Passages Hospice or Passages Palliative Care is committed to protecting the privacy of its patients and families.
The personal and medical information gathered by Passages Hospice or Passages Palliative Care is used to monitor and manage your medical condition. Passages Hospice and Passages Palliative Care will not release you name, address, telephone number, emergency information or health data related to your medical history to any 3rd party without your consent unless
- You expressly direct Passages Hospice or Passages Palliative Care to give your information to providers or family or
- Passages Hospice and Passages Palliative Care are required by law to share your information.
The Passages Hospice and Passages Palliative Care website has security measures in place to protect the loss, misuse and alteration of the information under our control. Passages Hospice and Passages Palliative Care uses special software to protect your privacy. All data is encrypted and transmitted over the internet through a secured server established by an SSL certificate. The in-house storage of your personal information in the Hope Hospice database is highly secure. Only employees authorized to access your data are able to do so based on a series of permission levels protected by passwords and software algorithms. All employees sign a confidentiality of data agreement at their time of employment in which they agree to uphold the confidentiality of any such information.
You email address may be used to communicate non-emergent information, unless otherwise requested by the user. Passages Hospice and Passages Palliative Care are not responsible for the privacy policies of other websites. If you choose to visit the links we provide, please read their privacy policies before providing any information.
HIPPAA Privacy Rule Receipt of Information Privacy Practices (164.520)
HIPPAA Privacy Rule of Patient Authorization Agreement (164.508)
CONSENT FOR THE USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION FOR TREATMENT, PAYMENT OR HEALTH CARE OPTIONS (164.506(a))
I understand that as part of my continue health care, Passages Hospice or Passages Palliative Care and its affiliated companies create and maintain health records containing information about my individual health history, symptoms, examination and test results, diagnosis and treatments provided to me, future treatment plans and payment for care provided to me.
I understand that this information serves as:
- A record indicating my care and treatment
- A communication instrument among the many health professionals who contribute to my care
- A history of diagnosis and treatment information utilized in the billing process
- A verification source available to Medicare and Medicaid review against billed and provided services
- An assessment tool defining quality and reviewing competence of health care professionals
I understand that I have the right to:
Request restrictions as to how my health information may be used or disclosed to carry out treatment, payment or health care operation, that Passages Hospice or Passages Palliative Care will weigh those requests and abide with all mutually agreed upon restrictions. Passages Hospice or Passages Palliative Care is not required by law to agree to the restrictions requested.
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. If you have any questions about this Notice of Privacy Practices, please contact our Privacy Officer @ (504) 875-4204.
This Notice of Privacy Practice describes how Passages Hospice or Passages Palliative Care may use and disclose your protected health information (PHI) to carry out treatment, payment or health information. PHI is information about you, including demographic information, that may identify you and that relates to your past, present or future, physical or mental health or condition and related healthcare services.
We are required to abide by the terms of the Notice of Privacy Practices. We may change the terms of our notice at any time. The new notice will be effective for all protected health information that is maintained at the time Upon your request, this facility will provide you with any revised Notices of Privacy Practices sent by mail.
As you have consented on the reverse of this form for Passages Hospice and Passages Palliative Care to use and disclose of your protected information, you information may be used and disclosed by Passages Hospice or Passages Palliative Care, the office staff and others outside our office that are involved in your care and treatment for the purpose of providing medical care services to you. Your protected health information may also be used and disclosed to pay your medical care bills and to support the operation of Passages Hospice or Passages Palliative Care.
We will you and disclose your protected health information to provide, coordinate or manage your medical care and any related services. This includes the coordination or management of your medical care with a 3rd party that has already obtained your permission to have access to your protected health information. In addition, Passages Hospice and Passages Palliative Care may disclose your protected health information to another physician or healthcare provider (e.g. a specialist, laboratory, etc) who, at the request of this facility becomes involved in your care by providing assistance with your medical care diagnosis or treatment facility.