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NOTICE OF PRIVACY PRACTICES:
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THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND RELEASED
AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
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Who Will Follow This Notice ?
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This notice describes our practice’s privacy practices and that of:
Any physician or health care professional authorized to enter information into your
medical chart.
All areas of the practice
All employees, staff, and other office personnel
All these individuals, sites and locations follow the terms of this notice.
In addition, these individuals, sites and locations may share medical information
with each other or with third party medical specialists for treatment, payment,
or office operations purposes described in this notice
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Our Pledge Regarding Medical Information:
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We understand that medical information about you and your health is personal. We
are committed to protecting medical information about you. We create a record of
the care and services you receive at our medical office. We need this record to
provide you with quality care and to comply with certain legal requirements. This
notice applies to all of the records of your care generated by our office.
This notice will tell you about the ways in which we may use and release medical
information about you. We also describe your rights and certain obligations we have
regarding the use and release of medical information.
We are required by law to:
make sure that medical information that identifies you is kept private
give you this notice of our legal duties and privacy practices with respect to medical
information about you; and
follow the terms of this notice that is currently in effect
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How We May Use and Release Medical Information About You ?
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The following categories describe different ways that we use and disclose medical
information. Not every use or release category will be listed. However, all of the
ways we are permitted to use and release information will fall within one of the
categories.
This notice will tell you about the ways in which we may use and release medical
information about you. We also describe your rights and certain obligations we have
regarding the use and release of medical information.
For Treatment. We may use medical information about you to provide you with medical
treatment or services. We may release medical information about you to the practice’s
office personnel who are involved in taking care of you at the office or elsewhere.
We also may release medical information about you to people outside our office who
may be involved in your care after you leave the office, such as family members
or others we use to provide services that are part of your care provided you have
consented to such release. These entities include third party physicians, hospitals,
nursing homes, pharmacies or clinical labs with whom the office consults or makes
referrals.
For Payment. We may use and release medical information about you so that the treatment
and services you receive at the medical office may be billed to and payment may
be collected from you, an insurance company or a third party. For example, we may
need to give your health plan information about medical procedures you received
at the office so your health plan will pay us or reimburse you for the services.
We may also tell your health plan about a treatment you are going to receive to
obtain prior approval or to determine whether your plan will cover the treatment.
For Health Care Operations. We may use and release medical information about you
for medical office operations. These uses and releases are necessary to run the
medical office and make sure that all of our patients receive quality care. For
example, we may use medical information to review our treatment and services and
to evaluate the performance of our staff in caring for you. We may also combine
medical information about many medical office patients to decide what additional
services the office should offer, what services are not needed, and whether certain
new treatments are effective. We may also release information to physicians, nurses,
and other office personnel for review and learning purposes.
Appointment Reminders. We may use and release medical information to contact you
as a reminder that you have an appointment for treatment or medical care at the
office.
Treatment Alternatives. We may use and release medical information to tell you about
or recommend possible treatment options or alternatives that may be of interest
to you.
Health-Related Benefits and Services. We may use and release medical information
to tell you about health-related benefits or services that may be of interest to
you.
Individuals Involved In Your Care or Payment for Your Care. We may release medical
information about you to a friend or family member who is involved in your medical
care provided you have consented to such release. We may also give information to
someone who helps pay for your care. In addition, we may release medical 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.
As Required By Law. We will disclose medical information about you when required
to do so by federal, state or local law.
To Avert a Serious Threat to Health or Safety. We may use and release medical information
about you when necessary to prevent a serious threat to your health and safety or
the health and safety of the public or another person. Any release, however, would
only be to someone able to prevent the threat.
Special Situations
Health Oversight Activities. We may release medical information to a health oversight
agency for activities authorized by law. These oversight activities include, for
example, audits, investigations, inspections, and licensure. These activities are
necessary for the government to monitor the health care system, government programs
and compliance with civil rights laws.
Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may release
medical information about you in response to a court or administrative order. We
may also release medical information about you in response to a subpoena, discovery
request, or other lawful process by someone else involved in the dispute, but only
if efforts have been made to tell you about the request or to obtain an order protecting
the information requested.
Coroners, Medical Examiners and Funeral Directors. We may also release medical information
to a coroner or medical examiner. This may be necessary, for example, to identify
a deceased person or determine the cause of death. We may also release medical information
about patients of the office to funeral directors as necessary to carry out their
duties.
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