Notice of Privacy Practices
This information is available in braille or audio cassette at your request. Call 1-800-639-5861 x 31.
This notice describes how your medical information may be used and disclosed and how you can get access to this information.
Please review it carefully.
Protecting Your Personal and Health Information
The Vermont Association for the Blind and Visually Impaired (VABVI) is committed to protecting the privacy of your personal information. We are required by applicable federal and state laws to maintain the privacy of your personal and health information. This notice explains our privacy practices, our legal duties, and your rights concerning your personal and health information. Personal and health information (referred to in this notice as "personal information") means any information that is identifiable to you as your personal information, including information regarding your health care and/or treatment; identifiable factors including your name, age, address, income or other financial information. We will follow the privacy practices that are described in this notice while it is in effect.
Why do we collect your personal information?
We collect personal information from you for a number of reasons, including helping us determine the appropriate products and services to offer, to pay claims, to provide case management services, and to provide quality improvement services.
How do we collect your personal information?
We collect your personal information through you and your health care providers. For example, we receive personal information from you in person, in a telephone interview, on your insurance, from health care and other providers, and through insurance transactions such as referrals for service and submission of claims for reimbursement of covered benefits.
How do we protect your personal information?
We protect your personal information by:
- Treating all of your personal information that we collect as confidential;
- Stating confidentiality policies and practices in our employee handbooks as well as disciplinary measures for privacy violations;
- Restricting access to your personal information only to employees who need to know in order to provide services to you;
- Only disclosing your personal information that is necessary for a service company to perform its function on our behalf, and the company agrees to protect and maintain the confidentiality of your personal information; and
- Maintaining physical, electronic, and procedural safeguards that comply with federal and state regulations to guard your personal information.
How do we use and disclose your personal information?
We won't disclose your personal information unless we are allowed or required by law to make the disclosure, or if you (or your authorized representative) give us permission. Uses and disclosures, other than those listed below, require your authorization. If there are other legal requirements under applicable state laws that further restrict our use or disclosure of your personal information, we'll comply with those legal requirements as well. Following are the types of disclosure that we may make as allowed or required by law:
Treatment: Personal information for our activities or for the treatment activities of a health care provider. Treatment activities include disclosing your personal information to a provider in order for that provider to treat you.
Payment and Billing: For our payment and billing activities, including payment and billing for claims from insurance companies, or other providers of service to you.
Health Care Operations: For our internal operations.
Business Associates: Third party "business associates" who perform certain activities for us such as our auditors or those who maintain our computer systems. We require these business associates to afford your personal information the same protection afforded by us.
To You or Your Authorized Representative: Once you provide us with an authorization, you may revoke it in writing at any time. Your revocation won't affect any use or disclosure permitted by your authorization while it was in effect. In certain situations when disclosure of your information could be harmful to you or another person, we may limit the information available to you, or use an alternative means of meeting your request.
To Your Parents, if you are a Minor: Some state laws concerning minors permit or require disclosure of protected health information to parents, guardians, and persons acting in a similar legal status. We will act consistently with the laws of the state where the treatment is provided, and will make any disclosure consistent with such laws.
Your Family and Friends: If you are unable to consent to the disclosure of your personal information, such as in a medical emergency, we may disclose your personal information to a family member or friend to the extent necessary to help with your health care or with payment for your health care. We'll only do so if we determine that the disclosure is in your best interest.
Marketing: To contact you with information about our products and services that may be of interest to you. We do not share or sell our mailing lists to other organizations.
Public Health and Safety: If we believe disclosure is necessary to avert a serious and imminent threat to your health or safety or the health and safety of others. We may disclose your personal information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, domestic violence, or other crimes.
Required by Law: We must disclose your personal information when we are required to do so by law.
Process and Proceedings: In response to a court or administrative order, subpoena, discovery request, or other lawful process.
Law Enforcement: We may disclose limited information to law enforcement officials.
Military and National Security: We may disclose to military authorities the personal information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials personal information required for lawful intelligence, counterintelligence, and other national security activities.
What rights do you have as an individual regarding use and disclosure of your personal information?
You have the right to request all of the following:
- Access to Your Personal Information: To review and receive a copy of your personal information. We may charge you a nominal fee for providing you with copies of your personal information. This right does not include the right to obtain copies of the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding: and protected health information that is subject to other state or federal laws that prohibit us to release such information. We may also limit your access to your personal information if we determine that providing the information could possibly harm you or another person. If we limit access based upon the belief that it could harm you or another person, you have the right to request a review of that decision.
- Amendment: To request that we amend your personal information. Your request must be in writing, and it must identify the information that you think is incorrect and explain why the information should be amended. We may decline your request for certain reasons, including if you ask us to change information that we didn't create. If we decline your request to amend your records, we'll provide you with a written explanation. You may respond with a statement of disagreement to be appended to the information you wanted amended. If we accept your request to amend the information, we will make reasonable efforts to inform others, including people you have authorized, of the amendment and to include the changes in any future disclosures of that information.
- Accounting of Disclosures: To receive a report of instances in which we or our business associates disclosed your personal information for purposes other than for treatment, billing/payment, health care procedures, and certain other activities. You are entitled to such an accounting for the 6 years prior to your request, though not for disclosures made prior to April 14, 2004. We'll provide you with the date on which we made a disclosure, the name of the person or entity to which we disclosed your personal information, a description of the personal information we disclosed, the reason for the disclosure, and other applicable information. If you request this list more than once in a 12-month period, we may charge you a reasonable fee for creating and sending these additional reports.
- Restriction Requests: That we place additional restrictions on our use or disclosure of your personal information for treatment, payment, health procedures or to persons you identify. We may be unable to agree to your requested restrictions. If we do, we'll abide by our agreement (except in an emergency).
- Confidential Communication: That we communicate with you in confidence about your personal information by alternative means or to an alternative location or address. If you advise us that disclosure of all or any part of your personal information could endanger you, we will comply with any reasonable request provided you specify an alternative means of communication.
- Electronic Notice: If you receive this notice on our Web site or by electronic mail (email), you're also entitled to receive this notice in written form. Please contact us using the information listed at the end of this notice to obtain this notice in written form.
When is this notice effective?
April 14, 2004 and will remain until we revise it.
What if this notice of privacy practices changes?
We reserve the right to change our privacy practices and the terms of this notice at any time, provided such changes are permitted by applicable law. For your convenience, a copy of our current notice of our privacy practices is always available in print, and you may request a copy at any time by contacting us at the number below.
How can you reach us?
If you want additional information regarding our Privacy Practices, or if you believe we have violated any of your rights listed in this notice, please contact our privacy officer:
Carol Eaton 1-877-350-8840; VABVI, 38 Park Place, Suite 2, Brattleboro, VT 05301
Steve Pouliot 1-800-639-5861, ext. 33; VABVI, 37 Elmwood Ave, Burlington, VT 05401
If you have a complaint, you may also submit a written complaint to the U. S. Department of Health and Human Services. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon your request. Your privacy is one of our greatest concerns and there's never any penalty to you if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.
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