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ALLIANCE NOTICE OF PRIVACY PRACTICES
In accordance with the Health Insurance Portability and Accountability Act (HIPAA), Alliance Health Care, Alliance Health Services, Alliance Health Services-FSE and Alliance Medical Supply (hereinafter referred to as "Alliance") are providing this Notice of Privacy Practices effective April 14th, 2003 for current clients. Notice will be given when beginning services for new clients. And notice will be provided if we amend this Notice.

Alliance has the responsibility, under the HIPAA Rule to retain the privacy of each client's personal protected health information. The HIPAA Rule is designed to ensure that protection for client privacy is implemented in a manner that maximizes privacy without compromising the availability or quality of medical care. In some cases, when state laws provide greater protection of your privacy, these provisions will be followed.

Covered Entities

Alliance has always been committed to maintaining the confidentiality of client and employee information. With the mandatory implementation of the HIPAA Privacy Rule effective April 14th, 2003, all healthcare providers, health plans, and healthcare clearinghouses (considered covered entities under HIPAA) will be governed by the same regulations. All covered entities will also have contracts with their business associates to protect personal health information of clients. A Notice of Privacy has also been provided to all Alliance Staff to insure understanding and compliance of the Privacy Standards.

Individually Identifiable Health Information

Privacy regulations protect any individually identifiable health information, including demographic information collected from an individual, that (a) is created or received by a health care provider, health plan, employer, or health care clearinghouse; and (b) relates to the past, present, or future physical or mental health or condition of an individual, the provision of health care to an individual, or the past, present, or future payment for the provision of health care to an individual, and identifies the individual or to which there is a reasonable basis to believe that the information can be used to identify the individual.

Health Information

Certain health information is allowed to be shared between covered entities under the Regulation, whether verbal or recorded in any form or medium and:
  • Is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and
  • Is related to the past, present, or future physical or mental health or condition of an individual, the provision of health care to an individual, or the past, present, or future payment for the provision of health care to an individual.
Individual Rights

Individuals/clients are given certain rights with respect to their health care information. Certain health information is allowed to be shared between covered entities when providing:
  • treatment and/or services,
  • payment (including determining eligibility, processing claims, utilization & management of insurance benefits, medical necessity of your treatment and/or services, coordination of your care, benefits, & services, and response to complaints, appeals, & external review processes), and
  • other health care operations (including qualification review, compliance programs, quality assessment, performance measurement & outcome assessments, case & disease management and care coordination services).
Policies are in place to maintain your health information and still retain the flow of information required to provide services to you. Below are the individual rights guaranteed by HIPAA:
  • Notice of Privacy Practices (this document) with content and distribution determined by HIPAA.
  • Individual Right to Access Records allowing you to access, inspect & obtain a copy of your "designated record set" (medical & billing records) of protected health information.
  • Amendments can be made by you, when appropriate, to your health information. The intent to amend is to ensure accurate & complete information, without altering existing records and to retain the integrity of the original medical record.
  • Restrictions may be requested by you regarding disclosures of your health information but your request must be in writing and we are not required to comply with your request. Restriction requests must explain what information you want restricted and from who, and for how long.
  • Specific authorization by you may be made to release your health information in non-routine circumstances or will be requested from you when appropriate.
  • Tracking Disclosures (after 4/14/03) for release of PHI made for reasons other than determining insurance eligibility/coverage payment, treatment and/or services to other health care operation functions (HIPAA permits disclosure of health information, without authorization, to continue to protect public health and safety, as it was before the Rule).
  • Complaints may be made when you feel that you health information privacy rights have been violated. Your services cannot be compromised or denied if you file a complaint. Complaints can be made with your service provider, Minnesota DHS Privacy Official, or Office of Civil Rights, Medical Privacy, Complaint Division.
Requests to access, amendment, track, restrict or to provide specific authorization should be made in writing to Alliance HIPAA Privacy Officer, 2204 East 117th Street, Burnsville, MN 55337. You may be required to pay for copies of your records.


For more information, please call 1-800-548-0980.