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) requires
all health care records and other individually identifiable health information
(protected health information) used or disclosed to us in any form, whether
electronically, on paper, or orally, be kept confidential. This federal law
gives you, the patient, significant new rights to understand and control how
your health information is used. 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.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU
The following categories describe different ways that we use and disclose
medical information. For each category of uses or disclosures we will explain
what we mean and try to give some examples. Not every use or disclosure in a
category will be listed. However, all of the ways we are permitted to use and
disclose information will fall within one of the categories.
For Treatment. We may use medical information about you to
provide you with medical treatment or services. We may disclose medical
information about you to doctors, nurses, technicians, medical students, or
other hospital personnel who are involved in taking care of you at the office or
hospital. For example, a doctor treating you for a broken leg may need to know
if you have diabetes because diabetes may slow the healing process. In addition,
the doctor may need to tell the dietitian if you have diabetes so that we can
arrange for appropriate meals. Different departments of the hospital also may
share medical information about you in order to coordinate the different things
you need, such as prescriptions, lab work and x-rays. We also may disclose
medical information about you to people outside the hospital who may be involved
in your medical care after you leave the hospital, such as family members,
clergy or others we use to provide services that are part of your care.
For Payment. We may use and disclose medical information about
you so that the treatment and services you receive at the office or hospital 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
surgery you received at the hospital so your health plan will pay us or
reimburse you for the surgery. 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 disclose medical
information about you for medical operations. These uses and disclosures 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 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 disclose
information to doctors, nurses, technicians, medical students, and other office
personnel for review and learning purposes. We may also combine the medical
information we have with medical information from other practices to compare how
we are doing and see where we can make improvements in the care and services we
offer. We may remove information that identifies you from this set of medical
information so others may use it to study health care and health care delivery
without learning who the specific patients are.
Recall and Appointment Reminders. We may use and disclose
medical information to contact you as a reminder that you have an appointment or
to inform you to make an appointment for treatment or medical care at the
office. Unless instructed otherwise, appointment and/or recall reminders may be
left on voice mail attached to a telephone number provided by you.
Treatment Alternatives. We may use and disclose 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 disclose
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. We may also give information to someone who helps
pay for your care. We may also tell your family or friends your condition and
that you are in the hospital. In addition, we may disclose 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
disclose 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 disclosure, however, would only be to someone able to help
prevent the threat.
SPECIAL SITUATIONS
Organ and Tissue Donation. If you are an organ donor, we may
release medical information to organizations that handle organ procurement or
organ, eye or tissue transplantation or to an organ donation bank, as necessary
to facilitate organ or tissue donation and transplantation.
Military and Veterans. If you are a member of the armed forces,
we may release medical information about you as required by military command
authorities. We may also release medical information about foreign military
personnel to the appropriate foreign military authority.
[A hospital that is a component of the Department of Defense or Transportation
should also include the following: "If you are a member of the Armed Forces, we
may disclose medical information about you to the Department of Veterans Affairs
upon your separation or discharge from military services. This disclosure is
necessary for the Department of Veterans Affairs to determine if you are
eligible for certain benefits."] [A hospital that is a component of the
Department of Veterans Affairs should also include the following: "We may use
and disclose to components of the Department of Veterans Affairs medical
information about you to determine whether you are eligible for certain
benefits."]
Workers' Compensation. We may release medical information about
you for workers' compensation or similar programs. These programs provide
benefits for work-related injuries or illness. Public Health Risks. We may
disclose medical information about you for public health activities. These
activities generally include the following:
1. to prevent or control disease, injury or disability; to report births and
deaths; to report child abuse or neglect; to report reactions to medications or
problems with products; to notify people of recalls of products they may be
using; to notify a person who may have been exposed to a disease or may be at
risk for contracting or spreading a disease or condition;
2. to notify the appropriate government authority if we believe a patient has been
the victim of abuse, neglect or domestic violence. We will only make this
disclosure if you agree or when required or authorized by law.
Health Oversight Activities. We may disclose 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
disclose medical information about you in response to a court or administrative
order. We may also disclose 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. Law Enforcement. We may
release medical information if asked to do so by a law enforcement official:
In response to a court order, subpoena, warrant, summons or similar process; To
identify or locate a suspect, fugitive, material witness, or missing person;
About the victim of a crime if, under certain limited circumstances, we are
unable to obtain the person's agreement; About a death we believe may be the
result of criminal conduct; About criminal conduct at the hospital; and
In emergency circumstances to report a crime; the location of the crime or
victims; or the identity, description or location of the person who committed
the crime.
Coroners, Medical Examiners and Funeral Directors. We may
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 hospital to
funeral directors as necessary to carry out their duties. National Security and
Intelligence Activities. We may release medical information about you to
authorized federal officials for intelligence, counterintelligence, and other
national security activities authorized by law. Protective Services for the
President and Others. We may disclose medical information about you to
authorized federal officials so they may provide protection to the President,
other authorized persons or foreign heads of state or conduct special
investigations.
