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.
Effective Date: August 1, 2007
LEGAL OBLIGATIONS:
Bowers & Associates, Inc. (Bowers) keeps the health and financial information of our current and former members private as required by law, accreditation standards and our rules. This notice explains your rights. It also explains our legal duties and privacy practices. Bowers must follow the privacy practices contained in this notice from its effective date and continue to do so until this notice is changed or replaced.
Bowers & Associates, Inc. reserves the right to change our privacy practices and the terms of this notice at any time, provided applicable law permits the changes. Any changes made in these privacy practices will be effective for all medical information that is maintained including medical information created or received before the changes were made. All members may request a copy of the current privacy practice by submitting a written request to:
Bowers & Associates, Inc.
Privacy Officer
9779 South Franklin Drive, Suite 300
Franklin, WI 53132
^ top of page
USES AND DISCLOSURES OF MEDICAL INFORMATION:
Patient identifiable information is called Protected Health Information (PHI). Bowers may be use and disclose your PHI for treatment, payment and health care operations, for example:
Treatment: Bowers does not provide treatment. This is the role of a health care provider such as your doctor or a hospital. However, your medical information may be disclosed to a doctor, hospital or other provider that asks for it to provide treatment to you.
Payment: Your medical information may be used or disclosed to the health plan and/or the claims administrator to pay claims for services provided to you by doctors or hospitals which are covered under your health insurance policy.
Health Care Operations: Your medical information may be used and disclosed to determine premiums, conduct quality assessment and improvement activities, to engage in care coordination or utilization, case, condition (disease), absence management and/or wellness, to pursue Rights of Recovery and Reimbursement/Subrogation, accreditation, all levels of appeal activity, conducting and arranging legal services, etc. This may include releasing information to the Plan, Broker or Bowers clinical consultants. Your medical information may be disclosed for underwriting, premium rating or other activities relating to the creation, renewal or replacement of a contract of health insurance or benefits.
To You: We must give you access to your own PHI. Bowers may also contact you to let you know about treatment options or other health-related benefits and services. Bowers may also send you specific health related materials based upon the clinical information available to us along with reminders about routine medical checkups and tests.
To Others: You may tell us in writing that it is OK for use to give your PHI to someone else for any reason. Also if you are present, and tell us it is OK, we may give your PHI to a family member, friend or other person. We would do this if it has to do with your current treatment or payment for your treatment. If you are not present, if it is an emergency, or you are not able to tell us it is OK, we may give your PHI to a family member, friend or other person if sharing your PHI is in your best interest.
Authorizations: You may provide written authorization to use your medical information or to disclose it to anyone for any purpose. You may revoke this authorization in writing at any time but this revocation will not affect any use or disclosure permitted by your authorization while it was in effect. Unless you give written authorization, we cannot use or disclose your medical information for any reasons except those described in this notice.
Plan Sponsors: Your medical information may be disclosed to your plan sponsor in order to perform plan administration functions. Please see your plan documents for a full description of the limited uses and disclosures the plan sponsor may make of your medical information in order to administer your group health plan. Plan sponsors that receive PHI are required by law to have controls in place to keep it from being used for reasons that are not proper.
INDIVIDUAL RIGHTS:
Under Federal Law you have the right to send us a written request to see or get a copy of certain PHI or ask that we correct your PHI that you believe is missing or incorrect. If someone else (such as your doctor) gave us the PHI, we will let you know so you can ask them to correct it.
You also have the right to send us a written request to ask us not to use your PHI for treatment, payment or health care operations activities. We are not required to agree to these requests.
You may give us a verbal or written request to ask us to send your PHI using other means that are reasonable. Also let us know if you want us to send your PHI to an address other than your home if sending it to your home could place you in danger.
Bowers will release upon written request, a list of certain disclosures of PHI.
All requests should be sent to the address listed below.
QUESTIONS OR COMPLAINTS:
If you would like more information concerning the companies’ privacy practices or have questions or concerns, please contact at the address listed below.
The company supports your right to protect the privacy of your medical information. There will be no retaliation in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.
Bowers & Associates, Inc.
Privacy Officer
9779 South Franklin Drive, Suite 300
Franklin, WI 53132
^ top of page