Notice of Privacy Practices - Network Health Ventures

Your Information. Your Rights. Our Responsibilities.

Network Health Ventures, LLC is committed to protecting the privacy of your confidential health information. This includes all oral, written and electronic protected health information across our organization. This Notice of Privacy Practices will be followed by all associates of our workforce, regardless of geographical location. It describes how medical information about you may be used and disclosed and how you can get access to or limit sharing of this information. Please review it carefully.

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health and non-public personal information.
We will let you know promptly if a breach occurs which may have compromised the privacy or security of your information.
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 in writing if you change your mind.

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

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 an electronic or paper copy of your health and claims records

You can ask to see or get an electronic or paper copy of your records and other health information we have about you. Ask us how to do this.
We will provide you with a copy or summary of your health and claims records within 30 days of your request. We may charge a reasonable, cost-based fee.
If we need an extension, we will let you know in writing the reason and a date when we will provide the records.
We may say “no” to your request, but we’ll tell you why in writing within 30 days with additional information on how you can have the decision reviewed.

Ask us to correct your health and claims records

You can ask us to correct your records if you think they are incorrect or incomplete. Ask us how to do this.
We may say “no” to your request, but we’ll tell you why in writing within 60 days and include information on how you can appeal this decision.

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 consider all reasonable requests, and must say “yes” if you tell us you would be in danger if we do not.

Ask us to limit what we use or share

You can ask us not to use or share certain health or claims information. Your request must be made in writing.
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 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 your health information

You can ask for a list showing 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 list per 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. You may also print a copy at any time from our website, networkhealth.com.

Choose someone to act for you

If you have given someone power of attorney for health care 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 the Privacy Manager, at 800-378-5234 (TTY 711). Complaints may also be made in writing to:

Network Health
Attn: Compliance
1570 Midway Pl.
Menasha, WI 54952

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 877-696-6775 or visiting gov/ocr/privacy/hipaa/complaints/index.html.
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 payment for 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
Sale of your information
State law may prohibit us from using or disclosing information related to certain medical conditions, including but not limited to, HIV/AIDS, mental health, substance abuse and developmental disabilities without written authorization. In these circumstances we will follow the applicable state law.

If you give us written authorization, you may revoke it at any time in writing. The revocation will not affect any uses or disclosures permitted while the authorization was in effect.

Our Uses and Disclosures

How do we typically use or share your health information?
We typically use or share your health information in the following ways.

Help manage the health care treatment you receive
We can use your health information and share it with professionals who are treating you.

For example – A doctor sends us information about your diagnosis and treatment plan so we can arrange additional services.

Run our organization
We can use and disclose your information to run our organization and contact you when necessary.

For example – We use health information about you to develop better services for you.

Bill for services
We can use and disclose your health information as necessary to obtain payment for the services we provide to you.

For example – We give information about you to your health insurance plan so it will pay for your services.

Business Associates
We may disclose your health information to persons or organizations which perform a service for us that requires the use or sharing of health information. Such persons or organizations are our contracted business associates, and they are held to the same privacy standards as our organization.

For example – We may need to disclose your health information to a mailing and fulfillment vendor for them to print and mail a letter to you about our diabetes program.

Health-Related Products, Benefits and Services
We may contact you to give you information about certain health-related benefits and services which may be of interest to you. We may also contact you to recommend alternative treatments, health care providers or care settings.

For example – If we think you could benefit from an annual health assessment in your home, we may send you a letter with information about it.

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 about this visit hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html.

Help with public health and safety issues
We can share health information about you for certain situations such as:

Preventing or controlling 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

Notification and communication with family and friends
We may share health information about you with family members, friends or others if those individuals are helping care for you or helping you pay your medical bills. We will disclose only the health information relevant to the person’s involvement. If you are unable or unavailable to agree or object to a disclosure to such a person, we will use our best professional judgment in communicating with your family or friends.

Compliance 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 they want to see that we’re complying with federal privacy law.

Respond to organ, eye and tissue donation and transplantation requests and work with a medical examiner or funeral director

We can share health information about you with organ, eye and tissue procurement and transplantation organizations.
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 the following.

Workers’ compensation claims
Law enforcement purposes or with a law enforcement official
Health oversight agencies for activities authorized by law, such as audits and investigations related to the oversight of government benefit programs (like Medicare)
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.

Disaster relief
We may use or disclose your name and location to a public or private entity authorized by law or by its charter to assist in disaster relief efforts.

Changes to the Terms of This Notice

This notice takes effect August 4, 2023, and it will remain in effect until we replace it. We can change the terms of this notice, and the changes will apply to all information we have about you. Any changes to the notice will be effective for all of your records created or maintained in the past, as well as any records we create or maintain in the future. The new notice will be available upon request, on our website, and we will mail a copy to you. If there are no changes to the notice, you will be notified at least every three years that this notice is available to you.

Other Instructions for Notice

If you have questions about any part of this notice or would like to request a copy, you may contact our Privacy Officer at 800-378-5234 (TTY 711), Monday–Friday, 8 a.m. to 5 p.m.

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