Introduction

We recognize that the privacy of your personal information is important.  This Online Privacy Policy describes our practices regarding any information we collect through our website, web portal or any other electronic services that we operate.

Terms such as “we”, “us”, “our”, “RCI” referenced in this policy refer to Regional Care Inc and it’s employees, agents, contractors or vendors.  Any information you provide, including any personal information, will be housed and controlled by servers located within the United States.

This policy is to be consistent with what is more commonly known as “HIPAA Privacy Rule” and any terminology not further defined in this policy should reflect the meaning as outlined in the HIPPA Privacy Rule.

(https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html)

By using any of our online services, you consent to the collection, use, storage and disclosure of information as described in this policy. 

Responsibilities

Per requirements of law, we are required to maintain the privacy of your PHI.  We are also required to:

• provide you with a copy of this Privacy Policy

• abide by the terms Privacy Policy currently in effect

•  notify you in the event of a breach of security concerning your PHI

Uses & Disclosure

The following describes the possible use and/or possible disclosure of your PHI.

Protected Health Information, or “PHI”, may be used by RCI, or disclosed by RCI  to carry out payment, health care operations and other purposes that are permitted or that may be required by legal obligations.  PHI consists of individually identifiable health information or demographic information gathered from you directly or received by a health care provider, health care plan, your employer or health care clearing house relating to:

• your past, present or future physical or mental health or condition

• the provision of health care to you

• the past, present or future payment for the provision of health care to you

Payment

RCI will use/disclose your PHI to pay claims for services provided to you.  This includes purposes to obtain stop-loss reimbursements or otherwise fulfill our obligations for coverage and providing benefits. 

Health Care

RCI will use/disclose your PHI in business functions including but not limited to:

• Quality Assessment and Improvement

• Reviewing Provider Performance

• Licensing

• Stop-Loss Underwriting

• Business Planning and Development

Legal Obligations

RCI will use/disclose your PHI to the requirements outlined by law.  This is defined in the HIPAA Privacy Rule.

Public Health

RCI will use/disclose your PHI in public health activities permitted or required by law.  Examples of public health activities would include preventing or controlling disease, injury or disability.  Also, this could include information regarding reports of child abuse or neglect.

Health Oversight

RCI will use/disclose your PHI to a health oversight agency permitted by law.  Examples of this would include:

• Audits

• Investigations

• Inspections

• License or Disciplinary Actions

• Civil or Criminal Proceedings

Abuse or Neglect

RCI will use/disclose your PHI to government authorities authorized by all to receive any reports of neglect, abuse or domestic violence.

Legal Proceedings

RCI will use/disclose your PHI during judicial proceedings, administrative proceedings, response of court or administrative tribunals, and in response to any subpoena, discovery request or any other lawful process once we have met all administrative requirements by the HIPAA Privacy Rule.

Law Enforcement

RCI will use/disclose your PHI under certain circumstances to law enforcement officers.  Examples of this would include but are not limited to:

• where required by law or legal process

• where necessary to locate or identify a suspect/fugitive/material witness/missing person

• where necessary to provide evidence of a crime occurring on our premises

Identify Deceased Person

RCI will use/disclose your PHI to a coroner or medical examiner for the purpose of identifying a person that has deceased, determine a cause of death or to perform other duties authorized by law.  RCI will use/disclose your PHI as authorized by law to funeral directors so they can carry out their job duties.  RCI will use/disclose your PHI to organizations handling organ, eye, or tissue donations and transplants.

Emergency

RCI will use/disclose  your PHI in emergency situations, where you are incapacitated or not present, to a family member, close personal contact, authorized disaster response agency or any other person you previously specified.  This disclosure would be in your best interest and would only include PHI directly relevant and necessary to individuals involved in your care.

Group Plan Administrators

RCI will use/disclose your PHI to sponsors of the group health plan.  Sponsors would include employers or other entities providing a health plan to you. 

Underwriting

RCI will use/disclose your PHI for underwriting purposes to make decisions about a coverage application or request.  If disclosed for underwriting purposes, RCI is prohibited from using or disclosing any genetic information.

Personal Representatives

RCI will use/disclose your PHI to a family member, relative, close personal contact or any other person you previously specified.  Such disclosure will be based on the involvement of such person is to your direct health care or payment related to your care.  Release of information to parents or legal guardians will be as allowed by law.

Business Associates

RCI will use/disclose your PHI to entities contracted to perform various functions or to provide certain services.  In order to perform these functions or provide these services our business associates will receive, create, maintain, use or disclose PHI only after they have agreed in writing to terms and conditions designed to appropriately protect your information.

Copy of Notice

You have the right to have a copy of this Privacy Notice.  You can contact our Customer Service Department to obtain a paper copy.

We reserve the right to change the provisions of this Privacy Policy and make those changes effective for all PHI maintained by RCI.Any changes to this policy will be posted on our website (www.regionalcare.com/privacy).

Complaints

You may complain to us if you believe that we have violated your privacy rights by contacting our Customer Service department.  You also may file a complaint with the Secretary of the U.S. Department of Health and Human Services. Complaints filed directly with the Secretary must: (1) be in writing; (2) contain the name of the entity against which the complaint is lodged; (3) describe the relevant problems; and (4) be filed within 180 days of the time you became or should have become aware of the problem. We will not penalize or in any way retaliate against you for filing a complaint with the Secretary or with us.