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.
Cylinder Health, Inc. and Cylinder Medical Group, (collectively “Cylinder Health”) is committed to obtaining, maintaining, using and disclosing your protected health information (“PHI”) in a manner that protects your privacy. We urge you to read this Notice of Privacy Practices (this “Notice”) carefully in order to understand both our commitment to the privacy of your PHI and your rights.
Cylinder Health is required by law to maintain the privacy of your PHI and to provide you with a notice of our legal duties and privacy practices with respect to PHI. PHI is information about you, including basic demographic information, that may identify you and that relates to your past, present or future physical or mental health condition, treatment, or payment for health services. This Notice describes how we may use and disclose your PHI to carry out treatment, payment or health care operations, and for other specified purposes that are permitted or required by law. The Notice also describes your rights with respect to your PHI.
Cylinder Health may amend this Notice from time to time. When material changes are made, Cylinder Health will promptly post the updated Notice on the Cylinder Health website. Cylinder Health is required to abide by the terms of the Notice currently in effect.
Uses and disclosures of your information
Cylinder Health may use or disclose your PHI for the following purposes:
Treatment.
Cylinder Health may use or disclose PHI for purposes of providing your clinical treatment. For example, Cylinder Health may disclose your PHI to your primary care provider if needed to coordinate your medical care.
Payment.
Cylinder Health may use or disclose PHI for purposes of billing and collecting payment for our services. For example, we may disclose PHI to your health plan to obtain payment for our services.
Health Care Operations.
Cylinder Health may use or disclose PHI to facilitate our business’ health care operations. For example, we may use or disclose PHI for quality improvement activities, such as enabling clinical decision support and auditing of care provided through review of your records or visit recordings.
As Required by Law.
Cylinder Health may use or disclose PHI if required to do so by federal or state law.
Disclosures to your Representative and/or Individuals Involved in Your Care.
Cylinder Health may disclose your PHI to your friends or family members who are involved in your care, including those who are responsible for paying for your care. We will seek your agreement to such disclosure if you are present or otherwise available. Cylinder Health may also disclose PHI to your personal representative, as established under applicable law, or to an administrator or authorized individual associated with your estate.
Disclosures to Business Associates.
Cylinder Health may disclose your PHI to some of our service providers that have agreed to maintain the privacy and security thereof. For example, if Cylinder Health contracts with an IT vendor, they may have access to your PHI – and they will also agree to protect its confidentiality.
Cylinder Health may also use or disclose your PHI in other ways as permitted by law. Generally, these are ways that serve public health and/or research.
Specifically:
- Cylinder Health may use or disclose your PHI as needed to assist with public health and safety issues and may disclose your PHI to law enforcement officials when needed, to health oversight agencies for authorized activities, and for special government functions including national security needs.
- Cylinder Health may disclose your PHI as needed to organ procurement organizations, medical examiners, and funeral directors in the event of an individual’s death.
- Cylinder Health may use or disclose your PHI to address workers’ compensation claims.
- Cylinder Health may use or disclose your PHI in response to a court or administrative order, or in response to a subpoena.
Uses and disclosures of PHI for purposes other than those described above, including for marketing purposes and disclosures that would constitute a sale of PHI, will not be made in the absence of a written authorization signed by you or your personal representative. Once you sign an authorization, you may revoke it by contacting Cylinder Health at any time unless it has already been relied upon to use or disclose PHI.
Cylinder Health may de-identify your PHI, meaning that Cylinder Health would remove all identifying features as determined by law to make it extremely unlikely that the information could identify you. De-identified information no longer qualifies as PHI, meaning that Cylinder Health may use and disclose it for purposes not set forth in this Notice.
Your rights regarding your PHI
You have the following rights with respect to your PHI:
- You have the right to request restrictions on certain uses and disclosures of your PHI. Cylinder Health will consider every request to restrict uses or disclosures of your PHI and will strive to honor those that are reasonable. However, Cylinder Health is not legally required to honor each request unless the requested restriction involves a disclosure not required by law to a health plan for purposes of payment or health care operations, and you have paid for the applicable services in full out of pocket. With respect to any requested restriction, if Cylinder Health agrees to honor it, we will document such restriction and continue to abide by it.
- You have the right to receive confidential communications of your PHI from Cylinder Health . Specifically, you may request that Cylinder Health communicate with you about your PHI using a specific means, phone number, or address. Cylinder Health will accommodate reasonable requests regarding confidential communications of your PHI.
- Subject to applicable state law, you have the right to inspect and copy your PHI. You also have the right to access and receive your PHI electronically if readily producible in such format.
- You have the right to correct or update your PHI. If you believe your PHI contains an error, you may request that Cylinder Health update it.
- You have the right to receive an accounting of certain disclosures of your PHI made by Cylinder Health. Upon receipt of such request, Cylinder Health will provide you with a list of disclosures made by Cylinder Health in the prior ten (10) years, not including certain types of disclosures such as, by way of example only, those made directly to you or pursuant to your written authorization.
- You have the right to obtain a paper copy of this Notice upon request.
- You have the right to choose someone to act for you.
To exercise any of these rights, please send written communication to Cylinder Health at or:
Cylinder Health, Inc.
2045 W Grand Ave Ste B, PMB 37767
Chicago, IL 60612-1577
Breach notification
Cylinder Health is required by law to notify you in the event that your PHI is subject to a security breach unless Cylinder Health reasonably determines, after fully investigating the situation and assessing the risk presented, that there is a low probability that the privacy or security of your PHI has been compromised. You will be notified without unreasonable delay and no later than sixty (60) days following the discovery of the security breach. Such notification will include information about the security breach, including steps that Cylinder Health has taken to mitigate potential harm, and a contact person to whom you may address additional questions.
Questions, comments, or complaints
If you have any questions or comments about this Notice or complaints about Cylinder Health’s privacy practices, please contact the Cylinder Health Privacy Officer at 1.888.200.5492 or .
You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services 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. Cylinder Health will not retaliate against you for filing a complaint.
