Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
At Omni Family Health, we are committed to treating and using protected health information about you responsibly. This Notice of Privacy Policies describes the personal information we collect, and how and when we use or disclose that information. It also describes you rights as they relate to your protected health information. This Notice is effective September 23, 2013 (updated May 7, 2019) and applies to all protected health information as defined by federal regulations.
Understanding Your Health Record/Information
Each time you visit Omni Family Health, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:
- Basis for planning your care and treatment,
- Means of communication among the many health professionals who contribute to your care,
- Legal document describing the care you received,
- Means by which you or a third-party payer can verify that services billed were actually provided,
- A tool in educating health professionals, A source of data for medical research,
- A source of information for public health officials charged with improving the health of this state and the nation,
- A source of data for our planning and marketing,
- A tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.
Understanding what is in your record and how your health information is used helps you to: ensure its accuracy, better understand who, what, when, where, and why other may access your health information, and make more informed decisions when authorizing disclosure to others.
Your Health Information Rights
Although your health record is the physical property of Omni Family Health, the information belongs to you. You have the right to:
- We will provide a copy or summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee
- Inspect and copy your health record as provided for in 45 CFR 164.524,
- Ask us to correct health information about what you think is incorrect or incomplete. Ask us how to do this. We may say “no” to your request, but we’ll tell you in writing why within 60 days
- Obtain an accounting of disclosures of your health information as provided in 45 CRF 164.528,
- Request confidential communications of your health information by asking 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 share or use, you can ask us not to 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 have 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.
- Request 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 power 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 this person has this authority and can act for you before we take any action.
- Revoke your authorization to use or disclose health information except to the extent that action has already been taken.
Omni Family Health is required to:
- By law maintain the privacy and security of your protected health information,
- Provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you,
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information Abide by the terms of this notice and give you a copy of it, Notify you if we are we are unable to agree to a requested restriction, and
- Accommodate reasonable requests you may have to communicate health information by alternative means or locations. We will not 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 changed your mind.
We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will mail a revised notice to the address you’ve supplied us, or if you agree, we will email the revised notice to you.
We will not use or disclose your health information without your authorization, except as described in this notice. We will also discontinue to use or disclosure of your health information after we have received a written revocation of the authorization according to the procedures included in the authorization.
For More Information or to Report a Problem
If you have questions and would like additional information, you may contact Omni Family Health 800-300-OMNI (66 64).
If you believe your privacy rights have been violated, you can file a complaint with Omni Family Health or with the office for Civil Rights, U.S. Department of Health and Human Services by writing a letter. There will be no retaliation for filing a complaint with either the Privacy Officer or Office for Civil Rights. The address for the OCR is listed below:
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Or you can do this by visiting:
Examples of Disclosures for Treatment, Payment and Health Operations
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.
Medical Treatment: We will use your health information for provision of treatment. We can also use your health information and share it with other professionals who are treating you.
For example: Information obtained by a nurse, physician, or other members of your healthcare team will be recorded in to our record and used to determine the course of treatment that should work best for you. Your physician will document in your record his or her expectations of the members of your health care team. Members of your health care team will then record the actions they took and their observations. In that way, the physician will know how you are responding to the treatment. Another example would be a doctor treating you for an injury asks another doctor about your overall health condition.
We will also provide your physician or a subsequent healthcare provider with copies of various reports that should assist him or her in treating you once you are discharged from this health center.
Billing and Payments: We will use your health information for payment. We can use and share your information to bill and get payment from health plans or other entities.
For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.
Administer your plan: We may disclose your health information to your health plan sponsor for plan administration.
For example: your company contracts with us to provide your company with certain statistics to explain the premiums we charge.
Health Operations: We will use your health information for regular health operations.
For example: Members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide. We use information about you to manage our services.
Business associates: There are some services provided in our organization through contacts with business associates.
For example: Physician services in the emergency department and radiology, certain laboratory tests, and a copy service we use when making copies of your health record. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we’ve asked them to do and bill you or your third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.
Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition.
Communication with family: Health professionals, using their best judgement, may disclose to a family member, another relative, close friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care.
Disaster situations: We may share information in a disaster relief situation.
Research: We may disclose information for health research activities.
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.
Organ and tissue donation requests: We can share health information about you with organ procurement organizations.
Marketing: We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you. We will not share your information unless you give us written permission.
Fundraising: We may contact you as part of a fundraising effort, but you can tell us not to contact you again.
Public health and safety issues: We can share information about you for certain situations such as: preventing disease, helping with product recalls, reporting suspected abuse, neglect, or domestic violence, and/ or preventing or reducing a serious threat to anyone’s health or safety. As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
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.
Address workers’ compensation, law enforcement, and other government requests: we can use or share health information about you in the following situations:
- For workers’ compensation claims
- For law enforcement purposes or with a law enforcement official
- With health oversight agencies for activities authorized by law
- or 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.
