Doc Halo

Using Halo ensures proper regulatory compliance and protection of your patients’ Protected Health Information (PHI) while communicating in real-time with colleagues and patient care teams.

Overview

Access Doc Halo Form

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Advanced Medical Imaging is committed to providing the highest quality patient care possible while doing so in a professional environment. The purpose of this secure messaging policy is to facilitate effective communication and proactive discussion for the clinical management of the patient. Secure messaging is not intended to replace verbal communication when necessary to discuss the patient’s clinical condition or to replace Computer Provider Order Entry (CPOE) within the Clinical Information System.

Halo is a secure messaging platform that enables secure communication of content, images, videos, voice files, and attachment messages. Using Halo ensures proper regulatory compliance and protection of your patients’ Protected Health Information (PHI) while communicating in real-time with colleagues and patient care teams.

Policy

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1. PROTECTED HEALTH INFORMATION (PHI)

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1.1 Communicating Orders
According to the Joint Commission, texting orders is prohibited; any order sent via Halo requires a verbal callback by the receiving staff member to the sending provider.
1.2 Transmission of PHI
Non-verbal PHI communication between providers and other patient care team members must occur using the secure messaging system, Halo. Under no circumstance should an Advanced Medical Imaging employee or affiliate with Halo send, or respond to, a text message, or other unsecure means. Beyond face-to-face communication or secure email, Halo is the clinical communication system and standard.
1.3 Photographs and Screenshots
Photographs and screenshots of reports and test results (i.e., patient pathology, lab, imaging results) may be transmitted via Halo to another provider. Proper escalation policies must be followed in the communication of critical values. Photographs and screenshots are prohibited from being saved in any other medium outside of Halo.
1.4 Clinically Significant Messages
The content of clinically significant secure messages must be properly documented in the medical record.

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2. SENDING AND RECEIVING SECURE MESSAGES
2.1 Personal Messages
Halo will not be used for personal messaging between users; this is a professional tool only.
2.2 Sent Status
Messages still in the Sent Status are indicative of a message recipient’s being in a poor Wi-Fi zone, not on the data network, signed off the application, not having downloaded the app on a mobile device and not utilizing the web app, or having the device turned off. In the instance of messages in a Sent Status, escalate to the next form of communication (Review Appendix A).
2.2 Read Status
If a message’s status is listed as Read and a response is solicited but not received, escalate to the proper escalation policies.
2.2.1 Set the Callback Number
Ensure the Callback Number field in Halo is appropriately set.

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3. SETTINGS MANAGEMENT
3.1 Auto-forward
The auto-forward functionality can only be used when the forwarding party has obtained verbal consent for the forwarding recipient party.
3.2 Off-duty
Colleagues should only employ the off-duty functionality outside of working hours.

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4. MESSAGING ETIQUETTE
4.1 Off-duty Override
Nursing staff should only initiate the off-duty override on messages to providers when there is a professionally deemed, clinically emergent, critical issue impacting patient care and condition.
4.2 Nurse-initiated communication
Nursing staff should exercise good clinical and professional judgment when initiating communication with a provider outside of the patient’s care team.
4.3 Responding to messages
The status of the Halo message is included on each message. Respond promptly to messages soliciting a response.
4.4 Messaging clarity
If a messaging thread is exhausted in its clarity, escalate to a verbal conversation.
4.5 SafeText
Traditional texting puts all messages from one user under the same thread, which can be dangerous, especially when communicating about different patients. SafeText provides users the option to start new threads with a recipient or continue with an older message thread. Colleagues should relegate content about one message per thread. For example, if Nurse and Doctor are communicating about Patient A, they should begin an entirely new messaging thread to begin communication about Patient B.
4.6 Urgent Messages
Colleagues must be sensitive to utilizing the urgent functionality and only employ in true clinical emergencies.

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5. PERSONAL DEVICE
5.1 Optional Use
Personal cell phone use is an option. Advanced Medical Imaging will not reimburse staff for the device, data, or battery (Appendix B). As such, Advanced Medical Imaging is not liable for the loss or damage of personal cell phones or electronic devices that are brought onto facility property.
5.2 Security
In order to gain access to Halo from your personal device, Advanced Medical Imaging does enforce a passcode be used for secure access into your cell phone or other electronic device.
5.3 Personal Information
All information transmitted via Halo is secure and encrypted. In addition, all information transmitted via Halo is kept within Halo—not anywhere else on the personal device. As such, in the event of legal action, all relevant medical information may be extracted from the Halo system, protecting personal device information unless otherwise noted (see Appendix C).

