THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW THE YOU CAN GET ACCESS TO THIS INFORMATION.
Activ Doctors Consult, LLC ("ADC"), operator of http://www.activdoctorsonline.com (the “Site”), is required by law to maintain the privacy of certain confidential health care information, known as Protected Health Information (“PHI”), and to provide you with a notice of our legal duties and privacy practices with respect to your PHI. ADC is also required to abide by the terms of the version of this Notice currently in effect.
PLEASE READ CAREFULLY BEFORE SIGNING ENROLLMENT FORM.
ADC is committed to maintaining your confidence and trust with respect to any information, recorded in any form, about an identified individual, or an individual whose identity may be inferred from the information. This includes, for example, name, e-mail, mailing address, and telephone number, billing and account information, and other information incidental to providing the products or services offered on the Site (the “Personal Information”).
Individuals accessing the Site shall be referred to as (collectively, “Users”, “you”, “your”). Second Medical opinion, medical records assistance, storage and access to medical records, and other services offered to Users are collectively referred to herein as the “Service” or “Services”. ADC intends to protect the PHI stored on the Site.
If you do not agree with these terms, you should not provide Personal Health Information. If you refuse or withdraws consent, or if you choose not to provide ADC with any required Personal Health Information, ADC may not be able to provide you with the offered Services on the Site.
Minors (as defined under the laws of their jurisdiction or residence) are not eligible to register for, use, or purchase the Services available on our Site. ADC does not knowingly collect Personal Health Information from any minor, and will not use this information if ADC discovers that it has been provided by a Minor.
Uses and Disclosures of PHI: ADC may use PHI for the purposes of rendering treatment, payment, and health care operations, in most cases without your written permission. Examples of ADC’s use of the User’s PHI:
For treatment: This includes such things as obtaining verbal and written information about your medical condition and treatment from you as well as from others, such as doctors who may have treated the you previously. ADC may give your PHI to other health care providers involved in your treatment.
For payment: This includes any activities ADC must undertakes in order to get reimbursed for the services provided to you, including such things as submitting bills to insurance companies, making medical necessity determinations and collecting outstanding accounts.
For health care operations: This includes quality assurance activities, licensing, and training programs to ensure that ADC personnel meets the requisite standards of care and follow established policies and procedures, as well as certain other management functions.
Use and Disclosure of PHI without User’s Authorization: ADC is permitted to use PHI without your written authorization, or opportunity to object, in certain situations, and unless prohibited by a more stringent state law, including:
For the treatment, payment or health care operations activities of another health care provider who treats you;
For health care and legal compliance activities; To a family member, other relative, or close personal friend or other individual involved in the your care, if ADC obtains your verbal agreement to do so or if ADC gives you an opportunity to object to such a disclosure and the you do not raise an objection, and in certain other circumstances where ADC is unable to obtain your agreement and believes the disclosure is in the your best interests;
To a public health authority in certain situations as required by law (such as to report abuse, neglect or domestic violence;
For health oversight activities including audits or government investigations, inspections, disciplinary proceedings, and other administrative or judicial actions undertaken by the government (or their contractors) by law to oversee the health care system;
For judicial and administrative proceedings as required by a court or administrative order, or in some cases in response to a subpoena or other legal process;
For law enforcement activities in limited situations, such as when responding to a warrant;
For military, national defense and security and other special government functions; To avert a serious threat to the health and safety of a person or the public at large; “For workers' compensation purposes, and in compliance with workers' compensation laws;
To coroners, medical examiners, and funeral directors for identifying a deceased person, determining cause of death, or carrying on their duties as authorized by law; If you are an organ donor, ADC may release health information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ donation and transplantation;
For research projects, but this will be subject to strict oversight and approvals; ADC may also use or disclose health information about you in a way that does not personally identify you.
Any other use or disclosure of PHI, other than those listed above will only be made with your written authorization. You may revoke authorization at any time, in writing, except to the extent that ADC has already used or disclosed medical information in reliance on that authorization.
Patient Rights: As a patient, You have a number of rights with respect to the User’s PHI, including:
The right to access copy or inspect the PHI: This means you may inspect and copy most of the medical information about you.
ADC will normally provide you with access to this information within 30 days of the request. ADC may also charge you a reasonable fee for you to copy any medical information that you have the right to access. In limited circumstances, ADC may deny you access to your medical information (e.g., non-payment of subscription fees), and you may appeal certain types of denials. ADC has available forms to request access to the PHI and ADC will provide a written response and a summary of appeal rights if ADC denies you access. You also have the right to receive confidential communications of the PHI. If you wish to inspect and copy your medical information, you should contact ADC’s privacy officer.
The right to amend the PHI: You have the right to ask ADC to amend any written medical information in its possession. ADC will generally amend your information within 60 days of a request and will provide notification upon amendment. ADC is permitted by law to deny your request to amend your medical information only in certain circumstances, such as when ADC believes the information requested for amendment is correct. If you wish to request that ADC amends the medical information in its possession, you should contact the ADC privacy officer.
