PRIVACY
POLICY
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.
A federal
regulation, known as the "HIPAA Privacy Rule," requires that we provide
detailed notice in writing of our privacy practices. The HIPPA Rule
requires us to address many specific things in this Notice.
I.
OUR COMMITMENT TO PROTECTING HEALTH INFORMATION ABOUT YOU.
In this
Notice, we describe the ways that we may use and disclose health information
about our patients. The HIPAA Privacy Rule requires that we protect
the privacy of health information that identifies a patient, or where
there is a reasonable basis to believe the information can be used
to identify a patient. This information is called "protected health
information" or "PHI." This Notice describes your rights as our patient
and our obligations regarding the use and disclosure of PHI. We are
required be law to:
A.
Maintain the privacy of the PHI about you:
B. Give you this Notice of our legal duties and privacy practices
with respect to PHI; and
C. Comply with the terms of our Notice of Privacy Practices
that is currently in effect.
We
reserve the right to make changes to the Notice and to make such changes
effective for all PHI we may already gave about you. If and when this
Notice is changed, we will post a copy in our office in a prominent
location. We will also provide you with a copy of the revised Notice
upon your request made to our Privacy Official.
II.HOW
WE MAY USE AND DISCLOSE PROTECTED HEALTH INFORMATION ABOUT YOU
A.
Treatment: We may use and disclose PHI about you to provide, coordinate
or manage your health care and related services. We may consult with
other health care providers regarding your treatment and coordinate
an manage your health care with others. We may also disclose PHI about
you for the treatment activities of another health care provider.
B. Payment: We may use and disclose PHI so that we can bill
and collect payment for the treatment and services provided to you.
Before providing treatment or services we may share details with your
health plan concerning the services you are scheduled to receive.
We may use and disclose PHI to find out if your health plan will cover
the cost of care and services we provide. We may use and disclose
PHI to confirm you are receiving the appropriate amount of care to
obtain payment for services. We may use and disclose PHI for billing,
claims management, and collection activities. We may disclose PHI
to insurance companies providing you with additional coverage. We
may disclose limited PHI to consumer reporting agencies relating to
collection of payments owed to us. We may also disclose PHI to another
health care provider or to a company or health plan required to comply
with the HIPAA Privacy Rule for the payment activities of that health
care provider, company or health plan.
C. Health Care Operations: We may use and disclose PHI in performing
business activities which are called health care operations. Health
care operations include doing things that allow us to improve the
quality of care we provide and to reduce health care costs. We may
use and disclose PHI about you in the following health care operations:
-Reviewing
and improving the quality, efficiency and cost of care that we provide
to our patients.
-Improving health care and lowering costs for groups of people who
have similar health problems and helping to manage and coordinate
the care for these groups of people. We may use PHI to identify
groups of people with similar health problems to give them information,
for instance, about treatment alternatives, and educational classes.
-Reviewing and evaluating the skills, qualifications, and performance
of health care providers taking care of you and our other patients.
-Providing training programs for students, trainees, health care
providers, or non-health care professionals to help them practice
or improve their skills.
-Cooperating with outside organizations that assess the quality
of the care that we provide.
-Cooperating with various people who review our activities. For
example, PHI may be seen by doctors reviewing the services provided
to you, and by accountants, lawyers, and others who assist us in
complying with the law and managing our business.
-Assisting us in making plans for our practice's future operations.
-Reviewing our activities and using or disclosing PHI in the event
that we sell our practice to someone else or combine with another
practice.
-Business management and general administrative activities of our
practice, including managing our activities related to complying
with the HIPAA Privacy Rule and other legal requirements.
D.
Communication From Our Office: We may contact you to remind you
of appointments and to provide you with information about treatment
alternatives or other health care related benefits and services that
may be of interest to you.
OTHER
USES AND DISCLOSURES WE CAN MAKE WITHOUT YOUR WRITTEN AUTHORIZATION.
We may
use and disclose PHI about you in some situations where you have the
opportunity to agree or object to certain uses and disclosures of
PHI about you. If you do not object, then we may make these types
of uses and disclosures of PHI.
-Individuals
involved in your care and payment for your care: We may disclose
PHI about you to your family member, close friend, or any other
person identified by you if that information is directly relevant
to the person's involvement in your care or payment of your care.
If you are present and able to consent or object (or if you are
available in advance), then we may only use or disclose PHI if you
do not object after you have been informed of your opportunity to
object. If you are not present or you are unable to consent or object,
we may exercise professional judgment in determining whether the
use or disclosure of PHI is in your best interests. We may also
use and disclose PHI to notify such persons of your location, general
condition, or death. We may also coordinate with disaster relief
agencies to make this type of notification. We also may use professional
judgment and our experience with common practice to make reasonable
decisions about your best interests in allowing a person to act
on your behalf.
OTHER
USES AND DISCLOSURES WE CAN MAKE WITHOUT YOUR WRITTEN AUTHORIZATION
OR OPPORTUNITY TO AGREE OR OBJECT
We may
use and disclose PHI about you in the following circumstances without
your authorization or opportunity to agree or object, provided that
we comply with certain conditions that may apply.
Required
By Law: We may use and disclose PHI as required by federal, state,
or local law. Any disclosure complies with the law and is limited
to the requirements of the law.
Public Health Activities: We may use or disclose PHI to public
health authorities or other authorized persons to carry out certain
activities related to public health, including the following activities:
-To
prevent or control disease, injury, or disability;
-To report disease, injury, birth, or death;
-To report child abuse or neglect;
-To report reactions to medications or problems with products or
devices regulated by the federal Food and Drug Administration or
other activities related to qualify, safety, or effectiveness of
FDA
-regulated products or activities;
-To locate and notify persons of recalls of products they may be
using;
-To notify a person who may have been exposed to a communicable
disease in order to control who may be at risk of contracting or
spreading the disease; or
-To report to your employer, under limited circumstances, information
related primarily to workplace injuries or illness, or workplace
medical surveillance.