Inmates. If you are an inmate of a correctional institution or under the custody
of a law enforcement official, we may release medical information about you to
the correctional institution or law enforcement official. This release would be
necessary (1) for the institution to provide you with health care; (2) to
protect your health and safety or the health and safety of others; or (3) for
the safety and security of the correctional institution.
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU
You have the following rights regarding medical information we maintain about
you:
Right to Inspect and Copy. You have the right to inspect and
copy medical information that may be used to make decisions about your care.
Usually, this includes medical and billing records, but does not include
psychotherapy notes.
To inspect and copy medical information that may be used to make decisions about
you, you must submit your request in writing to One Care Medical, Attn:
Christine Curley, Compliance Officer. If you request a copy of the information,
we may charge a fee for the costs of copying, mailing or other supplies
associated with your request. We may deny your request to inspect and copy in
certain very limited circumstances. If you are denied access to medical
information, you may request that the denial be reviewed. Another licensed
health care professional chosen by the office will review your request and the
denial. The person conducting the review will not be the person who denied your
request. We will comply with the outcome of the review.
Right to Amend. If you feel that medical information we have
about you is incorrect or incomplete, you may ask us to amend the information.
You have the right to request an amendment for as long as the information is
kept by or for the office.
To request an amendment, your request must be made in writing and submitted to
our Compliance Officer, Christine Curley. In addition, you must provide a reason
that supports your request. We may deny your request for an amendment if it is
not in writing or does not include a reason to support the request. In addition,
we may deny your request if you ask us to amend information that:
* Was not created by us, unless the person or entity that created the information
is no longer available to make the amendment; Is not part of the medical
information kept by or for the practice; Is not part of the information which
you would be permitted to inspect and copy; or Is accurate and complete.
Right to an Accounting of Disclosures. You have the right to
request an "accounting of disclosures." This is a list of the disclosures we
made of medical information about you.
To request this list or accounting of disclosures, you must submit your request
in writing to Our Medical Record Department, Attn: Compliance Officer. Your
request must state a time period which may not be longer than six years and may
not include dates before February 26, 2003. Your request should indicate in what
form you want the list (for example, on paper, electronically). The first list
you request within a 12 month period will be free. For additional lists, we may
charge you for the costs of providing the list. We will notify you of the cost
involved and you may choose to withdraw or modify your request at that time
before any costs are incurred.
Right to Request Restrictions. You have the right to request a
restriction or limitation on the medical information we use or disclose about
you for treatment, payment or health care operations. You also have the right to
request a limit on the medical information we disclose about you to someone who
is involved in your care or the payment for your care, like a family member or
friend. For example, you could ask that we not use or disclose information about
a surgery you had.
We are not required to agree to your request. If we do agree, we will comply
with your request unless the information is needed to provide you emergency
treatment.To request restrictions, you must make your request in writing to
One Care Medical, Compliance Officer. In your request, you must tell us (1)
what information you want to limit; (2) whether you want to limit our use,
disclosure or both; and (3) to whom you want the limits to apply, for example,
disclosures to your spouse.
Right to Request Confidential Communications. You have the
right to request that we communicate with you about medical matters in a certain
way or at a certain location. For example, you can ask that we only contact you
at work or by mail.
To request confidential communications, you must make your request in writing to
One Care Medical, Compliance Officer. We will not ask you the reason for
your request. We will accommodate all reasonable requests. Your request must
specify how or where you wish to be contacted.
Right to a Paper Copy of This Notice. You have the right to a
paper copy of this notice. You may ask us to give you a copy of this notice at
any time. Even if you have agreed to receive this notice electronically, you are
still entitled to a paper copy of this notice.
You may obtain a copy of this notice at our website, www.brfp.com. To obtain a
paper copy of this notice, contact One Care Medical, Compliance Officer.
CHANGES TO THIS NOTICE
We reserve the right to change this notice. We reserve the right to make the
revised or changed notice effective for medical information we already have
about you as well as any information we receive in the future. We will post a
copy of the current notice in the office. The notice will contain on the first
page, in the top right-hand corner, the effective date. In addition, each time
you register at the office for treatment or health care services, we will offer
you a copy of the current notice in effect.
We are required by law to maintain the privacy of your PROTECTED HEALTH
INFORMAION and to provide you with notice of our legal duties and privacy
practices with respect to PROTECTED HEALTH INFORMAION.
We are required to abide by the terms of the Notice of Privacy Practices
currently in effect. We reserve the right to change the terms of our Notice of
Privacy Practices and to make the new notice provisions effective for all
PROTECTED HEALTH INFORMAION that we maintain. Revisions to our Notice of Privacy
Practices will be posted on the effective date and you may request a written
copy of the Revised Notice from this office.You have the right to file a formal,
written complaint with us at the address below, or with the Department of Health
& Human Services, Office of Civil Rights, in the event you feel your privacy
rights have been violated. We will not retaliate against you for filing a
complaint.