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.
·
According to Federal
Law, all of our patients have a right to know how we use your health
information, when we can disclose this information, and what rights you have as
a patient. This Notice of Privacy Practices describes how we may use your
Protected Health Information to carry out treatment, payment and health care
operations and for other purposes that are permitted or required by law. It
also describes your rights to access and control your health information.
Protected Health Information (PHI) is information about you including
demographic information that may identify you and that relates to your past,
present or future physical or mental health and related health care services.
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USES
AND DISCLOSURES OF PROTECTED HEALTH INFORMATION
·
Your Protected Health
Information may be used and disclosed by your physician, our office staff and
others outside our office that are involved in your care and treatment for the
purpose of providing services to you, to pay health care bills, to support the
operation of the physician's office and any other use required by law.
·
Treatment: We will use and disclose your protected health
information to provide, coordinate, or manage your health care and any related
services. This includes the coordination or management of your health care with
a third party. For example, we would disclose your health information, as
necessary to a home health agency that provides care to you. We may also
disclose your health information to a physician that you have been referred to
so that the physician has the necessary information to diagnose and treat you.
·
Payment:
Your protected health
information will be used, as needed, to obtain payment for your health care
services. For example, obtaining approval for a hospital stay may require that
your relevant health information be disclosed to your health insurance plan to
obtain approval for the hospital admission.
·
Health
Care Operations: We may use or disclose,
as needed, your protected health information in order to support the business
activities of our office. These activities include, but are not limited to:
quality improvement activities, including making sure you receive quality
health care and correct medical procedures, and that all the rules and laws
have been followed; evaluate the competence of our health care providers;
resolve any complaining or grievances you may have; employee review activities,
training of medical students, licensing, certification or credentialing
activities, marketing or fund raising activities, and conducting or arranging
for other business activities. For example, we may disclose your health
information to medical students that see patients at our office. We may use a
sign in sheet at our registration desk and call you by name when you are seen.
We may use or disclose your health information, as necessary, to contact you to
remind you of your appointment.
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We may use or disclose
your protected health information (PHI) in the following situations without
your authorization.
·
We may use or disclose
your PHI for any purpose required by law. For example, FHS may be required by
law to respond to a court order.
·
We may disclose your PHI
for Public Health activities such as communicable diseases, injuries, birth or
death, and for public health investigations.
·
We may disclose your PHI
to the proper authorities if we suspect child abuse or neglect, or if we
believe you to be the victim of abuse, neglect or domestic violence.
·
We may disclose your PHI
if authorized by law, to a government oversight agency (e.g. State Insurance
Department, Food and Drug Administration) conducting audits, investigations, or
civil or criminal proceedings.
·
We may disclose your PHI
in the course of a judicial or administrative proceeding (e.g. to respond to a
subpoena or discovery request).
·
We may disclose your PHI
to the proper authorities for law enforcement purposes.
·
We may disclose your PHI
to the coroners, medical examiners, and/or funeral directors consistent with
the law.
·
We may use or disclose
your PHI for organ, eye or tissue donation.
·
We may use or disclose
your PHI for research purposes, but only as permitted by law
·
We may use or disclose
your PHI to avert a serious threat to health or safety.
·
We may use or disclose
your PHI if you are a member of the military, as required by the armed forces
services, and we may also disclose your PHI for other specialized government
functions such as national security or intelligence activities.
·
We may disclose your PHI to worker's
compensation agencies for your worker's compensation benefit determination.
·
We will, if required by
law, release your PHI to the Secretary of the Department of Health and Human
Services for enforcement of HIPAA.
·
Business
Associates: Certain areas of our
services may be performed through contracts with outside persons or
organizations. Examples of these include insurance agents, and vendors that
help us process your claims. At times it may be necessary for us to provide
certain parts of your PHI to one or more of these business associates.
·
Other permitted and
required uses and disclosures will be made only with your consent and signed
authorization or your opportunity to object, unless required by law. You may
revoke this authorization at any time in writing unless your physician has
already acted on this authorization.
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YOUR
PATIENT RIGHTS
·
You have the right to
inspect and request a copy of your Protected Health Information. Under federal
law, however, you may not inspect or copy the following records: psychotherapy
notes; information compiled in reasonable anticipation of, or use in a civil,
criminal or administrative action or proceeding; and protected health
information that is subject to law that prohibits access to this information.
·
You
have the right to request a restriction of your Protected Health Information. This means you may ask us to restrict certain
uses and disclosures of your health information. You may also request that any
part of your health information not be disclosed to family members or friends
who may be involved in your care. However, this office is not required to agree
to a requested restriction if it is believed that it is in your best interest
to disclose the information. You then have the right to use another health care
professional.
·
You
have the right to receive confidential communications from us. You may request any communication from us
remain confidential. You may request an alternative means or location for this
disclosure.
·
You
have the right to request that your physician amend your protected health
information. If your request for
amendment is denied, you then have the right to file a statement of
disagreement with us and we may prepare and provide you with a copy of a
rebuttal to your statement.
·
You
have the right to receive an accounting of disclosures of your protected health
information that is not related to treatment, payment or healthcare operations. These instances would require your authorization
and may include: marketing or selling of mailing lists, information released to
employers or life insurance companies.
·
You
have the right to receive a paper copy of this notice if you have agreed to receive it electronically.
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FAMILY
HEALTH MEDICAL SERVICES OBLIGATIONS TO YOU: Family Health Medical Services is required by law to maintain the
privacy of your protected health information and to provide you with this
notice of its legal duties and privacy practices with respect to that health
information. We are required to abide by the terms of the notice currently in
effect. Family Health Medical Services reserves the right to change the terms
of this notice and to make new terms effective for all protected health
information it maintains. We will provide you with a copy of any changes made.
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COMPLAINTS: You may complain to us or to the Secretary of
Health and Human Services if you believe your privacy rights have been
violated. You may file a complaint with us by notifying our privacy official of
your complaint. Family Health Medical Services will not retaliate in any way
against anyone filing a complaint. If you want to make a complaint, or would
like further information regarding your Protected Health Information or Patient
Rights under the HIPAA legislation, please contact our privacy official at
Family Health Medical Services.