The right to request an accounting: You may request an accounting from ADC of certain disclosures of the medical information that ADC made in the six years prior to the date of any request. ADC is required to give you an accounting of information ADC has used or disclosed for purposes of treatment, payment or health care operations, or when ADC shares your health information with any of its business associates for purposes of providing the Services pursuant to your subscription agreement. ADC is also not required to give you accounting of ADC’s uses of protected health information for which you have already given written authorization. If you wish to request an accounting, contact the ADC privacy officer.
The right to request that ADC restrict the uses and disclosures of the PHI:
You have the right to request that ADC restrict how ADC uses and discloses your medical information in its possession. ADC is not required to agree to any restrictions that you request, but any restrictions agreed to by ADC in writing are binding on ADC.
If you use a credit or debit card for any purchases of services, ADC will collect your credit or debit card information and keep a history of your purchases. We use this information to process your orders, to ensure proper delivery or services, and to better assist you when you visit us online or call us, as well as to improve our product and service offerings.
Personal Information Disclosure
ADC will not trade, rent or sell the User’s personal information, without the User’s prior consent, except as otherwise set out herein;
ADC will maintain the confidentiality of all personal information collected on the Site, and will only disclose such information to employees and contractors who require such information for the purposes described herein. ADC maintains administrative, technical, and physical safeguards to protect against unauthorized access, use, modification and disclosure of personal information in its custody and control.
Security Measures on Site
Secure shopping: When you subscribe for the Services on the Site, all of your subscription information, including your credit card number and delivery address, is transmitted through the Internet using Secure Socket Layers (SSL) technology. SSL technology causes the User’s browser to encrypt your order information before transmitting it to ADC’s secure server. SSL technology, an industry standard, is designed to prevent someone other than operators of the ADC Site from capturing and viewing your personal information.
ADC also takes the following measures to protect your personal information online:
Passwords: To provide you with an increased level of security, online access to your personal information is protected with a selected password. ADC strongly recommends that you not disclose the selected password to any third party. ADC will never ask you for the password in any unsolicited communication (including unsolicited correspondence such as letters, phone calls, or E-mail messages).
Subscription Information: Since any subscription information provided to ADC on the Site will be transmitted using a secure connection, if your web browser cannot support this level of security, you will not be able to subscribe for any services through the Site. The most recent versions of Netscape Navigator, Microsoft Internet Explorer and Firefox can support a secure connection and can be downloaded for free from the respective Netscape, Microsoft and Firefox websites.
No data transmission over the internet can be guaranteed to be 100% secure. While ADC strives to protect your personal information from unauthorized access, use or disclosure, ADC cannot ensure or warrant the security of any transmitted information to the Site.
Internet, Electronic Mail, and the Right to Obtain Copy of Paper Notice on Request: If ADC maintains a web site; ADC will prominently post a copy of this Notice on its web site. If you permit; ADC will forward this Notice to you by electronic mail instead of on paper and you may always request a paper copy of the Notice.
Patient Communications: From time to time, we may contact you about your account and to possibly offer other complimentary services that may positively impact your health.
Revisions to the Notice: ADC reserves the right to change the terms of this Notice at any time, and the changes will be effective immediately and will apply to all protected health information that we maintain. Any material changes to the Notice will be promptly posted in our facilities and posted to the Site. You are entitled to receive a copy of the latest version of this Notice by contacting the ADC privacy officer.
User Legal Rights and Complaints: You also have the right to complain to the ADC privacy officer, or to the Secretary of the United States Department of Health and Human Services if you believe privacy rights have been violated. You will not be retaliated against in any way for filing a complaint with ADC or to the government. Should you have any questions, comments or complaints, please direct all inquiries to the ADC privacy officer.
Accessing, Modifying Or Deleting Personal Information
ADC endeavors to ensure that your PHI is as accurate, complete, and current as necessary for the purposes for which ADC uses that information. ADC encourages you to login to the member account by visiting this page app.activdoctorsonline.com tab to review the User’s PHI.
You can access, update, correct, or modify the PHI by logging on with the designated user name and password.
If you request removal of the PHI stored on the Site, ADC will promptly do so, to the extent possible. Once PHI is removed, however, you will not be able to use many of the Services available on the Site unless you re-register.
Information Automatically Collected by the Site
ADC automatically collects certain non-personally identifying information, such as your computer’s IP address, the type of browser in use, and pages viewed when you visit the Site. ADC uses this information to understand how users navigate through the Site, to enhance the experience in using the Site, and to make the materials posted more valuable to users. This information is not linked to personally identifiable information
Second Medical Opinion
ADC is committed to protecting the privacy of information gathered about users while providing Second Medical Opinion (“SMO”) services as defined in the Terms and Conditions.
The privacy practices described in this Notice will be followed concerning the SMO services by: (1) the medical directors who receives your medical records and constitutes the physicians committees (2) the consulting physicians who review your medical records and give second medical opinions and (3) any employee, medical staff, trainee, or volunteer of ADC and/or agents, affiliates, or subsidiaries of ADC.