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HIPAA MEDICAL LAW IMPORTANT
Always Your Choice Medical Office Notice of Privacy Practices Effective Date: April 14, 2003
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.
PLEASE ALL PATIENTS READ THIS
For More Information, Please Contact Us:
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This Notice describes the privacy practices of Always Your Choice Medical Office and the privacy practices of:
- All of our doctors, nurses, and other health care professionals authorized to enter information about you into your medical chart.
- All of our departments, including, e.g., our medical records and billing departments.
- Our health center site Always Your Choice Medical Office.
- All of our employees, staff, volunteers and other personnel who work for us or on our behalf.
We Pledge: We understand that health information about you and the health care you receive is personal. We are committed to protecting your personal health information. When you receive treatment and other health care services from us, we create a record of the services that you received. We need this record to provide you with quality care and to comply with legal requirements. This notice applies to all of our records about your care, whether made by our health care professionals or others working in this office, and tells you about the ways in which we may use and disclose your personal health information. This notice also describes your rights with respect to the health information that we keep about you and obligations that we have when we use and disclose your health information.
We are required by law to:
- Make sure that health information that identifies you is kept private in accordance with relevant law.
- Give you this notice of our legal duties and privacy practices with respect to your personal health information.
- Follow the terms of the notice that is currently in effect for all of your personal health information.
We may use and disclose your personal health information for these purposes:
For Treatment We may use health information about you to provide you with health care treatment or services. We may disclose health information about you to the doctors, nurses, technicians, medical students and others who are involved in your care. They may work at the Health Center, at the hospital if you are hospitalized under our supervision, or at another doctor's office, lab, pharmacy or other health care provider to whom we may refer you for treatment, consultation, x-rays, lab tests, prescriptions or other health care services. They may also include doctors and other health care. for example, we may consult with a specialist who lends his/her to the Health Center about your care or disclose to an emergency room doctor who is treating you for a broken leg that have diabetes, because diabetes may affect your body's healing process.
For Payment We may use and disclose health information about you to bill and collect payment from you, your insurance company, including medicaid and medicare, or other third party that may be available to reimburse us for some or all of your health care. We may also disclose health information about you to other health care providers or to your health plan so that they can arrange for payment relating to your care. For example, if you have health insurance, we may need to share information about your office visit with your health plan in order for your treatment that you need to obtain your health plan's prior approval or to determine whether your will cover the treatment.
For Health Care Operations We may use and disclose health information about you for our day-to-day operation, and may disclose information about you to other health care providers involved in your care or to your health plan for use in their day-to-day operations. These uses and disclosures are necessary to run the Health Center and to make sure that all of our patients receive quality care, and to assist other providers and health plans in doing so as well. For example, we may use health information to review the services that we provide and to evaluate performance of our staff in caring for you. We may also combine health information about our patients with health information from other health care providers to decide what additional services the Health Center should offer, what services are not needed, whether new treatments are effective or to compare how we are doing with others and to see where we can make improvements. We may remove information that identifies you from this set of health information so others may use it to study health care delivery without learning who our patients are.
Appointment reminder We may use and disclose health information about you to contact you as a reminder that you have and appointment at the office.
Health Related Services and Treatment Alternatives We may use and disclose health information to tell you about health related services or recommend treatment options or alternatives that may be of interest to you. Please let us know if you do not wish for us to contact you with this information, or if you wish for us to use a different address when sending this information to you.
Individuals Involved In Your Care or Payment for Your Care We may release health information about you to a friend or family member who is involved in your health care or the person who helps pay for your care.
As Required By Law We will disclose health 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 health information when necessary to prevent a serious threat to your health and safety of the public or another person. Any about you disclosure, however, would only be to someone able to prevent the threat.
Military and Veterans If you are a member to the armed forces or separated/discharged from military services, we may release health information about you as required by military command authorities or the Department of Veterans Affairs as may be applicable. We may also release health information about foreign military personnel to the appropriate foreign military authorities.
Workers' Compensation We may release health information about you for workers' compensation or similar programs. These programs provide benefits for work - related injuries or illness.
Public Health Activities We may disclose health information about you for public health activities. The activities generally include the following:
- 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.
- 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.
- 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 health information about you to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, and inspections and licensure. These activities are necessary for the government to monitor the health care system, government and compliance with civil rights laws.
Law and Disputes We may disclose health information about you in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request or the lawful process that is not accompanied by a court or administrative order, 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 health information about you 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.
- Under certain limited circumstances, about the victim of a crime.
- About a death we believe may be the result of criminal conduct.
- About criminal conduct at Always Your Choice Medical Office.
- In emergency circumstances to report a crime, the location of the crime victims, or the identity, description or location of the person who committed the crime.
Coroners, Health Examiners and Funeral Directors We may release health information about patients to a coroner or health examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release health information to funeral directors as may be necessary
National Security and Intelligence Activities We may release health 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 health 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 health information about you to the corrections 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: You have certain rights with respect to your personal health information. This section of our notice describes your rights and how to exercise them:
Right to Inspect and Copy: You have the right to inspect and copy the personal health information in your medical and billing records, or in any other group.
Complaints: If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. You may file a complaint by mailing or faxing us a written description of your complaint or by telling us about your complaint in person or over the telephone:
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Please describe what happened and give us the dates and names of anyone involved. Please also let us know how to contact you so that we can respond to your complaint. You will not be penalized for filing a complaint.
Other Uses and Disclosures of Your Protected Health Information:
Other uses and disclosures of personal health information not covered by this notice or applicable law will be made only with your written authorization. If your give us your written authorization to use or disclose your personal health information, you may revoke your authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose your personal health information for the reasons covered by your written authorization. You understand that we are unable to take back any uses and disclosures that
we have already made with your authorization, and that we are required to retain our records of the care that we have provided to you.