Free Interpreter Services
Omni Family Health
4900 California Avenue, Suite 400-B
Bakersfield, California 93309
1-800-300-OMNI (66 64)
ATTENTION: If you speak any of the languages below, language assistance services, free of charge, are available to you. Please notify the patient service representative.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn.
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad.
주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다.
ՈՒՇԱԴՐՈՒԹՅՈՒՆ՝ Եթե խոսում եք հայերեն, ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ:
توجه: اگر به زبان فارسی گفتگو می کنید، تسهیلات زبانی بصورت رایگان برای شما
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода.
ملاحظة: إذا كنت تتحدث اللغة العربية، فإن خدمة الترجمة متوفرة مجاناً.
ਧਿਆਨ ਦਿਓ: ਜੇ ਤੁਸੀਂ ਪੰਜਾਬੀ ਬੋਲਦੇ ਹੋ, ਤਾਂ ਭਾਸ਼ਾ ਵਿੱਚ ਸਹਾਇਤਾ ਸੇਵਾ ਤੁਹਾਡੇ ਲਈ ਮੁਫਤ ਉਪਲਬਧ ਹੈ।
ប្រយ័ត្ន៖ បើសិនជាអ្នកនិយាយ ភាសាខ្មែរ, សេវាជំនួយផ្នែកភាសា ដោយមិនគិតឈ្នួល គឺអាចមានសំរាប់បំរើអ្នក។
LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj.
ध्यान दें: यदि आप हिंदी बोलते हैं तो आपके लिए मुफ्त में भाषा सहायता सेवाएं उपलब्ध हैं।
Sliding Fee Scale
Omni Family Health will see all patients regardless of the ability to pay.
We offer a Sliding Fee discount based on family size and income.
Please ask for more information at the nearest registration desk.
We will be happy to help you.
Omni Family Health atenderá a todos los pacientes independientemente de
su capacidad de pago. Ofrecemos un descuento de cargo variable según
el tamaño y los ingresos de la familia. Solicite más información en la mesa de
registro del centro más cercano. Estaremos encantados de brindarle ayuda.
Paglilingkuran ng Omni Family Health ang lahat ng pasyente nang hindi
alintana ang kakayahan nilang magbayad.
Nagbibigay kami ng diskwentong Sliding Fee batay sa laki at kita ng pamilya.
Mangyaring humingi ng higit pang impormasyon sa pinakamalapit na
registration desk. Ikalulugod naming tulungan ka.
ਓਮਨੀ ਫੈਮਲੀ ਹੈਲਥ (Omni Family Health) ਭੁਗਤਾਨ ਕਰਨ ਦੀ ਸਮਰੱਥਾ ਦੀ ਪਰਵਾਹ ਕੀਤੇ ਬਿਨਾ ਸਾਰੇ ਮਰੀਜ਼ਾਂ ਨੂੰ ਦੇਖੇਗੀ।
ਅਸੀਂ ਪਰਿਵਾਰ ਦੇ ਆਕਾਰ ਅਤੇ ਆਮਦਨੀ ਦੇ ਆਧਾਰ ਤੇ ਅਸਥਾਈ ਫੀਸ ਛੋਟ ਪੇਸ਼ ਕਰਦੇ ਹਾਂ।
ਕਿਰਪਾ ਕਰਕੇ ਨਜ਼ਦੀਕੀ ਰਜਿਸਟ੍ਰੇਸ਼ਨ ਡੈਸਕ ਤੇ ਹੋਰ ਜਾਣਕਾਰੀ ਲਈ ਪੁੱਛੋ।
ਅਸੀਂ ਤੁਹਾਡੀ ਮਦਦ ਕਰਕੇ ਖੁਸ਼ ਹੋਵਾਂਗੇ।
无论病人的支付能力，Omni Family Health 都会接诊病人。
Notice of Non-Discrimination
Discrimination is Against the Law
Omni Family Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. The U.S. Department of Health and Human Services (HHS) nondiscrimination notice lists the services available to you and how to file a complaint if you feel that Omni Family Health has failed to provide these services or discriminated in another way.
Omni Family Health:
- Provides free aids and services to people with disabilities to communicate effectively with us, such as:
- Qualified sign language interpreters
- Written information in other formats (large print, audio, accessible electronic formats, other formats)
- Provides free language services to people whose primary language is not English, such as:
- Qualified interpreters
- Information written in other languages
If you need these services, please contact Omni Family Health at 1-800-300-6664.
If you believe that Omni Family Health has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a complaint with our corporate office at 1-800-300-6664. You can file a grievance in person at or by mail at 4900 California Avenue, Suite 400-B, Bakersfield, California 93309, fax, or email. If you need help filing a grievance, staff are available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)