services.

 

Operations. GTS, Inc. may use or disclose protected health information to facilitate operations, including for credentialing counselors, for quality improvement programs, for case management, and for the detection and prevention of fraud.

 

Business Associates. Occasionally, GTS, Inc. contracts with business associates to perform services on GTS, Inc. behalf. We may disclose protected health information to these business associates in order to allow them to perform these services, unless prohibited. In the event this information is shared, the business associates also may collect, use or disclose protected health information on our behalf. We contractually obligate our business associates to provide the same privacy protections that we provide.

 

Required by Law. GTS, Inc. will use or disclose protected health. For example, GTS, Inc. reports certain wounds or diseases to government agencies when required by law or certain issues concerning child abuse to Child Protective Services information as required by law.

 

Legal Proceedings. GTS, Inc. may disclose protected health information in the course of a judicial or administrative proceeding; in response to a court order, subpoena, or discovery request; or to satisfy lawful process.

 

Law Enforcement. GTS, Inc. may disclose protected health information to law enforcement officials in response to a qualified administrative request, administrative subpoena, or warrant. GTS, Inc. also may disclose limited protected health information for the purposes of reporting a crime on our premises, performing fieldwork, or to locate a suspect, victim, or witness.

 

Military and National Security. GTS, Inc. may disclose protected health information to armed forces personnel for military activities and to authorized federal officials for national security or intelligence activities.

 

Correctional Institutions. If you are an inmate, GTS, Inc. may disclose protected health information to your correctional institution for treatment purposes or to ensure the safety of yourself or others.

 

Marketing. GTS, Inc. does not sell protected health information for marketing purposes. We do not use or disclose protected health information for marketing purposes without your authorization. However, we may communicate with you face-to-face about health-related products or services that may interest you or we may provide a promotional gift of nominal value.

 

Others Involved in Your Care. GTS, Inc. may disclose protected health information to persons involved in your care or involved in the payment for your care (to the extent of their involvement). If you give us permission or if your permission can be implied, we may disclose protected health information to family members or others that call on your behalf. For example, GTS, Inc.may provide your prescription to a person that you ask to pick up the prescription. In emergencies, GTS, Inc.may disclose protected health information to persons who accompany you to the hospital if the disclosure appears to be in your best interest.

 

Fundraising. GTS, Inc. may disclose limited information about you. You may opt out of these communications with GTS, Inc. Be assured that your ability to receive treatment or services is not dependent on your willingness to participate in fundraising activities.

 

Authorizations. GTS, Inc. must obtain your authorization to use or disclose your health information for purposes other than those described in this notice. Your authorization is also required to disclose psychotherapy notes. If you provide authorization, you have the right to revoke your authorization by notifying GTS, Inc.in writing. Any revocation will not affect uses or disclosures made prior to your revocation.

 

Future Changes

GTS, Inc. reserves the right to change our privacy practices and this notice at any time without advance notice. If we make a material change to our privacy practices, we will make a new, updated notice available to you. The new notice will apply to all protected health information in our possession, including any information created or received before the revised notice became effective.