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 Health Insurance Portability & Accountability Act of
1996 (“HIPAA”)
is a federal program that requires that all medical records and other individually
identifiable health information used or disclosed by us in any form, whether
electronically, on paper, or orally, are kept properly confidential. This Act
gives you, the patient, significant new rights to understand and control how
your health information is used. The “HIPAA” provides penalties
for covered entities that misuse personal health information.
As required by “HIPAA”, we have prepared this explanation of how
we are required to maintain the privacy of your health information and how
we may use and disclose your health information.
We may use and disclose your medical records without your authorization only
for each of the following purposes: Treatment, payment and health care operations.
Treatment means providing,
coordination, or managing health care and related services by one or more health
care providers. An example of this would include
a physical examination. Payment means such activities
as obtaining reimbursement for services, confirming coverage, billing or collection
activities, and utilization review. An example
of this would be sending a bill for your visit to your insurance company for
payment. Health care operations include
the business aspects of running our practice, such as conducting quality assessment
and improvement activities, auditing
functions, cost-management analysis, and customer service. An example would
be an internal quality assessment review.
We may also create and distribute de-identified health information by removing
all references to individually identifiable information. An example of this
would be studying surgery outcomes in research.
We may contact you to provide appointment reminders or information about treatment
or other health-related benefits and services that are requested by you.
Any other uses and disclosures will be made only with you written authorization.
You may revoke such authorization in writing and we are required to abide by
that written request, except to the extent that we have already taken actions
according to your initial authorization.
Workers’ compensation cases are exempt from the HIPAA requirement. That
means a caseworker can request any part of your medical records or information
without your written authorization.
You have the following rights with respect to your protected health information,
which you can exercise by presenting a written request to the Privacy Officer:
The right to request restrictions
on certain uses and disclosures of protected health information, including
those related to disclosures to family members,
other relatives, close personal friends, or any other person identified by
you. We are, however, not required to agree to a requested restriction. If
we do agree to a restriction, we must abide by it unless you agree in writing
to remove it. The right to reasonable
requests to receive confidential communications of protected health information
from us by alternative means or at alternative
locations. The right to inspect and
obtain a copy your protected health information. The right to amend your
protected health information. The right to receive an
accounting of disclosures of protected health information. The right to obtain a paper
copy of this notice from us upon request.