App-Nea offers services, such as helping you to find and learn about nearby healthcare providers, and managing and forwarding your health history forms and other health-related information to share with Your Healthcare Providers (“App-Nea Services”). As part of providing the App-Nea Services, App-Nea may collect, use, share, and exchange your health history forms and other health-related information with Your Healthcare Providers. Under a federal law called the Health Insurance Portability and Accountability Act (“HIPAA”), health and health-related information may be considered “protected health information” or “PHI” if such information is received from or on behalf of Your Healthcare Providers.
HIPAA protects the privacy and security of your PHI by limiting the uses and disclosures of PHI by most healthcare providers and by health plans (called “Covered Entities”) as well as companies, like App-Nea, that provide certain types of assistance to Covered Entities (called “Business Associates”). Under certain circumstances described in HIPAA, an individual needs to sign an Authorization form before a Covered Entity, like Your Healthcare Provider(s), can disclose protected health information to a third party.
The purpose of this App-Nea Authorization (“Authorization”) is to request your written permission to allow App-Nea to use and disclose your PHI in the same way as we use and disclose your Non-PHI. If App-Nea is a Business Associate of Your Healthcare Providers, App-Nea needs your Authorization to be able to use and disclose your PHI in the same way it can currently use and disclose your Non-PHI when App-Nea is not working on behalf of Your Healthcare Providers, but is instead working on its own behalf. Therefore, when App-Nea relies on this Authorization, and uses and discloses PHI as described in this Authorization, it is not working as a Business Associate and the HIPAA requirements that apply to Business Associates will not apply to such uses and disclosures.
If you e-sign this Authorization, you give your permission to App-Nea to retain your PHI and to use and/or disclose your PHI in the same way that you have agreed that your Non-PHI can be used and disclosed.
Specifically, you agree that App-Nea can use your PHI to:
You also agree that App-Nea can disclose your PHI to:
If App-Nea discloses your PHI, App-Nea will require that the person or entity receiving your PHI agrees to only use and disclose your PHI to carry out its specific business obligations to App-Nea or for the permitted purpose of the disclosure (as described above) App-Nea cannot, however, guarantee that any such person or entity to which App-Nea discloses your PHI or other information will not re-disclose it in ways that you or we did not intend or permit.
Your Authorization remains in effect until you provide written notice of revocation to App-Nea.
If you wish to revoke this Authorization, you must notify App-Nea by submitting a revocation through your account settings page or contacting App-Nea. Your decision not to execute this Authorization or to revoke it at any time will not affect your ability to use certain of the App-Nea Services. A Revocation of Authorization is effective after you submit it to App-Nea, but it does not have any effect on App-Nea’s prior actions taken in reliance on the Authorization before revoked.
Once App-Nea receives your Revocation of Authorization, App-Nea can only use and disclose your PHI as permitted in App-Nea’s agreements with Your Healthcare Provider(s). Your Revocation of Authorization does not affect App-Nea’s use of your Non-PHI.