NOTICE OF PRIVACY PRACTICES
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.Please review it carefully. The privacy of your medical information is important to us.
Our Legal Duty
We are required by applicable federal and state laws to maintain the privacy of your protected health information. We are also required to give you this notice about our privacy practice, our legal duties, and your rights concerning your protected health information. We must follow the privacy practices that are described in this notice while it is in effect. This notice takes effect April 14, 2003, and will remain in effect until we replace it.We reserve the right to change our privacy practices and the terms of this notice at any time, provided that such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our notice effective for all protected health information we crowded or received before we made the changes. You may request a copy of our notice (or my subsequent revised notice) at my time. For more information about our privacy practices, or for additional copies of this notice, please contact us using the information listed at the end of this notice.
Uses and Disclosures of Protected Health Information
We will use and disclose your protected health information about you for treatment; payment, and health care operations.Following are examples of the types of uses and disclosures of your protected healthcare information that may occur. These examples are not meant to be cumbersome , but to describe that types of uses and disclosures that may be made by our office.
Treatment: We will use and disclose your protected health information to provide, coordinate or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, we would disclose your protected health information, as necessary, to a home health agency that provides care to you. We will also disclose provided health information to other physicians who may be treating you. For example, your protected health information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.In addition, we may disclose your protected health information from time to time to another physician or health care provider (e.g. a specialist or laboratory) who, at the request of your physician, becomes involved in your care by providing assistance with your health care diagnosis or treatment to your physician.
Payment: Your protected health information will be used, as needed, to obtain payment for your health care services. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we recommend for you, such as: making a determination of eligibility or coverage for insurance, receiving services provided to you for protected healthcare information. For example, obtaining approval for a hospital stay may require that your recieved protected health information be disclosed to the health plan to obtain approval for the hospital admission.
Health Care Operations: We may use or disclose, as needed, your protected health information is order to conduct certain business and operational activities. These activities include, but are not limited to, quality training and training of students.For example, we may use a sign-in sheet at the registration desk, where you will be asked to sign your name. We may also call you by name in the waiting room when your doctor is ready to see you. We may use or disclose your protected health information, as necessary, to contact you by telephone or mail to remind you of your appointment.We will share your protected health information with third party “business associates” that, (e.g. billing, transcription service) for the practice. Whenever an arrangement between our office and a business associate involves the use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy of your protected health information.We may use or disclose your protected health information, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may also use and disclose your protected health information for other activities, for example, your name and address may be used to send you a newsletter about our practices and the services we offer. We may also send you information about products or services that we believe may be beneficial to you. You may contact us to request that those materials not be sent to you.
Uses and disclosures Based On Your Written Authorization
Other uses and disclosures of your protected health information will be made only with your authorization, unless otherwise permitted or required by law as described below.You may give us written authorization to use your protected health information or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosure permitted by your authorization while it was in effect. Without your written authorization, we will not disclose your health care information except as described in this notice.
Others Involved in Your Healthcare: Unless you object, we may disclose to a member of your family, a relative, a close friend, or any other person you identify.Your protected health information that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgement. We may use or disclose protected health information to notify or aid in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition or death. Marketing: We may use your protected health information to contact you with information about treatment alternatives that may be of interest to you. We may disclose your protected health information to a business associate to assist us in their activities. Unless the information is provided to you by a general newsletter or in person or is for products or services of material value, you may opt out of receiving further such information by telling us using the contact information listed at the end of this notice. We may use or disclose your protected health information for research purpose is limited circumstances. We may disclose the protected health information of a person to a mutual healthcare provider. Public Health and Safety: We may disclose your protected health information to the necessary authorities to avoid a serious threat to your health or safety, or the health or safety of others. We may disclose your protected health information to a government agency authorized to oversee the health care system or government health authorities for public health purposes. Health Overnight: Overnight agencies may request this information including government agencies that are in the health care system, government benefit programs, other government regulatory programs and civil right laws. Abuse or Neglect: We may disclose your protected health information to a public healthcare professional that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your protected health information if we believe that your have been a victim of abuse, neglect or domestic violence to the governmental information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws. Food and Drug administration: We may disclose your protected health information to a person or company required by Food and Drug Administration to report adverse events, product or problems, biologic product deviations, to track products, to initiate product recalls, to make repairs or replacements: or to conduct post marketing surveillance, as required. Criminal Activity: In accordance with applicable federal and state law, we may disclose your protected health insurance, if we believe that the use or disclosure is necessary to proved or lessen a serious threat to the health or safety of protected health information if it is necessary for law enforcement to identify or apprehend an individual. Required by Law: We may use or disclose your protected health information when we are required to do so by law. For example, we may disclose your protected health information to the U.S. Department of Health and Human Services upon request for purposes of determining whether we are in compliance with federal privacy laws. Process and Proceedings: We may disclose your protected health information in response to a court or administrative order, subpoena, discovery request, or other lawful process, under certain circumstances. Under limited circumstances, such as court order, warrant or grand jury subpoena, we may disclose your protected health information to law enforcement officials. Law Enforcement: We may disclose limited information to a law enforcement official concerning the protected health information of a suspect, fugitive, material witness, crime victim, or relating person. We may disclose that protected health information of an inmate or other person in lawful custody to a law enforcement official or correctional institution under certain circumstances. We may disclose protected health information when? necessary to assist law enforcement officials to capture an individual who has admitted to participation in a crime or has escaped from lawful custody.
Access: You have the right to look at or get copies of your protected health information, with limited exceptions. You must make a request in writing to the contact person. This person may then obtain access to your protected health information. You may also request access by sending us a letter to the address at the end of this notice. If you request copies, we will charge you $25.00 to copy your protected health information, and postage if you went to copies mailed to you. If you prefer, we will prepare a summary or an explanation of your protected health information for a fee. Contact us using the information listed at the end of this notice for a full explanation of our fee structure.