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 IT CAREFULLY.
Effective date
[Pending - set on publication]
Last updated
Draft
Document
HIPAA Notice of Privacy Practices
Issued by
Payor Systems
This document is in draft and has not been reviewed or approved by counsel. It is not the operative Notice of Privacy Practices for any ApiVoc entity. The final version, with effective date, will be published here upon legal review.
About this notice
This Notice of Privacy Practices is issued by Payor Systems, the ApiVoc subsidiary that operates as a HIPAA Covered Entity. It describes how Protected Health Information (PHI) about plan members and patients may be used and disclosed by Payor Systems, and how you can access this information.
This notice does not apply to AmbiScript, SmartyRx, or Noventa, which operate as Business Associates and handle PHI only under their respective Business Associate Agreements with Covered Entity customers.
Who This Notice Applies To
This Notice applies to PHI created, received, maintained, or transmitted by Payor Systems in connection with its medical claims processing and benefits adjudication services for health plans. PHI may include information about your medical history, treatments, prescriptions, claims, payments, and related plan benefits.
Where Payor Systems acts on behalf of a health plan or other Covered Entity, the policies of that plan or entity may also apply. In the event of a conflict, the more privacy-protective policy controls.
How We May Use and Disclose Your PHI
Payor Systems may use and disclose your PHI without your authorization for the following purposes:
Treatment
Although Payor Systems does not directly provide treatment, we may disclose your PHI to your healthcare providers to facilitate the treatment they provide to you.
Payment
We use and disclose your PHI to process medical claims, determine benefits eligibility, calculate cost share, coordinate with secondary payers, and otherwise carry out payment activities on behalf of your health plan.
Healthcare operations
We use and disclose your PHI in connection with operational activities of your health plan, including quality assessment, business management, and audit functions.
Required by law
We may use or disclose your PHI when required to do so by federal, state, or local law, including in response to valid subpoenas, court orders, and government investigations.
Public health and safety
We may disclose your PHI for public health activities, to report suspected abuse or neglect, to prevent serious threats to health or safety, and for other public-interest purposes permitted by HIPAA.
Business associates
We may disclose your PHI to business associates that perform services on our behalf. Business associates are required by contract to protect your PHI to the same standards we follow.
Uses and Disclosures Requiring Your Authorization
Other uses or disclosures of your PHI not described in this Notice will be made only with your written authorization. This includes, except as permitted by law:
- Most uses and disclosures of psychotherapy notes
- Uses and disclosures for marketing purposes
- Disclosures that constitute a sale of PHI
You may revoke any authorization in writing at any time, except to the extent we have already acted in reliance on it.
Your Rights Regarding Your PHI
Right of access
You have the right to inspect and obtain a copy of PHI we maintain about you, in the form and format you request if readily producible. We may charge a reasonable, cost-based fee.
Right to amend
You have the right to request that we amend PHI we maintain about you if you believe it is inaccurate or incomplete. We may deny your request in certain circumstances permitted by HIPAA.
Right to an accounting of disclosures
You have the right to receive an accounting of certain disclosures of your PHI made by us during the six years prior to your request, with limited exceptions.
Right to request restrictions
You have the right to request restrictions on certain uses and disclosures of your PHI. We are not required to agree to your request, except in limited circumstances specified by HIPAA.
Right to confidential communications
You have the right to request that we communicate with you about your PHI in a particular way or at a particular location. We will accommodate reasonable requests.
Right to a paper copy of this notice
You have the right to request a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
Right to be notified of a breach
You have the right to be notified following a breach of your unsecured PHI, as required by HIPAA.
Exercising your rights
To exercise any of these rights, contact us using the information in the “Complaints” section below. We will provide forms and respond within timeframes required by HIPAA.
Our Responsibilities
Payor Systems is required by law to:
- Maintain the privacy and security of your PHI
- Provide you with this Notice describing our legal duties and privacy practices
- Notify you if a breach occurs that may have compromised the privacy or security of your PHI
- Follow the duties and privacy practices described in this Notice and provide you with a copy
We will not use or disclose your PHI other than as described in this Notice unless you authorize us in writing.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.
Payor Systems · Privacy Officer
nrandall@apivoc.com
Phone
(480) 888-6820
Payor Systems · Privacy Officer
c/o ApiVoc LLC
20551 N. Pima Road, Suite 200
Scottsdale, AZ 85255
To file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, visit hhs.gov/hipaa/filing-a-complaint/ or call 1-877-696-6775.
Changes to This Notice
We may change this Notice at any time. Changes will apply to PHI we already have about you as well as PHI we receive in the future. The current Notice will always be posted here, with the effective date shown above.