Effective: April 14, 2003
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED. THIS NOTICE ALSO DESCRIBES HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
We agree to follow the terms of this Notice of Privacy Practices. We have the right to change the terms of this notice, and to make the new notice effective for all health information we hold. If we need to make any changes, we will give you an updated copy. The copy will be mailed to your address in our records.
A statement describing our policies and procedures for preserving the confidentiality of medical records is available and will be forwarded to you upon request.
Kern Family Health Care (KFHC) is required by law to make your health information private. We are also required to let you know how we secure your protected health information (PHI).
How does KFHC use and share my health information?
KFHC stores health-related records about you, which includes your:
- claims history,
- health plan enrollment information,
- case management records, and
- prior authorizations for health services.
We use this information and share it with others for the following reasons:
Treatment. KFHC uses your health information to plan your health care. For example, we share your health information with hospitals, clinics, physicians and other health care providers to help them provide services to you.
Payment. KFHC uses and shares your health information to pay for health care services you receive. For example, we tell providers that you are a member of KFHC, and tell them about your benefits. Health Care Operations. KFHC uses and shares your health information, when needed, to help us run our health plan. For example, we use our members' claims data for our internal accounting activities, and for quality purposes.
Contractors and Agents. We share health information with our contractors and agents who help us in the tasks listed above. We do obtain confidentiality agreements before we share information for payment or business purposes. For example, companies that provide or maintain our computer services may have access to computerized health information when providing services to us.
Contacting You. We may contact you to provide appointment reminders or information about treatments open to you. We may also contact you about other health-related services.
Can others involved in my care get information about me?
Yes, if we feel it is needed, we may release medical information to a friend or family member who is involved in your care, or is paying for your care. This includes responding to phone calls about eligibility and claim status.
Can my health information ever be released without my permission?
Yes, we may share health information without your consent. In addition to the reasons already listed, health information can be shared with government agencies and others at times where we are required or authorized by law. The following is a list of instances when we may be required or allowed to share health information without your consent:
- Disclosures that are required by state or federal law.
- To agencies responsible for governing the health care system, for audits, inspections or investigations.
- Upon receipt of a court order or to a court, investigator, or lawyer for cases about the operation of Medi-Cal. This may involve fraud or actions to recover money from others when Medi-Cal has paid your medical claims.
Are there any times when my PHI is not released?
Your health information may be covered under laws that may limit or prevent some uses or disclosures. For example, there are limitations on the sharing of health information relating to:
- HIV/AIDS status,
- mental health treatment,
- developmental disabilities, and
- drug and alcohol abuse treatment.
We comply with these limits in our use of your health information.
We will not allow other sharing or uses of your health information without your written consent.
What rights do I have as a Kern Family Health Care member?
As a KFHC member you have the following rights:
- You have the right to ask us to limit certain sharing and uses of your health information. However, KFHC is not required to agree to any restrictions requested by its members.
- You have the right to ask us to contact you only in writing or at a different address, post office box, or by telephone. We will accept reasonable request when necessary to protect your privacy.
- You have the right to see and copy your health records that KFHC holds. We must receive your request in writing. We will answer your request within 30 days. If your records are stored in another location, please allow 60 days for us to respond. We may charge a fee to cover the cost of copying your records. KFHC may deny your request. If your request is denied, we will tell you the reason why in writing. You have the right to appeal the denial.
- If you believe the information in our records is wrong, you have the right to ask us to change it. We may deny your request. If your request is denied, you have the right to submit a statement to be placed in the record.
- You have the right to get a report of non-routine sharing of your health information that we have made. Your request may be up to six years prior from the date of your request (but not earlier than April 14, 2003). There are some limitations. For example, we do not have records of
- information shared with your consent; information shared for the purposes of health care treatment, checking payment for health services, or conducting the health plan operations of KFHC;
information shared with you; and certain other disclosures.
How do I exercise these rights?
You can practice any of your rights by sending a written letter to our Privacy Official at the address listed below. To assist with the processing of your request, call us at the phone number listed below as well.
How do I file a grievance if my privacy rights are violated?
You have the right to file a grievance with our Privacy Official. You may also file a complaint with the Secretary of Health and Human Services.
KFHC will not hold anything against you in any way for filing a grievance. Filing a grievance will not affect the quality health care services you receive as a KFHC member.
Contact KFHC at:
c/o AIS/Compliance Department
Kern Family Health Care
9700 Stockdale Highway
Bakersfield, CA 93311
Contact the California Department of Health Services at:
c/o Office of Legal Services
California Department of Health Services
1501 Capitol Avenue
P.O. Box 997413, MS0010
Sacramento, CA 95899-7413