Your Information. Your Rights. Our Responsibilities.

Your rights under the Health Insurance Portability & Accountability Act of 1996 (HIPAA)

Revised July 2018

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.

For questions or concerns, please reach out to:

Pam Stout

3500 N College Ave

Fayetteville, AR 72703

479-445-6500

Your Information

Redline Health is committed to protecting the privacy of your health information. In conducting our business, we will create records regarding you and the services we provide to you.

Who is bound by this notice?

Who is Covered by the Privacy Rule?

Individual and group health plans that provide or pay the cost of medical care and covered entities. Health plans include health, dental, vision, and prescription drug coverage(s), health maintenance organizations (HMO’s), Medicare, Medicaid, Medicare Advantage and Medicare Supplement insurers. Health plans also include employer-sponsored group health plans, church-sponsored health plans, and multi-employer health plans.

What information is protected?

Uses and Disclosures of Your PHI

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get a copy of health and claims records

Ask us to correct health and claims records

Request confidential communications

Ask us to limit what we use or share

Get a list of those with whom we’ve shared information

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

File a complaint if you feel your rights are violated

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

Our Responsibilities

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.