Appendix A: Sent Date, Delivered, and Read in Messages Reports
Halo Message Report, Message Status
Halo Message Reports display three different times in the message delivery process:

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MESSAGE DATE
When the message was sent

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DELIVERED
When the message reaches the user’s web browser or mobile device (when the first notification is visible on the recipient’s device)

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READ
When the user clicks or taps on the message (blue dot is removed – new message count indicator changes)
Halo Message Reports – Sent, Delivered and Read Status

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WHEN IS THE MESSAGE SENT?
The message is sent by Halo within a few seconds if not immediately.
Mobile users
The Halo system will immediately start sending notifications to the recipient’s mobile device.

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WHAT CAUSES A DELAY IN SENDING?
A delay in sending would be caused by a weak or unavailable Wi-Fi or cellular connection.
Mobile users
If the message fails to send on the mobile app the user will immediately see a pop-up stating: Send message failed. Check network connection
The failed message will be indicated by Not delivered – Retry. The user can then tap Retry to re-send the message when a connection is available.

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WHAT CAUSES A DELAY IN DELIVERY?
Mobile users
Recipient has disabled notifications for the Halo app in their device settings.
Recipient has a weak or unavailable Wi-Fi or cellular connection. Connection strength can be determined on the mobile app using the Connection Status located in the Settings tab.
Web users: Recipient is not logged into their account on the mobile app or the Halo Notifier.

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WHY ARE SOME MESSAGES DELIVERED, BUT NOT READ?
A recipient may be able to view a shorter message without having to tap the message to open the thread and display the complete message.

Appendix B: Halo Communications Data and Battery Explanation

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DATA
Halo works on both Wi-Fi and cellular networks. When users are connected to Wi-Fi, no data is used. Alternatively, when the device is set to cellular instead of Wi-Fi, under average usage (defined as sending and receiving 25 messages a month), the app consumes only .0185 megabytes of data. Attachments use more data: photos average about 250 kilobytes per photo, voice memos average about 58 kilobytes per 10 seconds of recording, and videos average about 850 kilobytes per 10 seconds of recording.
Most users have network consumption from our app of less than 1 megabyte per month. To keep this in perspective, there are 1,024 megabytes in 1 gigabyte of data.

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BATTERY
The Halo mobile app only runs in the background briefly when a new message is received. The Halo Communications team frequently runs the app in simulated environments for testing processor and battery load to ensure that the app is efficient.
Users can check their battery usage by going to the mobile device’s Settings > Battery (or Power) page. From here, users can see a list of apps the device is running and the percentage of battery that each is using. The Halo app may not appear in this list, since it often uses less than 1% of the device’s battery.
If your battery is negatively impacted when you’re at the office or hospital, other apps or functionality could be running in the background. This may include home and lock Screens, SMS messages, Facebook Messenger, social media sites, etc. Remember, Halo does not run in the background.

Appendix C: Halo Comunications’ Legal Explanation for Discovery on BYOD

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Halo is a HIPAA-compliant secure messaging system for physicians, nurses, and other staff. Halo has an exclusive professional contact list that is integrated from the health organization and is completely independent of users’ personal phone contacts, as it does not allow for personal contacts to be imported or exported into our system. Our communication functionality cannot be accessed from anywhere outside of our web and mobile apps. We do not allow content to be shared outside of our system and our system does not allow photos, videos, or other information to be exported to the user’s device or photo gallery. Halo is an all-inclusive system that keeps and encrypts Protected Health Information within the application. Messaging content, critical labs, photos, videos, voice memos, imaging studies, Clinical Team information, and schedule data are not exportable to a user’s personal device.
Regarding the use of Halo on personal devices, we do not believe there is any material increase in risk that employee’s personal data might acquire into medical litigation. In general, before courts order the production of an individual’s personal data, there needs to be some evidentiary basis for a court to conclude that a personal device may contain evidence relevant to the medical claim. Halo usage should not increase such a likelihood and, in fact, should reduce it.

