HIPAA 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.
This NOTICE OF PRIVACY PRACTICES describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “PROTECTED HEALTH INFORMATION” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION: Your PHI may be used and disclosed by your physician, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills to support the operation of the physician’s practice, and any other use required by law.
TREATMENT: We will use and disclose your PHI 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 PHI, as necessary, to a home health agency that provides care to you or to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.
PAYMENT: Your PHI will be used, as needed, to obtain payment for your health care services. For example, obtaining approval for home medical equipment may require that your relevant PHI be disclosed to the health plan to obtain approval for the home medical equipment.
HEALTHCARE OPERATIONS: We may use or disclose, as needed, your PHI in order to support our business activities. These activities include, but are not limited to, quality assessment activities, employee review activities, training, licensing, and conducting or arranging for other business activities. We may use or disclose your PHI in the following situations without your authorization. These situations include: as required by law, FDA requirements, legal proceedings, law enforcement, and workers’ compensation.
OTHER PERMITTED AND REQUIRED USES AND DISCLOSURES: Will be made only with your consent, authorization or opportunity to object unless required by law.
YOU MAY REVOKE THIS AUTHORIZATION: At any time, in writing, except to the extent that we have taken an action in reliance on the use or disclosure indicated in the authorization.
YOUR RIGHTS: The following is a statement of your rights with respect to your protected PHI. You have the right to inspect and copy your PHI. Under federal law, however, you may not inspect or copy the following records: psychotherapy notes, information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and PHI that is subject to law that prohibits access to PHI.
You have the right to request a restriction of your PHI. This means that you may ask us not to use or disclose any part of your PHI for the purposes of treatment, payment or healthcare operations. You may also request that any part of your PHI not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in the NOTICE OF PRIVACY PRACTICES. Your request must sate the specific restriction requested and to whom you want the restriction to apply.
You have the right to request to receive confidential communications from us by alternative means or at an alternative location. You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice alternatively i.e. electronically. You have the right to receive an accounting of certain disclosures we have made, if any, of your PHI.
WE RESERVE THE RIGHT TO CHANGE THE TERMS OF THIS NOTICE. YOU WILL HAVE THE RIGHT TO OBJECT OR WITHDRAW AS PROVIDED IN THIS NOTICE.
COMPLAINTS: You may complain to us of the SECRETARY OF HEALTH AND HUMAN SERVICES if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our privacy contact of your complaint. WE WILL NOT RETALIATE AGAINST YOU FOR FILING A COMPLAINT.
This notice was published and becomes effective on April 14, 2003.n April 14, 2003.
To download your copy of HIPAA Privacy Practices please click this link: HIPAA NOTICE OF PRIVACY PRACTICES