DeKalb Family Medicine On Candler
Notice Of Privacy Practices<=
span
style=3D'mso-bookmark:_Hlt532295099'>
As Required by the Privacy Regulations Created=
as a
Result of the Health Insurance Portability and Accountability Act of 1996
(HIPAA)
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU (AS A PATIENT OF THIS PRACTICE )= MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION.
A. OUR COMMITMENT TO YOUR PRIVACY=
Our practice is dedicated to maintaining the privacy o= f your individually identifiable health information (IIHI). In conducting our business, we will create records regarding you and the treatment and services we provide to y= ou. We are required by law to maintain= the confidentiality of health information that identifies you. We also are required by law to pro= vide you with this notice of our legal duties and the privacy practices that we maintain in our practice concerning your IIHI. By federal and state law, we must = follow the terms of the notice of privacy practices that we have in effect at the time.
We realize that these laws are complicated, but we must provide you with the following important information:
· = How we may use and disclose your IIHI
· = Your privacy rights in your IIHI
· = Our obligations concerning the use and disclosure of your IIHI
The terms of =
this
notice apply to all records containing your IIHI that are created or retain=
ed
by our practice. We reserve t=
he
right to revise or amend this Notice of Privacy Practices. Any revision or amendment to this =
notice
will be effective for all of your records that our practice has created or
maintained in the past, and for any of your records that we may create or
maintain in the future. Our p=
ractice
will post a copy of our current Notice in our offices in a visible location=
at
all times, and you may request a copy of our most current Notice at any tim=
e.
B. IF YOU HAVE QUESTIONS ABOUT THIS N=
OTICE,
PLEASE CONTACT:
Samuel Armstrong (404) 289-4556
C.&nb=
sp; WE
MAY USE AND DISCLOSE YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION (IIH=
I)
IN THE
The following categories describe the different ways in which we may use and disclose your IIHI.
1. Treatment. Our practice may use your IIHI to = treat you. For example, we may ask = you to have laboratory tests (such as blood or urine tests), and we may use the results to help us reach a diagnosis. We might use your IIHI in order to write a prescription for you, or = we might disclose your IIHI to a pharmacy when we order a prescription for you. Many of the people who w= ork for our practice – including, but not limited to, our doctors and nur= ses – may use or disclose your IIHI in order to treat you or to assist ot= hers in your treatment. Additional= ly, we may disclose your IIHI to others who may assist in your care, such as your spouse, children or parents.
2. Payment. Our practice may use and disclose = your IIHI in order to bill and collect payment for the services and items you may receive from us. For example,= we may contact your health insurer to certify that you are eligible for benefi= ts (and for what range of benefits), and we may provide your insurer with deta= ils regarding your treatment to determine if your insurer will cover, or pay fo= r, your treatment. We also may use and disclose your IIHI to obtain payment from third parties that may be respons= ible for such costs, such as family members.&nb= sp; Also, we may use your IIHI to bill you directly for services and ite= ms.
3. Health Care Operations. Our practice may use and disclose = your IIHI to operate our business. As examples of the ways in which we may use and disclose your information for = our operations, our practice may use your IIHI to evaluate the quality of care = you received from us, or to conduct cost-management and business planning activities for our practice.
4. Appointment Reminders. Our practice may use and disclose = your IIHI to contact you and remind you of an appointment.
5. Treatment Options. Our practice may use and disclose = your IIHI to inform you of potential treatment options or alternatives.
6. Health-Related Benefits and Servic= es. Our practice may use and disclose = your IIHI to inform you of health-related benefits or services that may be of interest to you.
7. Release of Information to Family/F= riends. Our practice may release your IIHI= to a friend or family member that is involved in your care, or who assists in ta= king care of you. For example, a p= arent or guardian may ask that a babysitter take their child to the pediatrician’s office for treatment of a cold. In this example, the babysitter ma= y have access to this child’s medical information.
