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.
What are your rights?
You have the rights listed below.
1) To receive a paper or electronic copy of your health information: You may ask us to see or receive a paper or electronic copy of your medical record and other health information we have about you. We will provide such copy to you, usually within 30 days of your request, and we may charge a reasonable, cost-based fee.
2) Correct your paper or electronic medical record: You may ask us to correct health information about you that you think is incorrect or incomplete. If we disagree with the proposed correction, we may deny your request, but we will provide you a written explanation for doing so within 60 days.
3) Request confidential communications: You may ask us to contact you in a specific way (for example, by calling a specific number or sending mail to specific address). We will accommodate all reasonable requests.
4) Ask us to limit what information we share: You may ask us not to use or share certain health information for treatment, payment, or other internal operations. We are not required to agree to your request, and we may say “no” if it would affect your care or our ability to be paid for the services we provide you. If you pay for our services, or any particular services or items from us, out of your own pocket, you can ask us not to share your information with your health insurer. We will accommodate that request unless a law requires us to share that information. If you prefer not to have any health information used about you in research, you may request this by contacting our client services.
5) Get a list of those with whom we have shared your information: You can ask for a list (also known as an “accounting”) of the times we have shared your health information for six years prior to the date you ask, persons and entities with whom we shared such information and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We will provide one free accounting per year but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
6) Get a copy of this privacy notice: You may ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically, and we will promptly provide you a paper copy.
7) 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 health information. We will verify that the person has this authority and may act for you before we take any action.
8) File a complaint if you believe your privacy rights have been violated: If you are concerned that we have violated your privacy rights, you may contact us by e-mail at Support@EvolveGene.com or by telephone in the United States or Canada by dialing 1-800-963-3203 or outside of the United States or Canada by dialing 001-519-763-2720. If you are not satisfied with our response, you may file a written 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 877-696-6775, or visiting the HHS website (https://www.hhs.gov/ocr/privacy/hipaa/complaints/). We will not retaliate against you for filing a complaint.
How may we use and share your information?
When your sample is submitted to us, you agree that we may use the information you provide, as we describe in this notice. If we need to share your information for other purposes, we will ask for your written or electronic authorization, which you may later revoke by notifying us in writing of your desire to do so. We will inform you promptly if a breach occurs that may have compromised your privacy or the security of your information.
We may use and share your information as we do the following:
1) Treat you: We may use your health information and share it with other professionals treating you, e.g., we may share your genetic screening results with your doctor.
2) Run our organization: We may use and share your health information to run our practice, improve your care and contact you when necessary, e.g., we use your health information to manage your treatment and services, provide customer service when you have questions about your results, or to develop new screenings and other services.
3) Bill for your services: We may use and share your health information to bill and receive payment from health plans or other entities, as applicable.
4) Help with public health and safety issues: We may be allowed or required to share your information in other ways that contribute to the public good, such as public health and research, e.g., for the purpose of preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect or domestic violence, or preventing or reducing serious threats to a person’s health or safety. Before we may do so, however, we need to meet many legal conditions. For more information, see the HHS Guidance Materials (https://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html).
5) Do research: We may use or share your information for health research, as provided in Section 9 of your Informed Consent.
6) Comply with health oversight audits or inspections: We may use or share your information to comply with audits or inspections by the Department of Health and Human Services to show that we are complying with federal privacy laws.
7) Comply with the law: If we reasonably believe that sharing your information is necessary to comply with a law, regulation or legal process, we will share it, but we will make our best efforts to give you written notice in advance of such disclosure, unless prohibited by law or court order.
8) Respond to organ and tissue donation requests: We may share health information about you with organ procurement organizations.
9) Work with a medical examiner or funeral director: We may share health information with a coroner, medical examiner or funeral director when an individual dies.
10) Address workers’ compensation, law enforcement or other government requests: We may use or share health information about you for workers’ compensation claims, for law enforcement purposes or with law enforcement officials, with health oversight agencies for activities authorized by law, or for special governmental functions, such as military, national security, and presidential protective services.
11) Respond to lawsuits and legal actions: We may share health information about you in response to a court or administrative order or in response to a subpoena.
Will the terms of this notice change?
This notice is effective as of June 1st 2016. We may change the terms of this notice, and the changes will apply to all information we already hold about you as well as new information that we receive after the change occurs. The new notice will be available on our Site and upon request.
If you have any questions or concerns, you may contact us by e-mail at Support@EvolveGene.com or by telephone in the United States or Canada by dialing 1-800-963-3203 or outside of the United States or Canada by dialing 001-519-763-2720