Potomac Case Management

                                                         Hagerstown, MD. 21740

Service: ADMINISTRATION AND ALL PROGRAMS

Subject: Notice or Privacy Practices

Reviewed By:

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Revision Date:

Revision Number:

Reason for Revision:

{ } Ethical/Legal     { }Change Required by Regulating Board

 

{ }Quality Improvement      { }Other Evaluation Process

 

                                                                                                                        

Effective Date:

Approved By:

 

POLICY:  A Notice of Privacy Practices will be posted and provided to each person

                   receiving services through Potomac Case Management Services

              

   

Procedure:

1.      The Notice must contain the following statement header: “THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESSS TO THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.”

 

2.      The notice must be written in “plan language” and comply with the following details:

( I ) Uses and disclosures

·        A description including at least one example of the types of uses and disclosures the agency is permitted to make for each of the following: treatment, payment, and health care operations.

                                                              i.      Treatment: use diagnostic information received to:

·        Obtain authorization for services

·        Develop treatment plan in conjunction with client

      ii.    Payment: name and contact dates of services on billing form

·        Submitted to Maryland Health Partners for reimbursement of service

                              iii.    Health Care Operations: Use of diagnosis

·         To verify client meets criteria for services

                                    

     3.   An Authorization/Release of information specific to each entitlement          

                     linkage necessary to meet the needs of the individual treatment plan will  

               be required. 

 

     


 

Service: ADMINISTRATION AND ALL PROGRAMS

Subject:  Notice of Privacy Practices  

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3.      The Notice will contain a statement of the individual’s rights with respect to

confidential information and a brief description of how the individual may exercise these rights. These rights include:

·        Request to restrictions on certain uses and disclosures

·        The right to receive confidential communications

·        The right to inspect and copy confidential information

·        The right to amend confidential information

·        The right to receive an accounting of disclosures of confidential information

·        The right to a paper copy of the Notice from PCMS even when having agreed to receive the Notice electronically.

 

4.      The Notice will also contain the “Practice duties” of Potomac Case Management. Included but not limited to:

·        The requirement by law to maintain the privacy of confidential information and provide individuals with the notice of its legal duties and privacy practices with respect to such information;

·        A statement that PCMS is required to abide by the terms of the Notice currently in effect; and

·        For PCMS to apply a change in a privacy practice that is described in the Notice, a statement that is reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all confidential information that it maintains. 

·        The statement will describe how it will provide individuals with a revised Notice.

 

5.      The Notice will contain a statement addressing Complaints to include:

·        The individuals right to file a complaint to the practice and to the Secretary of the U.S. Department of Health and Human Services in the belief of privacy violation,

·        A brief description of how the complaint may be filed and,

·        A statement of non-retaliation for filing a complaint.

 

 

 

Service: ADMINSTRATION AND ALL PROGRAMS

Subject: THE NOTICE OF PRIVACY PRACTICES

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  1. The Notice will contain the name/title and telephone number of PCMS designated Privacy Officer

 

  1. The Notice will contain the date on which it becomes effective.

 

  1. PCMS maintains the right to limit the uses or disclosures that it is permitted to make when State Laws would give greater privacy or confidentiality to an individual’s personal information.

 

  1. PCMS will revise and distribute its Notice in a timely manner whenever there is a material change to the uses or disclosures, the individual’s rights, the covered entity’s legal duties, or other privacy practices stated in the Notice.

 

  1. Except when required by law, a material change to any term of the Notice will not be implemented prior to the effective date of the Notice in which such material change is reflected.