8. Disclosures Required By Law.
D.&n=
bsp;
USE AND DISCLOSURE OF YOUR IIHI IN CERTAIN SPECIAL CIRCUMSTANCES
The following categories describe unique scenarios in which we may use or disclose your identifiable health information:
1. Public Health Risks. Our practice may disclose your IIH= I to public health authorities that are authorized by law to collect information= for the purpose of:
· =
maintaining vital records, such as births and
deaths
· =
reporting child abuse or neglect
· =
preventing or controlling disease, injury or=
disability
· =
notifying a person regarding potential expos=
ure
to a communicable disease
· =
notifying a person regarding a potential risk
for spreading or contracting a disease or condition
· =
reporting reactions to drugs or problems with
products or devices
· =
notifying individuals if a product or device
they may be using has been recalled
· = notifying appropriate government agency(ies)= and authority(ies) regarding the potential abuse or neglect of an adult patient (including domestic violence); however, we will only disclose this informat= ion if the patient agrees or we are required or authorized by law to disclose t= his information
· = notifying your employer under limited circumstances related primarily to workplace injury or illness or medical surveillance.
2. Health Oversight Activities.
3. Lawsuits and Similar Proceedings. Our practice may use and disclose = your IIHI in response to a court or administrative order, if you are involved in= a lawsuit or similar proceeding. We also may disclose your IIHI in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if = we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.
4. Law Enforcement. We may release IIHI if asked to do= so by a law enforcement official:
· =
Regarding a crime victim in certain situatio=
ns,
if we are unable to obtain the person’s agreement
· =
Concerning a death we believe has resulted f=
rom
criminal conduct
· =
Regarding criminal conduct at our offices
· =
In response to a warrant, summons, court ord=
er, subpoena
or similar legal process
· =
To identify/locate a suspect, material witne=
ss,
fugitive or missing person
· = In an emergency, to report a crime (including the location or victim(s) of the crime, or the description, identity or location of the perpetrator)
5. Deceased Patients. Our practice may release IIHI to a medical examiner or coroner to identify a deceased individual or to identify the cause of death. If necess= ary, we also may release information in order for funeral directors to perform t= heir jobs.
6. Organ and Tissue Donation. Our practice may release your IIHI= to organizations that handle organ, eye or tissue procurement or transplantati= on, including organ donation banks, as necessary to facilitate organ or tissue donation and transplantation if you are an organ donor.
7. Research. Our practice may use and disclose = your IIHI for research purposes in certain limited circumstances. We will obtain your written authorization to use your IIHI for research purposes except when: (a) our use or disclosure was approved by an Institutional Review Board or a Privacy Board; (b) we obtain the oral or written agreement of a researcher = that (i) the information being sought is necessary for the research study; (ii) = the use or disclosure of your IIHI is being used only for the research and (iii) the researcher will not remove any of your IIHI from our practice; or (c) t= he IIHI sought by the researcher only relates to decedents and the researcher agrees either orally or in writing that the use or disclosure is necessary = for the research and, if we request it, to provide us with proof of death prior= to access to the IIHI of the decedents.
8. Serious Threats to Health or Safet= y. Our practice may use and disclose = your IIHI when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these circumstances, we will= only make disclosures to a person or organization able to help prevent the threat.
9.
Milita=
ry. Our practice may disclose your IIH=
I if
you are a member of
10. National Security. Our practice may disclose your IIH= I to federal officials for intelligence and national security activities authori= zed by law. We also may disclose = your IIHI to federal officials in order to protect the President, other official= s or foreign heads of state, or to conduct investigations.
11. Inmates. Our practice may disclose your IIH= I to correctional institutions or law enforcement officials if you are an inmate= or under the custody of a law enforcement official. Disclosure for these purposes woul= d be necessary: (a) for the institution to provide health care services to you, = (b) for the safety and security of the institution, and/or (c) to protect your health and safety or the health and safety of other individuals.
12. Workers’ Compensation.
You have the following rights regarding the IIHI that = we maintain about you:
1. Confidential Communications.
specifying the requested method of contact, or the loc= ation where you wish to be contacted. Our practice will accommodate reasonab= le requests. You do not need to = give a reason for your request.
