THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY
If you have any questions about this notice, please contact the Facility Privacy Official by sending a message via support. Each time you visit us a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, a plan for future care or treatment, and billing-related information. This notice applies to all of the records of your care generated.
OUR RESPONSIBILITIES We are required by law to maintain the privacy of your health information and provide you a description of our privacy practices. We will abide by the terms of this notice.
USES AND DISCLOSURES How we may use and disclose Health Information about you. The following categories describe examples of the way we use and disclose health information:
FOR TREATMENT: We may use health information about you to provide you treatment or services. We may disclose health information about you to doctors, nurses, technicians, medical students,facilities or other medical personnel who are involved in taking care of you.
FOR PAYMENT: We may use and disclose health information about your treatment and services to bill and collect payment from you or a third party payer.
FOR QUALITY REVIEW: Members of the medical staff and/or quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. The results will then be used to continually improve the quality of care for all patients we serve. For example, we may combine health information about many patients to evaluate the need for new services or treatment. We may disclose information to doctors, nurses, and other students for educational purposes We may remove information that identifies you from this set of health information to protect your privacy.
AFFILIATES As Required by Law: We may also use and disclose health information for the following types of entities, including but not limited to Food and Drug Administration or Public Health or Legal Authorities charged with preventing or controlling disease. injury or disability, Correctional Institutions, Workers Compensation Agents, Organ and Tissue Donation Organization, Health Oversight, Agencies or Funeral Directors, Coroners and Medical Directors, National Security and Intelligence Agencies, Protective Services for the President and Others. We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. State Specific Requirements: Many states have requirements for reporting including population-based activities relating to improving health or reducing health care costs. Some states have separate privacy laws that may apply additional legal requirements. If the state privacy laws are more stringent than federal privacy laws, the state law preempts the federal law.
YOUR HEALTH INFORMATION RIGHTS: Although your health record is the physical property of the healthcare practitioner or facility that compiled it, you have the right to inspect and obtain a copy of the health information that may be used to make decisions about your care Usually, this includes medical and billing records, but does not include psychotherapy notes. There may be a cost to provide a copy of records per state law. We may deny your request to inspect and copy in certain very limited circumstances, if you are denied access to health information, you may request that the denial be reviewed. If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the office. We may deny your request for an amendment and if this occurs, you will be notified of the reason for the denial.
ACCOUNTING OF DISCLOSURES: You have the right to request an accounting of disclosures This is a list of certain disclosures of your health information for purposes other than treatment, payment of health care operations where an authorization was not required. You have the right to request a restriction or limitation on the health information we use to disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had. We may also use and disclose health information to business associates we have contracted with to perform the agreed upon service. For example: To remind you that you have an appointment for medical care; To schedule an appointment; To assess your satisfaction with our services; To publish your reviews of our practice online; To tell you about possible treatment alternatives, To tell you about health-related benefits or services; To contact you as part of fundraising efforts; For population based activities relating to improving health or reducing health care costs; For conducting training programs or reviewing competence of health care professionals. When disclosing information, primarily appointment reminders and billing/collections efforts, we may leave messages on your answering machine/voice mail/text/email.
BUSINESS ASSOCIATES: There are some services provided in our organization through contracts termed business associates Examples include online scheduling and our answering service. When these services are contracted, we may disclose your health information to our business associates so that they can perform the job we've asked them to do and bill you or your third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.
INDIVIDUALS INVOLVED IN THE PAYMENT OF YOUR CARE: We may release health information about you to a friend or family member who is involved in your medical care or who helps pay for your care. In addition, we may disclose health information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
INDIVIDUALS INVOLVED IN THE DELIVERY OF CARE: We may release health information about you to a referred provider or facility who is involved in your medical care for the provision, scheduling or coordination of your care.
RESEARCH: We may disclose information to researchers when an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information has approved their research and granted a waiver of the authorization requirement.
MARKETING: We may disclose protected health information that you provide such as your name and comments that you make to our practice on any public website or review program as a verified patient of our practice. You agree to this disclosure.
ELECTRONIC COMMUNICATIONS: We may communicate to you via newsletters, mail outs or other means regarding treatment options, health related information, disease management programs, wellness programs, or other community based initiatives or activities our facility is participating in.
PAPER COPY OF NOTICE: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice upon request.
EXERCISING YOUR RIGHTS: To exercise any of your rights, please obtain the required forms from the Privacy Official and submit your request in writing.
CHANGES TO THIS NOTICE: We reserve the right to change this notice and the revised or changed notice will be effective for information we already have about you as well as any information we receive in the future. The current notice will be posted ur website.
COMPLAINTS If you believe your privacy rights have been violated, you may file a complaint with the office by following the process outlined in the facility's Patient Rights documentation. You may also file a complaint with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing.
OTHER USES OF HEALTH INFORMATION: Other uses and disclosures of health information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose health information about you, you may revoke that permission, in writing, at any lime. If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you
FACILITY PRIVACY OFFICIAL 832-415-0376