You have the right to:
• Request restrictions by asking that we limit the way we use or disclose your PHI for treatment, payment, or healthcare operations. You may also ask that we limit the information we give to someone who is involved in your care, such as a family or friend. Please note that we are not required to agree to your request, except when a restriction has been requested regarding a disclosure to a health plan in situations where the patient has paid for services in full and where the purpose of the disclosure is for payment. If we do agree, we will honor your limits unless it is an emergency situation. To facilitate a restriction request, complete a
Restriction Request Form and submit it to
medicalrecords@onemedical.com.
• Ask that we communicate with you by another means. For example, if you want us to communicate with you at a different address, we can usually accommodate that request. We may ask that you make your request to us in writing. We will agree to reasonable requests.
• Request to access or receive an electronic or paper copy of your PHI. To access or receive a copy of your PHI, you can: (1) submit the request electronically via your One Medical patient account (“Request Records”), (2) complete a
Medical Records Request Form and submit it to
medicalrecords@onemedical.com, or (3) submit a request in writing to the Privacy Officer at One Embarcadero Center, 19th Floor, San Francisco, CA 94111. We may charge a reasonable fee for the cost of producing or mailing the copies, which you will receive usually within 30 days. In certain situations, we may deny your request and will tell you why we are denying it. In some cases, you may have the right to ask for a review of our denial.
• Ask to amend PHI we created that you feel is incorrect or incomplete. To request an amendment to your PHI that you believe is inaccurate or incomplete, please complete an
Amendment Form and submit it to
medicalrecords@onemedical.com In certain cases, we may deny your request and we will do so in writing. You may respond by filing a written statement of disagreement with us and ask that the statement be included with your PHI.
• Choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will confirm the person has the authority and can act for you before we take any action.
• Seek an accounting of certain disclosures by asking us for a list of the times we have disclosed your PHI. To request an accounting of disclosures list, please complete an
Accounting of Disclosures Form and submit it to
medicalrecords@onemedical.com. You may request disclosures made up to six years before your request. You may receive one list per year at no charge. If you request another list during the same year, we may charge you a reasonable fee. These lists will not include disclosures made for treatment, payment, or healthcare operations and certain other disclosures as permitted by law.
• Request a paper copy of this Notice.
• Receive written notification of any breach of your unsecured PHI.
• File a complaint if you believe your privacy rights have been violated. You can file a written complaint with us at the address below, or with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting
www.hhs.gov/ocr/privacy/hipaa/complaints. We will not retaliate against you for filing a complaint.
Communication Platforms
We may also use PHI to send you appointment reminders and other communications relating to your care and treatment, or let you know about treatment alternatives or other health related services or benefits that may be of interest to you, via email, phone call, or text message.
We may make certain PHI, such as information about care or treatment, appointment histories and medication records, accessible to you through secured online tools such as your MyOne patient account.
If you choose to communicate with us via emails, texts or chats, you acknowledge that we may exchange PHI with you via email, text or chat, that email, text and certain chat functionality may not be a secure method of communication, and that you agree to the security risks of such communication. If you would prefer not to exchange PHI via email, text or chat, you can choose not to communicate with us via those means, and you can notify us at
privacy@onemedical.com.