Use and Disclosure of Health Information For Treatment, Payment, or Healthcare Operations
Mobile Care Chicago takes protection of health information seriously, and makes every effort to ensure patients and guardians are aware of how health information could be transmitted and/or used.
As part of health care provision for children, Mobile Care Chicago originates and maintains paper and/or electronic records describing the child’s health history, symptoms, examination and test results, diagnosis, treatment, and the child’s plans for future care or treatment. This information serves as:
- A basis for planning each patient’s care and treatment,
- A means of communication among the many health professionals who may contribute to a patient’s care,
- A source of information for applying a patient’s diagnosis and other information to an insurance claim
- A means by which a third-party payer can verify that services billed were actually provided, and
- A tool for routine healthcare operations such as assessing quality and reviewing the competence of healthcare professionals
Mobile Care Chicago may gather other information to aid in service promotion, as well as health care delivery for patients. This may include:
- Photographs or videos of the clinic setting to help with medical device education and keeping patients and parents/guardians informed of patient health
- Photographs or videos of the clinic setting for charitable literature, as well as scientific and educational purposes, though the identity of patients will not be disclosed
All patients (and guardians of patients under the age of 18) have the following rights and privileges:
- The right to review this notice prior to signing consent
- The right to object to the use of their health information for directory purposes, and,
- The right to request restrictions as to how health information may be used or disclosed to carry out treatment, payment, or health care operations
Mobile Care Chicago is not required to agree to the restrictions requested, though the organization will make every effort to accommodate requests. Patients/guardians may revoke consent in writing, except to the extent that the organization has already taken action in reliance thereon. By refusing to grant consent or revoking consent, Mobile Care Chicago may refuse treatment as permitted by Section 164.506 of the Code of Federal Regulations.
Mobile Care Chicago reserves the right to change their notice and practices and prior to implementation, in accordance with Section 164.520 of the Code of Federal Regulations. Should Mobile Care Chicago change their notice, they will send a copy of any revised notice to the address on file (whether U.S. mail or, if I agree, email).
To request restrictions on the use or disclosure of your or your child’s health information, please write to asthma@mobilecarefoundation.org
As part of Mobile Care Chicago’s treatment, payment, or health care operations, it may become necessary to disclose protected health information to another entity, including disclosures via fax.
