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.

Arizona Liver Health is committed to protecting the confidentiality of information about you and is required by law to do so.  This notice describes how your information may be used and disclosed to others outside of Arizona Liver Health. This notice also describes the right you have concerning your own health information and how you can get access to your medical records. Please review it carefully.

Effective date May 22, 2024.

Your Rights

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

Inspect and copy of your medical record

• You have the right to inspect and receive an electronic or paper copy the protected health information (PHI) that we maintain about you in our designated record set for as long as we maintain that information. This designated record set includes your medical and billing records, as well as any other records we use for making decisions about you. You may not inspect or copy psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; or PHI that is subject to law that prohibits access to PHI. In some circumstances, you may have a right to review our denial.
• If you wish to inspect or copy your PHI, you must submit your request in writing to the attention of our Compliance Officer at our address set forth in this notice. We may charge you a reasonable, cost-based fee for fulfilling your request. You may mail your request or bring it to our office. Usually we will respond to your request for information within 30 days of receiving your request.

Ask us to correct your medical record

• You have the right to request that we amend your PHI. You must make this request in writing to our compliance department. The request must state the reason for the amendment.
• We may deny your request if it is not in writing or does not state the reason for the amendment. We may also deny your request if the information was not created by us, unless you provide reasonable information that the person who created it is no longer available to make the amendment; is not part of the record which you are permitted to inspect and copy; the information is not part of our designated record; or is accurate and complete, in our opinion.

Request confidential communications

• You have the right to request how we communicate with you to preserve your privacy. For example, you can ask us not to call your home, but to communicate only by mail. We may condition the accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact.
• You must submit your request in writing to our Compliance Officer. The request must specify how or where we are to contact you. We will accommodate all reasonable requests.

Ask us to limit what we use or share

• You have the right to request a restriction or limitation of how we use or disclose your PHI for treatment, payment, or health care operations; to persons involved in your care; or for notification purposes as set forth in this notice. Although we are not required to agree to your requested restriction, if we do agree, we will comply with your request unless the information is needed for emergency treatment.
• If you pay in full 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.
• You must submit your request in writing to our Compliance department. The request must specify the restriction.

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

• You can ask for a list (accounting) of the times we’ve shared (disclosed) your PHI for six years prior to the date you ask, who we shared it with, and why. We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
• We will include all the disclosures, except for disclosures for treatment, payment, or health care operations; to you; incident to a use or disclosure set forth in this notice; to persons involved in your care; pursuant to your written authorization; for notification purposes; for national security or intelligence purposes; to correctional institutions or law enforcement officials; as part of a limited data set; that occurred before six years from the date of the request.
• Your request must be in writing to our Compliance department and must state the time period for the requested information.

Get a copy of this notice

• You have the right to receive a paper copy of this notice upon request. We will provide you with a paper copy promptly.
• You may obtain a copy by asking our receptionist at your next visit or by calling and asking us to mail you a copy.

Choose someone to act for you

• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your PHI.
• We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

• You have the right to file a complaint with our Compliance Officer or with the Secretary of the Department of Health and Human Services if you believe we have violated your privacy rights. Complaints to our office must be in writing and sent to us by email at Soccompliance@azliver.com, or by mail at 2201 W Fairview Street, Ste 9, Chandler, AZ, 85224.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting hhs.gov/ocr/privacy/hipaa/complaints/.
• We will not retaliate against you for filing a complaint.

Our Uses and Disclosures

How do we typically use or share your information?

We typically use or share your PHI in the following ways.

Treat you

We may use your PHI and share it with other professionals who are treating you, such as doctors, physician assistants, nurses, therapist, emergency service and medical transportation providers, medical equipment providers, and others involved in your care.

Example: We will allow your physician to have access to your medical record to assist in your treatment and for follow-up care.

We may make your PHI available electronically through an electronic health information exchange to other health care providers and health plans that request your information for their treatment or payment purposes.

We may also use and disclose your PHI to contact you to remind you of an upcoming appointment, to inform you about possible treatment options or alternatives, or to tell you about health-related services available to you. 

Bill for your services

We may use and disclose your PHI to get paid for the medical services and supplies we provide to you.  We may also disclose your PHI to another health care provider, health care clearinghouse or health plan for their payment activities.

Example: Your health plan or health insurance company may request to see parts of your medical record before they will pay us for your treatment.

Business Activities

We may use and disclose your PHI to support our business activities. We may disclose your PHI to another health care provider, health care clearinghouse, health plan or “organized health care arrangement” we participate in, for certain business activities. We may also disclose your PHI to third parties who perform certain activities for us (e.g., billing services). Finally, we may disclose to certain third parties a limited data set containing your PHI for certain business activities.

Example:, We may use your PHI to review and evaluate our treatment and services or to evaluate our staff’s performance while caring for you.