2. Requesting Restrictions. You have the right to request a restriction in our use or disclosure of your IIHI for treatment, payment or health care operations. Additionally, you have the right to request that we restrict our disclosure of your IIHI to only certain individuals involved in your care or the payment for your care, such as family members and friends. We are not required to agree t= o your request; however, if we do agree, we are bound by our agreement except = when otherwise required by law, in emergencies, or when the information is neces= sary to treat you. In order to req= uest a restriction in our use or disclosure of your IIHI, you must make your reque= st in writing to
Samuel Armstrong (404) 289-4556
Your request must describe in a clear and concise fash= ion:
= (a) the information you wish restricted;
= (b) whether you are requesting to limit our practice’s use, disclosure or both; a= nd
= (c) to whom you want the limits to apply.
3. Inspection and Copies. You have the right to inspect and = obtain a copy of the IIHI that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your r= equest in writing
Samuel Armstrong =
(404) 289-4556
in order= to inspect and/or obtain a copy of your IIHI.= Our practice may charge a fee for the costs of copying, mailing, lab= or and supplies associated with your request.= Our practice may deny your request to inspect and/or copy in certain limited circumstances; however, you may request a review of our denial. Ano= ther licensed health care professional chosen by us will conduct reviews.
4. Amendment. You may ask us to amend your health
information if you believe it is incorrect or incomplete, and you may reque=
st
an amendment for as long as the information is kept by or for our
practice. To request an amend=
ment,
your request must be made in writing and submitted to
Samuel Armstrong =
(404) 289-4556
You must provide us with a reason that supports your r= equest for amendment. Our prac= tice will deny your request if you fail to submit your request (and the reason supporting your request) in writing. Also, we may deny your request if you ask us to amend information th= at is in our opinion: (a) accurate and complete; (b) not part of the IIHI kept= by or for the practice; (c) not part of the IIHI which you would be permitted = to inspect and copy; or (d) not created by our practice, unless the individual= or entity that created the information is not available to amend the informati= on.
5. Accounting of Disclosures. All of our patients have the right= to request an “accounting of disclosures.” An “accounting of disclosures” is a list of certain non-routine disclosures our practice has made of your IIHI for non-treatment or operations purposes. Use of your IIHI as part of the ro= utine patient care in our practice is not required to be documented. For example, the doctor sharing information with the nurse; or the billing department using your informatio= n to file your insurance claim. In= order to obtain an accounting of disclosures, you must submit your request in wri= ting
Samuel Armstrong =
(404) 289-4556
All requests for an “accounting of disclosures&#= 8221; must state a time period, which may not be longer than six (6) years from t= he date of disclosure and may not include dates before April 14, 2003. The first list you request within a 12-month period is free of charge, but our practice may charge you for additional lists within the same 12-month period. Our practice will notify you of the costs involved with additional requests, and you may withdraw your request before you incur any costs. <= /p>
6. Right to a Paper Copy of This Noti= ce. You are entitled to receive a pape= r copy of our notice of privacy practices. You may ask us to give you a copy of this notice at any time. To obtain a paper copy of this not= ice, contact
Samuel Armstrong =
(404) 289-4556
7. Right to File a Complaint. If you believe your privacy rights= have been violated, you may file a complaint with our practice or with the Secre= tary of the Department of Health and Human Services. To file a complaint with our pract= ice,
Samuel Armstrong =
(404) 289-4556
All complaints must be submitted in writing. You will not be penalized for filing a complaint.
8. Right to Provide an Authorization =
for
Other Uses and Disclosures. Our
practice will obtain your written authorization for uses and disclosures th=
at
are not identified by this notice or permitted by applicable law. Any authorization you provide to us
regarding the use and disclosure of your IIHI may be revoked at any time
Again, if you have any questions regarding this notice=
or
our health information privacy policies, please contact
Samuel Armstrong =
(404) 289-4556