Smart Decision Inc. Authorization
Smart Decision Inc. offers services, such as helping you to find and learn about nearby healthcare providers, booking appointments with the healthcare provider(s) of your choice (each, “Your Healthcare Provider”) and managing and forwarding your health history forms and other health-related information to share with Your Healthcare Providers (“Smart Decision Inc. Services”). As part of providing the Smart Decision Inc. Services, Smart Decision Inc. 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”), this 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 Smart Decision Inc., that provide certain types of assistance to Covered Entities (called “Business Associates”). Under certain circumstances described in HIPAA, the 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.
Non-Protected Health Information
Your PHI Authorization
The purpose of this Smart Decision Inc. Authorization (“Authorization”) is to request your written permission to allow Smart Decision Inc. to use and disclose your PHI in the same way as we use and disclose your Non-PHI. If Smart Decision Inc. is a Business Associate of Your Healthcare Providers, Smart Decision Inc. 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 Smart Decision Inc. is not working on behalf of Your Healthcare Providers but is instead working on its own behalf. When Smart Decision Inc. 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 Smart Decision Inc. 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 Smart Decision Inc. can use your PHI to:
- enable and customize your use of the Smart Decision Inc. Services;
- provide you alerts or other Smart Decision Inc. Services regarding future appointments;
- notify you regarding providers we think you may be interested in learning more about;
- share information with you regarding services, products or resources about which we think you may be interested in learning more;
- provide you with updates and information about the Smart Decision Inc. Services;
- market to you about Smart Decision Inc. and third party products and services;
- conduct analysis for Smart Decision Inc.’s business purposes;
- support development of the Smart Decision Inc. Services; and
- create de-identified information and then use and disclose this information in any way permitted by law, including to third parties in connection with their commercial and marketing efforts.
You also agree that Smart Decision Inc. can disclose your PHI to:
- third parties assisting Smart Decision Inc. with any of the uses described above;
- Your Healthcare Providers to enable them to refer you to, and make appointments with, other providers on your behalf, or to perform an analysis on potential health issues or treatments, provided that you choose to use the applicable Smart Decision Inc. Service;
- a third party as part of a potential merger, sale or acquisition of Smart Decision Inc.;
- our business partners who assist us by performing core services (such as hosting, billing, fulfillment, or data storage and security) related to the operation or provision of our services, even when Smart Decision Inc. is no longer working on behalf of Your Healthcare Providers;
- a provider of medical services, in the event of an emergency; and
- organizations that collect, aggregate and organize your information so they can make it more easily accessible to your providers.
If Smart Decision Inc. discloses your PHI, Smart Decision Inc. 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 Smart Decision Inc. or for the permitted purpose of the disclosure (as described above). Smart Decision Inc. cannot, however, guarantee that any such person or entity to which Smart Decision Inc. discloses your PHI or other information will not re-disclose it in ways that you or we did not intend or permit.
Expiration and Revocation of Authorization
Your Authorization remains in effect until you provide written notice of revocation to Smart Decision Inc.
YOU CAN CHANGE YOUR MIND AND REVOKE THIS AUTHORIZATION AT ANY TIME AND FOR ANY (OR NO) REASON.
If you wish to revoke this Authorization, you must notify Smart Decision Inc. by submitting a revocation through your account settings page. Your decision not to execute this Authorization or to revoke it at any time will not affect your ability to use certain of the Smart Decision Inc. Services. A Revocation of Authorization is effective after you submit it to Smart Decision Inc., but it does not have any effect on Smart Decision Inc.’s prior actions taken in reliance on the Authorization before revoked.
Once Smart Decision Inc. receives your Revocation of Authorization, Smart Decision Inc. can only use and disclose your PHI as permitted in Smart Decision Inc.’s agreements with Your Healthcare Provider(s). Your Revocation of Authorization does not affect Smart Decision Inc.’s use of your Non-PHI.
We will make available to Your Healthcare Provider(s), current and past, your agreement to or revocation of this Authorization.