Chrysalis Consulting Group is a covered entity under HIPAA (Health Insurance Portability and Accountability Act). As a covered entity, Chrysalis Consulting Group is committed to ensuring that your private health information is treated confidentially. This notice describes instances when your health information may be disclosed (used outside of Chyrsalis). Other than the disclosures described in this notice, your health information will not be disclosed without your signed authorization.

Use of Information for Treatment, Payment and Operations

  • In order to provide medical care to you (treatment), obtain payment for services (payment), and ensure quality and efficiency in our daily functions (operations), there will be times when we must share information outside of this organization. For example:
    • For treatment purposes, we may need to call a physician or hospital to which we are referring you and provide them with information about your condition.
    • For payment purposes, we might send information to your insurance company that is required in order to process your claim.
    • For operations purposes, we may allow your chart to be reviewed by an external reviewer or auditor.
  • If your personal health information is disclosed for any of the above listed reasons, the outside entities receiving your information will either be bound by federal and/or state law or otherwise obligated to keep your personal health information confidential.
  • Information disclosed for any of the above listed reasons could include, but is not limited to, information regarding HIV/AIDS, substance abuse, and/or psychological/mental health treatment.
  • You may ask us not to use or share certain health information for the above listed purposes, but we are not required to agree to your request and we will say “no” if it would affect your care.

Other Uses/Disclosures of Information

  • Chrysalis Consulting Group is allowed or required to share your personal health information in other ways once certain conditions under the law have been met. Your information may be shared for the following reasons:
    • To help with public health and safety issues, such as preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect, or domestic violence, or preventing or reducing a serious threat to anyone’s health or safety.
    • For the purposes of health research.
    • If required by state or federal law, including to show compliance with federal privacy law.
    • To respond to organ and tissue donation requests.
    • With a coroner, medical examiner, or funeral director when an individual dies.
    • For worker’s compensation claims, for law enforcement purposes or with a law enforcement official, with health oversight agencies for activities authorized by law, or for special government functions such as military, national security, and presidential protective services.
    • In response to a court or administrative order, or in response to a subpoena.

The Right to Inspect and Amend Records

  • You have the right to inspect or receive a copy of your medical record or any other health information Chrysalis Consulting Group has about you with rare exceptions. We will provide a copy or summary of your health information, usually within thirty (30) days of your request. We may charge a reasonable, cost-based fee.
  • If you believe that any information in your medical record is inaccurate, you have the right to request that the information be corrected. We may say “no” to your request, but we will tell you why within sixty (60) days.
  • A request to inspect or amend your health information must be in writing. Should you make such a request, it will be evaluated by the Chrysalis Privacy Officer or designee to determine if your request will be granted.
  • If information in your medical record is corrected as requested, an effort will be made by Chrysalis Consulting Group to inform other entities who may have received the inaccurate information.
  • If your request to correct your medical record is denied, you may appeal the decision by resubmitting the request in writing and stating that you are appealing a previous decision. Your request will be reevaluated by a licensed physician not involved in your treatment or in the initial decision to deny your request. The decision at the second level of review will be final.

Additional Patient Rights

  • You can request confidential communications. You can ask that we contact you in a specific way (for example, home or office phone) or send mail to a different address. We will say “yes” to all reasonable requests.
  • You can ask for a list (an accounting) of the times we have shared your health information for six (6) years prior to the date you ask, who we shared it with, and why. We will include all disclosures except those for treatment, payment, or operations or certain other disclosures (such as those made at your request).
  • You can request a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.
  • You can choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • You can complain if you feel we have violated your rights by submitting a complaint in writing to the Performance Improvement Department, 19990 Governors Highway, Olympia Fields, IL 60461 or verbally by calling (708) 747-7544.
  • You have the right to file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.

This privacy notice may be subject to change. If a change should occur, the change will be posted on our website at the time of implementation or as soon as possible after implementation. You may request a current notice at any time verbally or in writing.