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PRIVACY POLICY

Your Information. Your Rights. Our Responsibilities.

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.

Your Rights

You have the right to:

Get a copy of your paper or electronic medical record

Correct your paper or electronic medical record

Request confidential communication

Ask us to limit the information we share

Get a list of those with whom we’ve shared your information

Get a copy of this privacy notice

Choose someone to act for you

File a complaint if you believe your privacy rights have been violated

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. You can ask your provider, e-mail us at info@freestatehealthcare.com, or call 888-505-1776, extension 1, and speak to someone, or leave a message.

We will provide a copy or a summary of your health information, usually within 30 days of your request. We charge a cost-based fee for paper copies.

Ask us to correct your medical record

You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.

We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

You can ask us to contact you in a specific way (for example, home or office phone, e-mail, text message) or to send mail to a different address.

We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care, but we will try to comply whenever possible, or explain why we cannot.

If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Your Choices

You have some choices in the way that we use and share information as we:

Tell family and friends about your condition

Provide disaster relief

Include you in a hospital directory

Provide mental health care

Market our services and sell your information

Raise funds

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

Share information with your family, close friends, or others involved in your care

Share information in a disaster relief situation

Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

Marketing purposes

Most sharing of psychotherapy notes

Please note that we DO NOT sell personal information of any kind.

Our Uses and Disclosures

We may use and share your information as we:

Treat you

Run our organization

Bill for your services

Help with public health and safety issues

Do research

Comply with the law

Respond to organ and tissue donation requests

Work with a medical examiner or funeral director

Address workers’ compensation, law enforcement, and other government requests

Respond to lawsuits and legal actions

How do we typically use or share your health information?

We typically use or share your health information in the following ways.

Treat you

We can use your health information and share it with other professionals who are treating you.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Bill for services

We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your health insurance plan so it will pay for services we have provided to you.

How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many legal conditions before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html

Help with public health and safety issues

We can share health information about you for certain situations such as:

Preventing disease

Helping with product recalls

Reporting adverse reactions to medications

Reporting suspected abuse, neglect, or domestic violence

Preventing or reducing a serious threat to anyone’s health or safety

Do research

We can use or share your information for health research. Your consent will be collected, and your information anonymized, prior to use.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you:

For workers’ compensation claims

For law enforcement purposes, or with a law enforcement official

With health oversight agencies for activities authorized by law

For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information.

We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

We must follow the duties and privacy practices described in this notice, and give you a copy of it.

We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. You will be notified if any changes are made, and the new notice will be available upon request, in our office, and on our website.

Permanently delete your FreeState Healthcare account

What happens if you permanently delete my FreeState Healthcare account?

We are required to follow state laws regarding the preservation of medical records. You can cancel your subscription or seek care with another provider at any time. You also can request a copy of your records, or that your records be sent to another care provider.

However, by law we can not destroy your medical records until the legally-required amount of time has passed. The exact amount of time depends on which state you live in, but typically runs at least 7 years.

Some states require more, including our home state of Kansas, where records must be kept for at least 10 years. Records include things like secure texts with your doctor, and video calls.

We are required to follow all HIPAA privacy laws, and as such take responsibility for keeping your data secure while being stored.

We also will never share your information with anyone unless you specifically ask us to do so.

Delete your FreeState Healthcare account through your application settings

1. Open the Freestate application.

2. Login to the Freestate application.

3. Click on your profile picture in the top right of the application or click on My Account from the left side menu options.

4. Click on the Delete account button.

5. Select the checkbox to accept the terms, then click on the Delete button.

6. Click on the 'Yes' button in the confirmation popup.

7. Enter the OTP received on the registered mobile number.

8. Click on the 'Verify' button.

If you have additional questions or concerns,
please call us at 800-924-8140, or e-mail support@freestatehealthcare.com.

Additional Information

We will comply with state or other laws that require greater limits on disclosures, and any such limitations will be addended to this section of the privacy policy if and when applicable.

Effective Date of this Notice: 6/1/2015 Privacy Contact Information:

Name: Dr. Aaron Chen
Email Address: achen@freestatehealthcare.com Phone Number: 888-505-1776, extension 702
Other entities covered by this notice and their locations include:

Vigilias LLC, 4723 E. Oakland St. Wichita, KS 67218

© 2017 FreeState Healthcare , 4723 E. Douglas Avenue Wichita KS 67218