Notice of Privacy Practices

 

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.

uBiome is committed to protecting the privacy of your personal health information, laboratory test orders, and laboratory test results.

OUR RESPONSIBILITY

uBiome is required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to keep your personal health information (“Protected Health Information”) confidential. This Notice describes the ways in which we may use and disclose health information about you and describes your rights and our obligations regarding the use and disclosure of that information.

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

Your Protected Health Information may be used and disclosed for treatment, payment, healthcare operations and other purposes permitted or required by law. uBiome may use and disclose health information for the following purposes:

  • Treatment
    We may use health information that you have provided to μBiome for our testing services. We may disclose health information about you to doctors, healthcare providers or other personnel who are involved in taking care of you and your health.
  • Payment
    We may use and disclose health information about you so that the testing services you receive at μBiome may be billed to and payment may be collected from you, an insurance company or a third party.
  • Health Care Operations
    We may use and disclose health information about you for activities necessary to support and improve μBiome testing services. For example, we may use your Protected Health Information to monitor the quality of our testing services, establish reference ranges for our tests, and review the competence and qualifications of our laboratory professionals.
  • Business Associates
    We may disclose your Protected Health Information to other companies or individuals, known as “Business Associates,” who provide services to us. For example, we may use a company to perform billing services on our behalf. Our Business Associates are required to protect the privacy and security of your Protected Health Information and notify us of any improper disclosure of information.
  • Research
    We may use and disclose health information about you for research purposes. All research projects at uBiome are subject to review by a committee responsible for ensuring the protection of individual research subjects, appropriate patient authorization, and an adequate plan to safeguard Protected Health Information. In preparation for research, we may review limited Protected Health Information to draft research protocols, to identify prospective research participants, or for similar purposes provided the information is not removed from our premises.
  • As Required By Law
    We will disclose health information about you when required to do so by federal, state or local law
  • Judicial and Administrative Proceedings
    Under certain circumstances, we may disclose your Protected Health Information in the course of a judicial or administrative proceeding in response to a court order, subpoena, or other lawful process.
  • Serious Threat to Health or Safety
    We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
  • Family and Friends
    We may disclose health information about you to your family members or friends if we obtain your verbal agreement or if we can infer from the circumstances, based on our professional judgment that you would not object.
  • Personal Representatives
    We may disclose Protected Health Information about you to your authorized personal representative, such as a lawyer, administrator, executor or other authorized person responsible you or your estate.
  • Communications about Products and Services
    We may use and disclose your Protected Health Information to contact you about other uBiome products and services which we believe may be of interest to you. Any other use, disclosure, or sale of Protected Health Information to third parties for marketing purposes requires your written authorization.
  • Health and Government Agencies
    As permitted by HIPAA, we may disclose your PHI to:
    • Public Health Authorities
    • The Food and Drug Administration
    • Health Oversight Agencies
    • Military Command Authorities
    • National Security and Intelligence Organizations
    • Correctional Institutions
    • Organ and Tissue Donation Organizations
    • Coroners, Medical Examiners and Funeral Directors
    • Workers Compensation Agents

 

 

ALL OTHER USES AND DISCLOSURES OF HEALTH INFORMATION

We will not use or disclose your health information for any purpose other than those identified above without your specific, written Authorization. You may revoke such Authorization, in writing, at any time, except for disclosures that the company has already acted upon.

YOUR RIGHTS REGARDING HEALTH INFORMATION

You have the following rights regarding health information we maintain about you:

  • Right to Inspect and Copy.
    You have the right to inspect and copy your health information, such as medical and billing records. You must submit a written request to privacy officer in order to inspect and/or copy records of your health information.
    Right to Amend.
    If you believe health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request a correction or amendment as long as the information is kept by μBiome. To request an amendment, complete and submit a written request to the privacy officer. We may deny your request for an amendment under certain circumstances. If we deny your request, we will provide a written explanation.
    Right to an Accounting of Disclosures.
    You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of medical information about you for purposes other than testing services or payment when specifically authorized by you and a limited number of special circumstances involving national security, correctional institutions and law enforcement. To obtain this list, you must submit your request in writing to the privacy officer. It must state a time period, which may not be longer than six years.
    Right to Request Restrictions.
    You have the right to request a restriction or limitation on the health information we use or disclose about you for testing services or payment. While we will consider all requests for additional restrictions carefully, we are not required to agree to a requested restriction except for Payment or Operations restrictions where payment has been made “out-of-pocket” and paid-in-full.
    Right to Request Confidential Communications.
    You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. Your request must be in writing and must specify how or where you wish to be contacted.
    Right to a Paper Copy of This Notice.
    You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive it electronically, you are still entitled to a paper copy. To obtain such a copy, contact the privacy officer.

 

CHANGES TO THIS NOTICE

We reserve the right to change this notice, and to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. You are entitled to a copy of the notice currently in effect. We will promptly post any changes on our website under our NOTICE OF PRIVACY PRACTICES.

BREACH OF HEALTH INFORMATION

We will inform you if there is a breach of your unsecured health information, unless there is a demonstration, based on a risk assessment, that there is a “low probability” that the Protected Health Information has been compromised. COMPLAINTS If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. at: Office for Civil Rights Region at 200 Independence Avenue, S.W., Washington, D.C. 20201, U.S. Department of Health & Human Services. uBiome will not take retaliatory action against you and you will not be penalized in any way if you choose to file a complaint.

CONTACT INFORMATION

Attn: Privacy Officer
μBiome
360 Langton St Ste 301
San Francisco, CA 94103
privacy@ubiome.com

 

Effective: 2015