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Because of HIPAA and related laws, most medical providers already routinely prohibit their employees from using unsecured personal devices to transmit medical information. Halo app usage does not violate such policies, because all information transmitted in Halo is secure and encrypted. In addition, as described above, there is no basis for any party to conclude that any information transmitted through Halo might migrate anywhere else in the device. All information is kept within the Halo platform, and all information may be extracted from the Halo platform when and if required for legal proceedings. There is no reason for anyone, including a court, to conclude that any other relevant medical information might be found on any personal device, especially those where the Halo app is installed.

Disclaimers & Disclosures

Good Faith Estimate

This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The
estimate is based on information known at the time the estimate was created.

The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute
(appeal) the bill.

If you are billed for more than this Good Faith Estimate, you have the right to dispute the bill.
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You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.

You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.

There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith
Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.

To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call 1-800-985-3059.

For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 1-800-985-3059.

“I love how simple the online interface is to get all the basic things done.”

Kelly Brimbore, Newcastle

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

In accordance with the Nebraska Out-Of-Network Emergency Medical Care Act, if you receive emergency services from any health care providers, such providers are not permitted to bill you in excess of any deductible, copayment, or coinsurance amount applicable to in-network providers’ emergency services pursuant to your health benefits plan. Your insurer is obligated to make sure that you do not incur out-of-pocket costs greater than the out-of-pocket costs you would have incurred had you received emergency services from an in-network health care provider.

Certain services at an in-network hospital or ambulatory surgical center When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

The Nebraska Out-Of-Network Emergency Medical Care Act applies only to emergency services. Therefore, as applicable, the billing of your care involving non-emergency services is governed by federal law such as the rights and protections involving non-emergency services discussed in this notice.

When balance billing isn’t allowed, you also have the following protections:

You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.

Your health plan generally must:

- Cover emergency services without requiring you to get approval for services in advance (prior authorization).
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- Cover emergency services by out-of-network providers.
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- Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
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- Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact the Department of Health and Human Services (HHS) at 1-800-985-3059.

Visit https://www.cms.gov/nosurprises website for more information about your rights under federal law.

If you have insurance-related questions, please contact the Nebraska Department of Insurance at 402-471-2201 or call toll-free consumer hotline at 1-877-564-7323. Visit www.doi.nebraska.gov for more information about your rights under Nebraska law.

“I love how simple the online interface is to get all the basic things done.”

Kelly Brimbore, Newcastle

Facebook Contest Rules

1. Eligibility: The AMI BBQ Memorial Day giveaway is open to all legal residents of the United States who enter on Facebook. The winner must be able to come to Advanced Medical Imaging, 7601 Pioneers Blvd, Lincoln Nebraska to claim their prize. Entrants must be 16 years of age as of their date of entry in this promotion in order to qualify. This giveaway is subject to federal, state, and local laws and regulations and void where prohibited by law. Advanced Medical Imaging’s employees, its subsidiaries, affiliates, suppliers, partners, advertising and promotion agencies, and directors (collectively the “Employees”), as well as those living in the same household of Employees are ineligible to participate in the giveaway.

2. Sponsorship. The Sponsor is Advanced Medical Imaging, located at 7601 Pioneers Blvd, Lincoln, Nebraska. Sponsor will conduct the giveaway substantially as described in these Official Rules.

3. Agreement to Rules: By entering this giveaway, the Entrants agree to abide by the Sponsor’s Official Rules and decisions, which are fully and unconditionally binding in all respects. The Sponsor reserves the right to refuse, withdraw, or disqualify any entry at any time at the Sponsor’s sole discretion. By entering this giveaway the You represents and warrants that You are eligible to participate based on eligibility requirements explained in the Official Rules. You also agree to
accept the decisions of the Sponsor as final and binding as it relates to the content of this giveaway.

4. AMI BBQ Memorial Day giveaway Entry Period: This promotion begins on 5-20-2022 at 330 pm CST and ends on 5-20-2022 at 3 pm CST. To be eligible for the giveaway, entries must be received within the specified Entry Period.

5. How to Enter: Eligible entrants can enter AMI BBQ Memorial Day giveaway by liking and commenting on the specified post at https://www.facebook.com/amimaging. As a participant, your entry must fully meet all giveaway requirements, as specified in the Official Rules, in order to be eligible to win the prize. Incomplete entries or those that do not adhere to the Official Rules or specifications will be disqualified at the Sponsor’s sole discretion. Participants may only
enter once.

