Pear Suite | HIPAA Notice of Privacy Practices

Overview

Your Information. Your Rights. Our Responsibilities.

This Notice describes how medical and related information about you may be used and disclosed and how you can access this information. Please review it carefully.

This Notice describes the ways Pear Suite-affiliated provider entities and licensed health care professionals providing professional services through those entities, together with Pear Suite, Inc. and its affiliates that provide administrative, technical, billing, payment, quality, compliance, care coordination, and other non-clinical support services, may use and disclose health information about you. This Notice also describes your rights and our obligations regarding the use and disclosure of your health information.

Pear Suite supports care delivery and care coordination services across multiple legal entities. Services may be delivered through affiliated provider entities, including Pear Suite Provider Group, P.A., Pear Suite Provider Group CA, P.C., Pear Suite Provider Group KS, P.A., and Pear Suite Provider Group NJ, P.C. Pear Suite, Inc. does not itself provide professional clinical services where such services must be delivered by a licensed provider entity. Subject to applicable HIPAA protections, Pear Suite, Inc. and its affiliates may act as business associates to the affiliated provider entities and may provide administrative, billing, payment, technical, quality, compliance, care coordination, and other non-clinical support services necessary for you to receive services.

Services may include community health worker services, community health integration services, care coordination, health education, health system navigation, referrals, and support in addressing health-related social needs that may affect your care.

Where permitted by law, Pear Suite’s affiliated legal entities may share protected health information with each other only as necessary to carry out treatment, payment, health care operations, and other purposes permitted or required by law. All legal entities covered by this Notice agree to comply with its terms.

This Notice applies only to health information that is protected health information as defined by HIPAA. It does not apply to information that is not covered by HIPAA. Please see Pear Suite’s general Privacy Policy for terms that apply to non-HIPAA-covered products and services.

Our Responsibilities

We are required by law to make sure that health information that identifies you is kept private, provide you with this Notice of our legal duties and privacy practices with respect to your protected health information, notify you following a breach of unsecured protected health information when required by law, and follow the terms of the Notice currently in effect.

Although this Notice may be provided to you electronically, you have the right to request a paper copy at any time. We reserve the right to change our privacy practices and the terms of this Notice at any time, and to make any updated or new notice provisions effective for all protected health information that we maintain, including information created or received before the effective date of any revision. You may obtain a copy of the revised Notice on our website.

How Your Information Is Used

We may use and disclose your health information for the purposes of providing services and quality care. Providing treatment services, collecting payment, and conducting health care operations are necessary activities for quality care. State and federal law allow us to use and disclose your health information for these purposes.

Examples include the following, though this list is not exhaustive:

To provide treatment. We may use and disclose your health information to provide, coordinate, and manage your care. This may include connecting you with community health workers, health care providers, prescribers, community-based organizations, or other service partners involved in your care.

To manage the health care treatment you receive. We may receive, use, and share information among Pear Suite-affiliated provider entities, community health workers, and authorized support personnel in order to arrange additional services, coordinate care, support referrals, or assist with follow-up.

To verify insurance and coverage. Pear Suite or its business associates may use and disclose health information to verify your insurance eligibility, benefits, and coverage.

To collect payment. Pear Suite or its business associates may submit claims for reimbursement to Medicare, Medicaid, commercial health plans, or other payors in order to obtain payment for the services we provide to you.

For health care operations. We may use and disclose your health information for quality assessment and improvement activities, review of treatment and care coordination procedures, documentation review, compliance oversight, workforce management, credentialing, care gap identification and closure, population health analytics, and internal operational activities necessary to support services and quality care.

For health information exchanges. Pear Suite may participate in health information exchanges and may electronically access or share your health information for treatment, payment, and health care operations purposes with other participants in those exchanges. Health information exchanges may allow Pear Suite and other health care providers and organizations involved in your care to access, share, and better use information necessary for your treatment and other lawful purposes. If you are a resident of a state that allows you to opt out of Pear Suite requesting or sharing your data with a health information exchange, and you wish to opt out, you may contact us at privacyrights@pearsuite.com with the subject line “HIE Opt-Out.” If you are a resident of a state that requires your authorization before Pear Suite may access your data from a health information exchange, and you wish to opt in, you may contact us at privacyrights@pearsuite.com with the subject line “HIE Opt-In.” You may later opt out at any time. Please note that information already shared may not be able to be withdrawn and may no longer be removable from downstream systems.

For trusted exchange and interoperability frameworks. Pear Suite or its business associates may disclose health information through interoperability frameworks, including the Trusted Exchange Framework and Common Agreement (TEFCA), for HIPAA-authorized treatment purposes and other lawful purposes, subject to contractual and legal protections for privacy and security.

