Partners BHM may have a health care relationship with you. We may have access to your personal health information in one or more of the following ways:
- We may be the manager of the mental health, intellectual/developmental disability, and/or substance
abuse (MH/IDD/SA) services you receive. If so, Partners BHM staff may assess, manage, authorize, and/or monitor your care. Staff may also link you with
other community resources
Actions may include:
- Referring you to a provider of your choice;
- Working with your provider to make sure you receive the care and services you need;
- Monitoring the quality of services; and
- Helping resolve problems with your treatment.
- Partners BHM may be
the payer of claims for MH/IDD/SA services you receive.
- Partners BHM may
have been a provider of
MH/IDD/SA services for
you as Crossroads Behavioral Healthcare, Mental Health Partners or Pathways LME. If so, we will keep your records for as long as required by law.
- Partners BHM may be the medical records custodian for current or previously contracted MH/IDD/SA providers. If so, we will keep your records for as long as required by law.
- Partners BHM may use and disclose your personal health information on behalf of your MH/IDD/SA service provider when you have given us and/or your
provider your permission to
do so, or under the conditions described in this notice and as allowed by law.
Federal laws which protect your health information, including information related to payment for health care services, include, but may not be limited to:
- The Health Insurance Portability and Accountability Act of 1996 (HIPAA); and
- Health Information Technology for Economic and Clinical Health (HITECH)
- HIPAA Omnibus Rule Finalization (Modification to CFR Parts 160 & 164)
- The Substance Abuse Treatment Confidentiality Law
In North Carolina, General Statute 122(C) also protects your information. These laws require Partners BHM to keep your personal health information confidential. Partners BHM may not tell anyone that you receive mental health, intellectual/developmental disabilities or substance abuse services, except as permitted by law.
Partners Behavioral Health Management Rights and Duties
Partners Behavioral Health Management is required by law to:
- Maintain the privacy of your personal health information
- Provide you with a notice of our legal duties and privacy practices related to your health information
- Obey the terms of this notice
We have the right to change the terms of this notice.
The current notice will be posted in every Partners BHM facility, and on the Partners BHM website at www.partnersbhm.org. Printed copies are available upon request at each regional office.
With some exceptions, certain kinds of information (see “Exceptions”); Partners BHM may use and share your protected health information. This use is limited to payment of claims for your MH/IDD/SA services, and for health care operations. Partners BHM staff are authorized to review your personal health information to provide care coordination, utilization review, service authorization, quality management, provider monitoring, case review, complaints, appeals resolutions, and for other operational purposes.
Permitted Disclosures without Authorization
With some exceptions for certain types of information (see “Exceptions”), the laws allow Partners to disclose information without your written permission under
the following conditions:
- If the law requires the use and/or disclosure
- To health oversight agencies, like the North Carolina Department of Health and Human Services. Such agencies may need information to perform activities authorized by law and as necessary to monitor Partners BHM and its provider network
- As necessary to respond to a serious and imminent threat of harm; for example, to report a threat to commit a violent crime on Partners BHM premises or against Partners BHM personnel or others
- In the event of a medical emergency, to medical personnel as needed for
the provision of emergency medical treatment
- If Partners BHM has reason
to believe that you may be a danger to yourself or others, as needed to file a petition for involuntary commitment
- To report suspected child abuse or neglect, or suspected abuse or neglect of a disabled adult to the Department of Social Services
- In response to a valid court order to disclose information
- To the executor of your estate, or your next of kin if you die
- To your health care power of attorney if:
- You have an advance directive for mental health treatment; and
- A physician or board-certified psychologist finds that you lack sufficient understanding or capacity to make and communicate mental health treatment decisions.
- If Partners BHM determines it is in your best interest, as needed to file a petition for a ruling of incompetency.
- To establish initial and continued eligibility for public benefits.
- To an attorney who represents Partners BHM or an employee of Partners BHM, if relevant to litigation, to operations, or to the payment for MH/IDD/SA services provided to you by a member of Partners BHM provider network.
Before Partners BHM can use or disclose any information about your health in a manner not described above, we must first obtain your written authorization allowing us to make the disclosure. Any such written authorization may be revoked by you in writing, except to the extent use or disclosure has already been made.
Examples of Uses and Disclosures that require written authorization:
- Disclosures that constitute a sale of your protected health information
- Uses and disclosures of “Psychotherapy note” maintained by a covered entity
- Uses and disclosures for research or marketing purposes
- Disclosures to employers
The laws regarding certain types of personal health information are more restrictive. Those laws require Partners BHM to obtain your specific written authorization before personal health information can be shared with someone outside of Partners BHM, including for some of the purposes listed above.
For example, if your personal health information identifies you as someone who has received a diagnosis and/or treatment for drug or alcohol abuse, Partners BHM or your provider must have your specific written authorization to share information.
Your Privacy Rights
- Under a federal law known as the Health Insurance Portability and Accountability Act (HIPAA), you have the right to request restrictions on certain uses and disclosures of your health information. Partners Behavioral Health Management is not required to agree to your requested restrictions unless specifically required by law. For example, if you requested a use and/or disclosure restriction for services that you paid a provider for fully and solely for (self-pay), in which you did not want shared with a health plan we would have to honor your request, unless otherwise required by law. If Partners BHM agrees to the restriction, we may not use or disclose any information you have restricted. Restrictions do not apply in a medical emergency or as required by law.
- You have the right to request that we communicate with you by alternative means or at an alternative location. Such requests are honored if they are reasonable. We will not request an explanation from you. For example, you may want us to call you at a different telephone number.
- You have the right to view your record. You must request your records from Partners BHM in advance to review. In some situations, requests may be denied if a licensed health care professional decides that the request is likely to endanger the individual’s safety. You have the right to request, in writing, a personal copy of your record for a fee. Partners BHM must respond to your request within 30 days.
- You have the right, with some exceptions, to request changes to health care information maintained in our records. You must request changes in writing. Partners BHM must respond to your change request within
- You have the right to request and receive a list of disclosures of your health-related information made by Partners BHM during the six years prior to your request. We are required to provide a listing of all disclosures except for the following:
- Your treatment;
- Billing and collection of payment for your treatment;
- Our health care operations;
- Requests made to or by you;
- Disclosures you authorized;
- Redisclosures occurring as a result of permitted uses and disclosures;
- Disclosures made to individuals involved in your care;
- Disclosures allowed by law; or
- Disclosures when the released information did not identify you.
- You have a right to receive a paper copy of this notice. Copies are available at all Partners BHM offices or call to have a copy mailed to you.
- You have the right to be notified upon a breach of any of your unsecured protected health information.
How to Obtain your Personal Health Information:
You can send a written request to:
Partners Behavioral Health Management
Attn: Privacy Officer
901 S. New Hope Rd.
Gastonia, NC 28054
OR come into one of our Corporate or Regional offices and request to fill out the appropriate request form.
Complaints and Reporting Violations
You may file a complaint with Partners BHM and/or the Secretary of the United States Department of Health and Human Services if you feel your HIPAA privacy rights have been violated. If you file a complaint, it will not change the way Partners BHM treats you.
To file a complaint with Partners BHM, you may do so using any of the options below:
1. Online, please visit: https://partnersbhm.alertline.com
2. By phone, please callour Alert Line at:1-866-806-8777.
3. Mail your written complaint to (please include your full name, address, and phone number):
Partners Behavioral Health Management
Attn: Privacy Officer
901 S. New Hope Rd.
Gastonia, NC 28054