NOTICE
OF PRIVACY PRACTICES
THIS NOTICE
DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU
MAY BE
USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO
THAT INFORMATION
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.