Uses and Disclosures Requiring Authorization

For uses and disclosures for purposes other than treatment, payment, and health care operations, we are required to have your written authorization unless the use or disclosure falls within an exception permitted by law.

Most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes, and disclosures that constitute the sale of protected health information require your authorization.

Additionally, federal and state law require special privacy protections for certain health information about you. This may include sensitive information such as mental health information, HIV/AIDS-related information, genetic information, and other categories of information protected under applicable law. In order for us to disclose such information for a purpose other than one permitted by law, we must obtain your authorization.

Authorizations may be revoked at any time in writing to stop future uses and disclosures, except to the extent that we have already taken action in reliance on your authorization.

Disclosures That Can Be Made Without Authorization

Emergencies. We may share sufficient information to address an immediate emergency you are facing.

Judicial and administrative proceedings. We may disclose your health information in the course of a judicial or administrative proceeding in response to a valid court order or other lawful legal process, including as relevant to workers’ compensation claims where permitted by law.

Public health activities. We may disclose health information as permitted or required for public health activities and, where permitted by law, if necessary to prevent or lessen a serious and imminent threat to health or safety.

Child or elder abuse or neglect. We may disclose health information related to suspected child abuse, elder abuse, neglect, or domestic violence where permitted or required by law.

Criminal activity or danger to others. We may disclose health information if a crime is committed on our premises or against our personnel, or if we believe someone is in immediate danger and disclosure is permitted by law.

Health oversight activities. We may disclose health information to a health oversight agency for activities authorized by law, including audits, inspections, investigations, licensure actions, and other oversight necessary for the government to monitor the health care system and ensure compliance with applicable laws. The minimum necessary information will be provided in these instances where applicable.

Business associates. We may disclose the minimum necessary health information to business associates that perform functions on our behalf or provide services to us if the information is necessary for those functions or services. These may include billing vendors, technology vendors, analytics vendors, care coordination support vendors, or other service providers. All business associates are required by contract to protect the privacy and security of your information, may only use or disclose information as permitted by law and contract, and are required to notify us of breaches of protected health information as required by law.

Research. Under certain circumstances, we may use and disclose health information for research as permitted by law. We may also permit researchers to review non-identifying information to help plan research projects.

Scheduling appointments and service communications. We may call, email, or otherwise contact you to schedule or remind you of appointments, follow up on services, or communicate with you about your care and care coordination.

Your Individual Rights

To exercise any of the rights described below, please submit your request in writing to privacyrights@pearsuite.com. You may also contact the Privacy Officer at privacyrights@pearsuite.com or 628-204-4124 for more information about this Notice.

Right to inspect and copy. You have the right to inspect and obtain a copy of your health information, with limited exceptions. If you request a copy, a reasonable cost-based fee may be charged where permitted by law.

Right to amend. You have the right to request that we amend your health information if you believe it is incorrect or incomplete. Your request must explain why the information should be amended. We may deny your request in certain circumstances permitted by law.

Right to an accounting of disclosures. You have the right to receive a list of certain disclosures of your health information made for purposes other than treatment, payment, or health care operations, subject to applicable limitations and exceptions.

Right to request restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you, including, where applicable, certain information related to substance use disorder records for which you previously gave consent. We are not required to agree to your request, except in certain situations required by law, including certain disclosures to a health plan where you have paid in full out of pocket for the related service and the disclosure is for payment or health care operations and otherwise meets legal requirements. If we do agree, we will comply with the restriction unless the information is needed for emergency treatment or disclosure is otherwise required by law.

Right to request confidential communications. You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you may request that we contact you only by mail or at a different address. You must specify the alternative means or location you would like us to use. We will accommodate reasonable requests as required by law.

Right to receive a paper copy of this Notice. You have the right to receive a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.

Right to file complaints. You may complain to us and to the Secretary of the U.S. Department of Health and Human Services if you believe your privacy rights have been violated. You may file a complaint with us by contacting the Privacy Officer at privacyrights@pearsuite.com or 628-204-4124. We will not retaliate against you for filing a complaint.

Email and Text Messages

Some patients prefer to communicate with members of the care team by email or text message. Email and text messages have inherent privacy and security risks, and you should consider those risks before using them. Errors in transmission or interception of messages can occur. Email or text messages may not be secure communications between you and your care team. At our discretion and to the extent permitted by law, your email or text message communications and any responses may become part of your medical record. For urgent or emergency situations, you should not rely on email or text communications. In an emergency, call 911.

Changes to This Notice

We may change the terms of this Notice at any time. Any changes will apply to all protected health information we maintain. The updated Notice will be posted on our website and made available upon request.