Notice of Privacy Practices
Effective date: [COUNSEL: this notice must not go live until reviewed and finalized by counsel]
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.
Insight Ind. LP ("Insight") is a Missouri DMH-certified provider of Individualized Supported Living, Individualized Skill Development, Community Integration, and Personal Care Assistance. We are committed to protecting the privacy of your protected health information (PHI). This notice describes how we may use and disclose your PHI and your rights regarding that information. It applies to everyone we serve, and to guardians and conservators acting on behalf of someone we serve.
How we may use and disclose your health information
We may use and disclose your PHI without your written authorization for the following purposes:
- Treatment and support: to provide, coordinate, and manage your Individualized Supported Living, Skill Development, Community Integration, or Personal Care Assistance services, including sharing information with your support coordinator and the Missouri Department of Mental Health (DMH) as needed to coordinate your care
- Payment: to obtain payment for services, including billing Medicaid or your HCBS waiver
- Health care operations: for quality assessment, staff training, and routine administration of our services
- As required by law: including mandatory reporting of abuse, neglect, or exploitation, and in response to a valid court order
[COUNSEL: full descriptions, examples, and any additional permitted disclosures must be completed and finalized before this notice goes live.]
Uses requiring your written authorization
Other than the uses described above, we will not use or disclose your PHI without your written authorization (or the written authorization of your guardian or conservator). You may revoke that authorization in writing at any time, except to the extent we have already acted on it.
Our duties
We are required by law to maintain the privacy of your PHI, to provide you with this notice of our legal duties and privacy practices, and to abide by the terms of the notice currently in effect.
Your rights
You, or your guardian or conservator on your behalf, have the right to:
- Access, inspect, and obtain a copy of your PHI
- Request an amendment to your PHI
- Request an accounting of certain disclosures we've made
- Request restrictions on certain uses and disclosures
- Request confidential communications by an alternate method or at an alternate location
- Receive a paper copy of this notice at any time, upon request
Changes to this notice
We reserve the right to change this notice and to make the revised notice effective for PHI we already have as well as any information we receive in the future. The current notice will always be posted on this website and available at our office.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be retaliated against for filing a complaint.
Contact
To exercise your rights, ask questions, or file a complaint, contact our Privacy Officer:
Insight Ind. LP, Privacy Officer
1966 NW Copper Oaks Circle, Blue Springs, MO 64014
info@insightdmh.net · (816) 412-0853