Notice of Privacy Practices
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.
Protecting Your Privacy
Hospice at Home of Arizona understands the importance and sensitivity of your health information. We follow federal and state laws that govern your health information. We use your health information (and allow others to have it) only as permitted by federal and state laws.
What Are Your Rights
How We Will Use and Disclose Your Health Information
Common Uses of Health Information. When we care for you, we will gather your health information. The law allows us to use or share this health information to:
Treatment: Understand your health condition and to treat you when you are sick. For example, we may look at your x-rays or share x-rays we take of you with your treating doctor, who may be outside of the hospice.
Family or Others: Disclose information to family or representatives who are involved in your care. You may notify us if you do not want information disclosed to family or others involved.
Payment: Bill for your healthcare services and receive payment for our services; for example, we share your health insurance information with other healthcare providers who treat you — like your attending physician so they can bill for those services.
Eligibility: Determine if a patient is eligible for hospice services with Medicaid by submitting personally identifiable information to the Medicaid program or other insurance programs.
Operations: Improve our care. For example, we may contact you to understand what you thought of our care and to learn how to enhance our services to you.
Business Partners: Improve our services to you by allowing companies with whom we contract, called “business associates,” to perform certain specialized work for us. The law requires these business associates to protect your health information and obey the same privacy laws that we do.
Research: Perform limited health-data research, where the researcher keeps patient-identifiable information confidential. Hospice reviews every research request to make sure privacy is appropriately protected before sharing health information. Law enforcement, but only as authorized by law.
Required by Law: Investigate a crime against hospice or any of its patients or to law enforcement officials to prevent serious threat to health or safety. Hospice will share your information as required by federal, state or local law.
Required Uses of Health Information. The law sometimes requires us to share information for specific purposes, with:
Uses According to Your Requests. If you let us know how you want us to disclose your information in the following situations, we will follow your directions.
Uses of Health Information with Your Authorization. Any sharing of your health information, other than as explained above, requires your written authorization. For example, we will not use your health information unless you authorize us in writing to:
If you authorize us to share your health information but then change your mind, please notify the hospice in writing. We will honor your decision, but we will not be able to get back the health information that you authorized us to send before your revocation.
If You Still Have Questions
Hospice employees are trained to help you with any questions you may have about the privacy of your health information. They can also address any privacy concerns you may have about your health information and help you fill out any forms that are needed to exercise your privacy rights. You may contact our Compliance Officer at (480) 478-0643.
Effective July 1, 2013. We may change this privacy notice at any time. You can see our current privacy notice on our website www.hospicehomeaz.com or you can also obtain a copy of this notice from any of our staff by asking for a copy.
If you believe that your privacy rights have been violated, you may file a grievance with the hospice or the U.S. Secretary of the Department of Health and Human Services. There will be no retaliation against you for filing a complaint. For further information contact:
1423 S Higley Rd. Ste 121
Mesa, Arizona 85206
Hospice at Home of Arizona
2500 S. Power Rd, Suite 125A, Mesa, Arizona 85209
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Hospice at Home of Arizona is licensed by The State of Arizona, Certified by Medicare and the Community Health Accreditation Program
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