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.
Who We Are
This notice describes the privacy practices of the affiliated medical practice that provides clinical services to patients of Ascenva Labs through our telehealth platform (the "Practice"). The Practice is operated through a partnership with OpenLoop Health, Inc. and its affiliated professional corporations. Where the Practice is part of an Affiliated Covered Entity (ACE) under HIPAA, the participating entities may share your protected health information (PHI) with each other as needed to carry out treatment, payment, and health care operations (TPO). The Practice and its affiliated entities have a designated Privacy Officer responsible for HIPAA compliance.
Your Rights
You have the right to:
- Get a copy of your paper or electronic medical record
- Correct your paper or electronic medical record
- Request confidential communication
- Ask us to limit the information we share
- Get a list of those with whom we've shared your information
- Get a copy of this privacy notice
- Choose someone to act for you
- File a complaint if you believe your privacy rights have been violated
You have some choices in the way that we use and share information as we:
- Tell family and friends about your condition
- Provide disaster relief
- Market our services and sell your information
- Raise funds — We may contact you to support fundraising efforts. You have the right to opt out of future fundraising communications at any time, and choosing not to receive them will not affect your care. To opt out, contact our Privacy Office by emailing privacy@openloophealth.com.
Our Uses and Disclosures
We may use and share your information without your permission as we:
- Treat you
- Run our organization
- Bill for your services
- Help with public health and safety issues
- Do research
- Comply with the law
- Respond to organ and tissue donation requests
- Work with a medical examiner or funeral director
- Address workers' compensation, law enforcement, and other government requests
- Respond to lawsuits and legal actions
Your Rights in Detail
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. You can exercise any right below by emailing privacy@openloophealth.com.
Get an electronic or paper copy of your medical record
- You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
- You can ask us to correct health information about you that you think is incorrect or incomplete.
- We may say "no" to your request, but we'll tell you why in writing within 60 days.
Request confidential communications
- You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
- We will say "yes" to all reasonable requests.
Ask us to limit what we use or share
- You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say "no" if it would affect your care.
- If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say "yes" unless a law requires us to share that information.
Get a list of those with whom we've shared information
- You can ask for a list (accounting) of the times we've shared your health information for six years prior to the date you ask, who we shared it with, and why.
- We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We'll provide one accounting a year for free, but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
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
- 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 make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
- You can complain if you feel we have violated your rights by contacting us using the information below.
- You can file a complaint 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.
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:
- Share information with your family, close friends, or others involved in your care
- Share information in a disaster relief situation
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:
- Marketing purposes — we will obtain your HIPAA authorization before using your information for marketing
- Sale of your information
- Psychotherapy notes except where permitted by law or with your written authorization
In the case of fundraising:
- We may contact you for fundraising efforts, but you can tell us not to contact you again.
Our Uses and Disclosures in Detail
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
Treat you
- We can use your health information and share it with other professionals who are treating you.
- Example: A licensed clinician treating you for a condition asks another licensed clinician about your overall health condition.
Run our organization
- We can use and share your health information to run our practice, improve your care, and contact you when necessary. We might send you appointment reminders by email or text, or leave messages on an answering machine. Electronic communications involve the risk of unauthorized access. By providing your contact information, you acknowledge and accept these risks. We use artificial intelligence (AI) and machine learning tools to analyze health information to identify ways to improve our services, enhance our clinical workflows, and refine our AI systems for better performance. These tools are used in compliance with HIPAA and other applicable laws. They do not replace a licensed healthcare professional's clinical judgment or decision making.
- Example: We use health information about you to manage your treatment and services.
Bill for your services
- We can use and share your health information to bill and get payment from health plans or other entities.
- Example: We give information about you to your health insurance plan so it will pay for your services.
How else can we use or share your health information?
We are allowed or required to share your information in other ways — usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
We can share health information about you for certain situations, such as:
- Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic violence
- Preventing or reducing a serious threat to anyone's health or safety
Do research
We can use or share your information for health research.
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we're complying with federal privacy law.
Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers' compensation, law enforcement, and other government requests
We can use or share health information about you:
- For workers' compensation claims
- For law enforcement purposes or with a law enforcement official
- With health oversight agencies for activities authorized by law
- For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Medical Record Retention
Medical records are retained for adult patients for a minimum of 10 years starting from the last date the patient was seen. This complies with the longest state-required retention periods as well as CMS requirements. Records for minor patients are retained for the longer of (i) 10 years from the last date of service, or (ii) the period required by applicable state law for minor patients.
Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. Notification will be provided without unreasonable delay, but no later than 60 days after discovery, as required by law.
- Where state laws require greater privacy protections than HIPAA, we will follow state law.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know by sending a notice in writing to our Privacy Office if you change your mind.
For more information, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.
Privacy Officer Contact
For questions related to the Ascenva Labs website or services that are not related to your protected health information, you may also contact:
Ascenva Labs, Inc.
A Delaware corporation
Mailing address: 10760 Brunello Place, #206, Wellington, FL 33414
Email: privacy@ascenvalabs.com
Phone: (772) 918-9876