Notice of Privacy Practices for Protected Health Information
Protected health information is the information we create and obtain in providing our services to you. Such information may include documenting your symptoms, examination and test results, diagnoses, treatment, and applying for future care or treatment. It also includes billing documents for those services.
Examples of uses of your health information for treatment purposes are:
· A technician obtains treatment information about you and records it in a health record.
· During your treatment, the physician determines he will need to consult with another specialist in the area. He will share the information with such specialist and obtain his/her input.
Example of use of your health information for payment purposes:
· We submit requests for payment to your health insurance company. The health insurance company (or other business associate helping us obtain payment) requests information from us regarding medical care given. We will provide information to them about you and the care given.
Example of use of your information for health care operations:
· We obtain services from our insurers or other business associates such as quality assessment, quality improvement, outcome evaluation, protocol and clinical guidelines development, training programs, credentialing, medical review, legal services, and insurance. We will share information about you with such insurers or other business associates as necessary to obtain these services.
The health and billing records we maintain are the physical property of the doctor’s office/hospital. The information in it, however, belongs to you. You have a right to:
· Request a restriction on certain uses and disclosures of your health information by delivering the request in writing to our office – we are not required to grant the request, but we will comply with any request granted;
· Obtain a paper copy of the Notice of Privacy Practices for Protected Health Information by making a request at our office.
· Request that you be allowed to inspect and copy your health record and billing record – you may exercise this right by delivering the request in writing to our office using the form we provide to you upon request;
· Appeal a denial of access to your protected health information except in certain circumstances;
· Request that your health care record be amended to correct incomplete or incorrect information by delivering a written request to our office using the form we provide to you upon request (The physician or other health care provider is not required to make such amendments);
· File a statement of disagreement of your health information as required to be maintained by law by delivering a written request to our office using the form we provide to you upon request. An accounting will not include internal uses of information for treatment, payment, or operations, disclosures made to your or made at your request, or disclosures made to family members or friends in the course of providing care;
· Request that communications of your health information be made by alternative means or at an alternative location by delivering the request in writing to our office using the form we give you upon request; and
· Revoke authorizations that you made previously to use of disclose information except to the extent information or action has already been taken by delivering a written revocation to our office.
If you want to exercise any of the above rights, please contact Judy Bell, 478-757-8806, in person or in writing, during normal hours. They will provide you with assistance on the steps to take to exercise your right.
The office is required to:
· Maintain the privacy of your health information as required by law;
· Provide you with a notice as to our duties and privacy practices as to the information we collect and maintain about you;
· Abide by the terms of this notice;
· Notify you if we cannot accommodate a requested restriction or request; and
· Accommodate your reasonable requests regarding methods to communicate health information with you.
We reserve the right to amend, change, or eliminate provisions in our privacy practices and access practices and to enable new provisions regarding the protected health information we maintain. If our information practices change, we will amend our notice. You are entitled to receive a revised copy of the Notice by calling a requesting a copy of our Notice or by visiting our office and picking up a copy.
To request information or file a complaint
If you have questions, would like additional information, or want to report a problem regarding the handling of your information, you may contact Judy bell, Office Manager, at 478-757-8806.
Additionally, if you believe your privacy rights have been violated, you may file a written complaint at our office e by delivering the written complaint to Judy Bell. You may also file a compliant by mailing it or e-mailing it to the Secretary of Health and Human Services.
· We cannot, and will not, require you to waive the right to file a complaint with the Secretary of Health and Human Services (HHS) as a condition of receiving treatment from the office.
We cannot, and will not, take action against you for filing a compliant with Secretary of Health and Human Services.
Other Disclosures and Uses
Notification – Unless you object, we may use of disclose your protected health information to notify, or assist notifying a family member, personal representative, or other person responsible for your care, about your location, and about your general condition, or your death.
Communication with Family – Using our best judgement, we may disclose to a family member, other relative, close friend, or any other person you identify, health information relevant to that person’s involvement in your care or in payment for such care if your do not object or in an emergency.
Research – We may use and disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.
Disaster Relief – We may use and disclose your protected health information to assist in disaster relief efforts.
Funeral Directors or Coroners – We may disclose your protected health information to funeral directors or coroners consistent with applicable law to allow them to carry out their duties.
Organ Procurement Organizations – Consistent with applicable law, we may disclose your protected health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for tissue donation and transplant.
Marketing – We may contact you to provide you with appointment reminders, with information about treatment alternatives, or health information about other health-related benefits and services that may interest you.
Fund Raising – We may contact you as a part of a fund-raising effort.
Food and Drug Administration (FDA) – If you are seeking compensation through Workers Compensation, we may disclose your protected health information to the extent necessary to comply with laws relating to Workers Compensation.
Public Health – As required by law, we may disclose your information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
Abuse & Neglect – We may disclose your protected health information to public authorities as allowed by law to report abuse or neglect.
Correctional Institutions – If you are an inmate of a correctional institution, we may disclose to the institution or it’s agents the protected health information necessary for your health and the health and safety of other individuals.
Law Enforcement – We may disclose your protected health information for law enforcement purposes as required by law, such as when required by a court, or in cases involving felony prosecutions, or to the extent an individual is in the custody of law enforcement.
Health Oversight – Federal law allows us to release your protected health information to appropriate health oversight agencies or for health oversight activities.
Judicial/Administrative Proceedings – We may disclose your protected health information in the course of any judicial or administrative proceeding as allowed or required by law or as directed by a proper court order.
Serious Threat to Health or Safety – To avert a serious threat to health or safety, we may disclose your protected health information consistent with applicable law to prevent or lessen a serious, imminent threat to the health or safety of a person of the public.
For Specialized Governmental Functions – We may disclose your protected health information for specialized government functions as authorized by law as to Armed Forces personnel, for national security purposes, or to public assistance program personnel.
Other Uses – Other uses and disclosures besides those identified in this Notice will be made only as otherwise authorized by law or with written authorization and you may revoke the authorization as previously provided.