NOTICE
OF PRIVACY PRACTICES
THIS
NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU
MAY
BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO
PLEASE
REVIEW THIS NOTICE CAREFULLY.
This Practice is committed to maintaining the privacy of your
protected health information ("PHI"), which includes
information about your health condition and the care and treatment
you receive from the Practice. The creation of a record detailing
the care and services you receive helps this office to provide
you with quality health care. This Notice details how your PHI
may be used and disclosed to third parties. This Notice also details
your
rights regarding your PHI. The privacy of PHI in patient files
will be protected when the files are taken to and from the Practice
by placing the files in a box or brief case and kept within the
custody of a doctor or employee of the Practice authorized to
remove the files from the Practice's office. It may be necessary
to take patient files to a facility where a patient is confined
or to a patient's home where the patient is to be examined or
treated.
NO
CONSENT REQUIRED
The Practice may use and/or disclose your PHI for the purposes
of:
(a) Treatment - In order to provide you with the health care you
require, the Practice will provide your PHI to those health care
professionals, whether on the Practice's staff or not, directly
involved in your care so that they may understand your health
condition and needs. For example, a physician treating you for
a condition or disease may need to know the results of your latest
physician examination by this office.
(b) Payment - In order to get paid for services provided to you,
the Practice will provide your PHI, directly or through a billing
service, to appropriate third party payors, pursuant to their
billing and payment requirements. For example, the Practice may
need to provide the Medicare program with information about health
care services that you received from the Practice so that the
Practice can be properly reimbursed. The Practice may also need
to tell your insurance plan about treatment you are going to receive
so that it can determine whether or not it will cover the treatment
expense.
(c)
Health Care Operations - In order for the Practice to operate
in accordance with applicable law and insurance requirements and
in order for the Practice to continue to provide quality and efficient
care, it may be necessary for the Practice to compile, use and/or
disclose your PHI. For example, the Practice may use your PHI
in order to evaluate the performance of the Practice's personnel
in providing care to you.
1.
The Practice may use and/or disclose your PHI, without a written
Consent from you, in the following additional instances:
(a) De-identified Information - Information that does not identify
you and, even without your name, cannot be used to identify you.
(b) Business Associate - To a business associate if the Practice
obtains satisfactory written assurance, in accordance with applicable
law, that the business associate will appropriately safeguard
your PHI. A business associate is an entity that assists the Practice
in undertaking some essential function, such as a billing company
that assists the office in submitting claims for payment to insurance
companies or other payers.
(c)
Personal Representative -To a person who, under applicable law,
has the authority to represent you in making decisions related
to your health care
(d) Emergency Situations -
(i) for the purpose of obtaining or rendering emergency treatment
to you provided that the Practice attempts to obtain your Consent
as soon as possible; or
(ii)
to a public or private entity authorized by law or by its charter
to assist in disaster relief efforts, for the purpose of coordinating
your care with such entities in an emergency situation.
(e) Communication Barriers - If, due to substantial communication
barriers or inability to communicate, the Practice has been unable
to obtain your Consent and the Practice determines, in the exercise
of its professional judgment, that your Consent to receive treatment
is clearly inferred from the circumstances.
(f) Public Health Activities - Such activities include, for example,
information collected by a public health authority, as authorized
by law, to prevent or control disease and that does not identify
you and, even without your name, cannot be used to identify you.
(g) Abuse, Neglect or Domestic Violence - To a government authority
if the Practice is required by law to make such disclosure; if
the Practice is authorized by law to make such a disclosure, it
will do so if it believes that the disclosure is necessary to
prevent serious harm
(h) Health Oversight Activities - Such activities, which must
be required by law, involve government agencies and may include,
for example, criminal investigations, disciplinary actions, or
general oversight activities relating to the community's health
care system.
(i)
Judicial and Administrative Proceeding - For example, the Practice
may be required to disclose your PHI in response to a court order
or a lawfully issued subpoena.
(j)
Law Enforcement Purposes - In certain instances, your PHI may
have to be disclosed to a law enforcement official. For example,
your PHI may be the subject of a grand jury subpoena. Or, the
Practice may disclose your PHI if the Practice believes that your
death was the result of criminal conduct.
(k)
Coroner or Medical Examiner - The Practice may disclose your PHI
to a coroner or medical examiner for the purpose of identifying
you or determining your cause of death.
(l) Organ, Eye or Tissue Donation - If you are an organ donor,
the Practice may disclose your PHI to the entity to whom you have
agreed to donate your organs.
(m) Research - If the Practice is involved in research activities,
your PHI may be used, but such use is subject to numerous governmental
requirements intended to protect the privacy of your PHI and that
does not identify you and, even without your name, cannot be used
to identify you.
(n)
Avert a Threat to Health or Safety - The Practice may disclose
your PHI if it believes that such disclosure is necessary to prevent
or lessen a serious and imminent threat to the health or safety
of a person or the public and the disclosure is to an individual
who is reasonably able to prevent or lessen the threat.
(o) Workers' Compensation - If you are involved in a Workers'
Compensation claim, the Practice may be required to disclose your
PHI to an individual or entity that is part of the Workers' Compensation
system.
