02 Personnel Policies - Laserfiche WebLink

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DRAFT inappropriately. We may use or disclose your protected health information without your authorization as follows: . To health care providers, other health plans and health care clearinghouses for treatment, payment, and health care operations. To a business associate if the business associate needs the information to perform treatment, payment or health operations on behalf of the City Treatment is the provision, coordination, or management of health care and related services. An example of a disclosure of protected health information for treatment is when your family doctor refers you to a specialist. . Payment includes City activities such as billing, claims management, subrogation, plan reimbursement, reviews for medical necessity and appropriateness of care, utilization reviews, and pre-certification of health care services. For example, the City may tell a doctor whether you are eligible for coverage and what percentage of the bill the City will pay. Health care operations include quality assessment and improvement, reviewing competence or qualifications of health care professionals, underwriting, and other activities necessary to create or renew health plans. It also includes disease management, case management, conducting or arranging for medical review, legal services, auditing functions including fraud and abuse compliance programs, business planning and development, business management and general administrative activities. For example, the City or its business associate may use information from your claims to contact you regarding health related benefits and services that may be of interest to you. Health care providers, other health plans, health care clearinghouses, and the City business associates are all required to maintain the privacy and confidentiality of the protected health information they receive from the City. All uses and disclosures of protected health information made by the City of Paris for treatment, payment, and health care operations are kept to the minimum necessary to accomplish the intended purpose. OTHER DISCLOSURES PERMITTED OR REQUIRED BY LAW Protected health information may also be disclosed as follows: . Directly to you or your personal representative. A personal representative is a person who has legal authority to make health care decisions on your behalf. In the case of a child under 18 years of age, your personal representative may be a parent, guardian, or conservator. In the case of an adult, a personal representative may be a person who has a durable power of attorney to make health care decisions in the event you are incapacitated. 70 Rev. 10/27/04