How else can we use or share your information?

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

Persons Involved in Your Care

We may use and disclose to a family member, a close friend, or any other person you identify, your PHI that is directly relevant to the person’s involvement in your care or payment related to your care, unless you object to such disclosure. If you are unable to agree or object to a disclosure, we may disclose the information as necessary if we determine that it is in your best interest based on our professional judgment.

Notification

We may use or disclose your PHI to notify or assist in notifying a family member, personal representative or other person responsible for your care, of your location, general condition or death.

Disaster Relief

We may use and disclose your PHI to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.

Research

We may use and disclose your PHI for research projects – e.g., for a project studying the effectiveness of a treatment. Generally, such research projects must have been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your information.

As Required by Law

We may use and disclose your PHI to the extent the use or disclosure is required by law. If required by law, you will be notified of any such uses or disclosures.

Public Health

We may disclose your PHI for public health activities to a public health authority that is permitted by law to collect or receive the information. Disclosures will be made for purposes of controlling disease, injury or disability. If directed by the public health authority, we may disclose your PHI to a foreign government agency that is collaborating with the public health authority.

Abuse or Neglect

We may disclose your PHI to a public health authority that is authorized by law to receive reports of child abuse or neglect. If we believe you are a victim of abuse, neglect or domestic violence, we also may disclose your PHI to the governmental agency that is authorized to receive this information. All disclosures will be consistent with the requirements of the applicable laws.

Communicable Diseases

If authorized by law, we may disclose your PHI to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a communicable disease.

Legal Proceedings

We may disclose your PHI in the course of any judicial or administrative proceeding; in response to an order of a court or administrative tribunal; to the extent the disclosure is expressly authorized; or, if certain conditions have been satisfied, in response to a subpoena, discovery request or other lawful process.

Law Enforcement

If certain legal requirements are met, we may disclose your PHI to a law enforcement official for law enforcement purposes, including legal processes; identification and location of suspects, fugitives, material witnesses or missing persons; information regarding victims of a crime; suspicion that death has occurred as a result of criminal conduct; evidence of criminal conduct occurring on our premises; and, in a medical emergency, reporting criminal conduct not on our premises.

Coroners, Funeral Directors, and Organ Donation

We may disclose your PHI to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose your PHI to a funeral director, as authorized by law, in order to permit the funeral director to carry out her duties or in reasonable anticipation of death. Finally, we may use or disclose your PHI for facilitating organ, eye or tissue donation and transplantation.

To Avert a Serious Threat to Public Health or Safety

Consistent with applicable laws, if we believe using and disclosing your PHI is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public, we may use and disclose your PHI. We may also disclose your PHI if it is necessary for law enforcement to identify or apprehend an individual.

Military Activity and National Security

When the appropriate conditions apply, we may use or disclose your PHI: (1) for activities deemed necessary by appropriate military command authorities; (2) for determining your eligibility for benefits by the Department of Veterans Affairs; or (3) to foreign military authority if you are a member of that foreign military service. We may also disclose your PHI to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.

Workers’ Compensation

We may use and disclose your PHI for workers’ compensation or similar programs that provide benefits for work-related injuries or illness.

Department of Health and Human Services

As required by law, we may disclose your PHI to the Department of Health and Human Services to determine our compliance with applicable laws.

Food and Drug Administration

We may disclose your PHI to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls; to make repairs or replacements; or to conduct post-marketing surveillance.

Inmates

We may use and disclose your PHI if you are an inmate of a correctional facility and we created or received your PHI in the course of providing care to you.

Fundraising

We may contact you for fundraising efforts, but you can tell us not to contact you again for fundraising.

Other Uses & Disclosures – Written Authorization

Certain uses and disclosures of your PHI require us to obtain your prior written authorization, including: certain uses and disclosures of PHI that constitutes psychotherapy notes;  uses and disclosures for marketing purposes; and disclosures of your PHI in exchange for remuneration. Otherwise, except as stated in this notice, we will not use or disclose your PHI without your written authorization. You may revoke your authorization at any time, in writing, except to the extent that we have used or disclosed your information in reliance on the authorization.

Our Responsibilities

• We are required by law to maintain the privacy and security of your PHI.
• We are required to provide you with this notice.
• We are required to notify you 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.

Changes to the Terms of this Notice

We reserve the right to change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be posted in a prominent location in our office and on our website. Upon request, we will provide you with a copy of the revised notice.

Do you have questions?

Arizona Liver Health is required by law to give you this notice and to follow the terms of the notice that is currently in effect. If you have any questions about this notice, or have further questions about how we may use and disclose information about you, please contact our Compliance Department at soccompliance@azliver.com or by phone at 480-470-4000, or by mail: 2201 W Fairview Street, Ste 9, Chandler, AZ 85224.