6. Prizes: The Winner of the AMI BBQ Giveaway for Memorial Day will receive BBQ gril tools and basket. The actual/appraised prize value may differ at the
time the prize is awarded. The prize(s) shall be determined solely by the Sponsor. There shall be no cash or other prize substitution permitted except at the Sponsor’s discretion. The prize is non-transferable. The Winner, upon acceptance of the prize, is solely responsible for all expenses related to the prize, including without limitation any and all local, state, and federal taxes. The Winner shall not transfer assignment of the prize to others nor shall the Winner request the cash equivalent or prize substitution. By accepting the prize, the selected Winner grants permission for the Sponsor to use the Winner’s likeness, entry, and name for
purposes of advertising and trade without further compensation unless prohibited by law.

7. Odds: The total number of eligible entries received determines the odds of winning.

8. Selection and Notification of Winner: The Winner will be selected by a random drawing by the Sponsor. The Sponsor will notify the Winner by Facebook messenger within one day following Winner selection. The Sponsor is not responsible for nor shall have no liability for Winner’s failure to receive notices due to security settings that may cause notifications to be marked as spam or junk email. Nor shall be Sponsor be liable for the Winner’s provision of incorrect or otherwise non-functioning contact information. If the Winner 1) fails to claim the prize within 30 days from the time the award notification was sent, 2) is found ineligible the prize may be forfeited and an alternate Winner will be selected. IF THE WINNER VIOLATES ANY OF THESE OFFICIAL RULES, THE WINNER (AT THE SPONSOR’S SOLE DISCRETION) WILL BE DISQUALIFIED AND ALL PRIVILEGES AS WINNER WILL BE IMMEDIATELY TERMINATED.

9. Rights Granted by You: By submitting an entry (e.g., text, video, photo, etc.) into this giveaway, You understand and agree that the Sponsor, any individual acting on the Sponsor’s behalf, and the licensees successors, and assigns of the Sponsor shall, where permitted by law, have the right to print, publish, broadcast, distribute and use in any media known now or hereafter developed, in perpetuity, worldwide, and without limitation, your submission, name, image and statements about the giveaway for news, publicity, advertising, promotional purposes and public relations without any further notice, review, consent, compensation, or remuneration.

10. Terms & Conditions: In its sole discretion, the Sponsor reserves the right to modify, suspend, cancel, or terminate the giveaway should non-authorized human intervention, a bug or virus, fraud, or other causes beyond the Sponsor’s control, impact or corrupt the security, fairness, proper conduct, or administration of the giveaway. The Sponsor, in the event of any of the above issues, may determine the Winner based on all eligible entries received prior to and/or after (if
appropriate) the action taken by the Sponsor. Individuals who tamper with or attempt to tamper with the operation or entry process of the giveaway or website or violates these Terms & Conditions will be disqualified by the Sponsor in its sole discretion. In its sole discretion, the Sponsor has the right to maintain the integrity of the giveaway, to void votes for any reason, including, but not limited to: multiple entries from the same user; or the use of bots, macros, scripts, or
other technical means for entering. Attempts by any entrant to deliberately damage any website or undermine the legitimate operation of the giveaway may be a violation of criminal and civil laws. If any such attempt is made, the Sponsor reserves the right to seek damages to the fullest extent permitted by law.

12. Disputes: THIS GIVEAWAY IS GOVERNED BY THE LAWS OF THE UNITED STATES AND NEBRASKA, WITHOUT RESPECT TO CONFLICT OF LAW DOCTRINES. The Entrant agrees, as a condition of participating in this promotion, that if any disputes cannot be resolved between the Entrant and the Sponsor, and if causes of action arise out of or are connected with this giveaway, they shall be individually resolved exclusively before a court located in Nebraska having
jurisdiction, without resorting to any form of class action. Under no circumstances in any such dispute shall the participant be permitted to obtain awards for, and hereby waives all rights to, punitive, incidental, or consequential damages, including reasonable attorney’s fees, other than participant’s actual out-of-pocket expenses (i.e. costs associated with entering this giveaway). The participant waives all rights to have damages multiplied or increased.

15. The giveaway hosted by Advanced Medical Imaging is in no way sponsored, endorsed, administered by, or associated with Facebook.

“I love how simple the online interface is to get all the basic things done.”

Kelly Brimbore, Newcastle

Doc Halo

Overview

Policy

Disclaimers & Disclosures

Good Faith Estimate

Your Rights and Protections Against Surprise Medical Bills

Facebook Contest Rules

How Can We Assist?

Advanced Medical Imaging

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