Abuse,
Neglect, or Domestic Violence: We may disclose PHI in certain
cases to proper government authorities if we reasonably believe that
a patient has been a victim of domestic violence, abuse, or neglect.
Health
Oversight Activities: We may disclose PHI to a health oversight
agency for oversight activities including, for example, audits, investigations,
inspections, licensure and disciplinary activities and other activities
conducted by health oversight agencies to monitor the health care
system, government health care programs, and compliance with retain
laws.
Lawsuits
and Other Legal Proceedings: We may use or disclose PHI when required
by a court or administrative tribunal order. We may also disclose
PHI in response to subpoenas, discovery requests, or other required
legal process when efforts have been made to advise you of the request
or to obtain an order protecting the information requested.
Law
Enforcement: Under certain conditions, we may disclose PHI to
law enforcement officials for the following purposes where the disclosure
is:
-About
a suspected crime victim if, under certain limited circumstances,
we are unable to obtain a person's agreement because of incapacity
or emergency;
-To alert law enforcement of a death that we suspect was the result
of criminal conduct;
-Required by law;
-In response to a court order, warrant, subpoena, summons, administrative
agency request, or other authorized process;
-To identify or locate a suspect, fugitive, material witness, or
missing person;
-About a crime or suspected crime committed at our office; or
-In response to a medical emergency not occurring at the office,
if necessary to report a crime, including the nature of the crime,
the location of the crime or the victim, and the identity of the
person who committed the crime.
Coroners,
Medical Examiners, Funeral Directors: We may disclose PHI to a
coroner or medical examiner to identify a deceased person and determine
the cause of death. In addition, we may disclose PHI to funeral directors,
as authorized by law, so that they may carry out their jobs.
Organ
and Tissue Donation: If you are an organ donor, we may use or
disclose PHI to organizations that help procure, locate, and transplant
organs in order to facilitate an organ, eye, or tissue donation and
transplantation.
Research:
We may use and disclose PHI about you for research purposes under
certain limited circumstances. We must obtain a written authorization
to use and disclose PHI about you for research purposes except in
situations where a research project meets specific, detailed criteria
established by the HIPAA Privacy Rule to ensure the privacy of PHI.
To
Avert a Serious Threat to Health or Safety: We may use or disclose
PHI about you in limited circumstances when necessary to prevent a
threat to the health or safety of a person or to the public. This
disclosure can only be made to person who is able to help prevent
the threat.
Specialized
Government Functions: Under certain circumstances we may disclose
PHI;
-For
certain military and veteran activities, including determination
of eligibility for veterans for veterans benefits and where deemed
necessary by military command authorities;
-For national security and intelligence activities;
-To help provide protective services for the president and others;
-For the health or safety of inmates and others at correctional
institutions or other law enforcement custodial situations for the
general safety and health related to corrections facilities.
Disclosures
required by HIPAA Privacy Rule: We are required to disclose PHI
to the Secretary of the United States Department of Health and Human
Services when requested by the Secretary to review our compliance
with the HIPAA Privacy Rule. We are also required in certain cases
to disclose PHI to you upon your request to access PHI or for an accounting
of certain disclosures of PHI about you (those requests are described
in Section III of this Notice).
OTHER
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION REQUIRE YOUR
AUTHORIZATION
Workers'
Compensation: We may disclose PHI as authorized by workers' compensation
laws or other similar programs that provide benefits for work-related
injuries or illness.
OTHER
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION REQUIRE YOUR
AUTHORIZATION
All other
uses and disclosures of PHI about you will only be made with your
written authorization. If you have authorized us to use or disclose
PHI about you, you may revoke your authorization at any time, except
to the extent we have taken action based on the authorization.
II.
YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION ABOUT YOU
Under
federal law, you have the following rights regarding PHI about you:
Right
to Request Restrictions: You have the right to request additional
restrictions on the PHI that we may use for treatment, payment, and
health care operations. You may also request additional restriction
on our disclosure of PHI to certain individuals involved in your care
that otherwise are permitted by the Privacy Rule. We are not required
to agree to your request. If we do not agree to your request, we are
required to comply with our agreement except in certain cases, including
where the information is needed to treat you in the case of an emergency.
To request restrictions, you must make your request in writing to
our Privacy Official. In your request, please include (1) the information
that you want to restrict; (2)how you want to restrict the information;
and (3) to whom you want those restrictions to apply.
Right
to Receive Confidential Communications: You have the right to
request that you receive communications regarding PHI in a certain
manner or at a certain location. You must make your request in writing
to our Privacy Official. You must specify how you would like to be
contacted. We are required to accommodate reasonable requests.
Right
to Inspect and Copy: You have the right to request the opportunity
to inspect and receive a copy of PHI about you in certain records
that we maintain. This includes your medical and billing records but
does not include psychotherapy notes or information gathered or prepared
for a civil, criminal, or administrative proceeding. We may deny your
request to inspect or copy PHI only in limited circumstances. To inspect
and copy PHI please contact our Privacy Official. If you request a
copy of PHI about you, we may charge you a reasonable fee for the
copying, postage, labor and supplies used in meeting your request.
Right
to Amend: You have the right to request that we amend PHI about
you as long as such information is kept by or for our office. To make
this type of request you must submit you request in writing to our
Privacy Official. You must also give us a reason for your request.
We may deny your request in certain cases, including if it is not
in writing or if you do not give us a reason for the request.
Right
to Receive an Accounting of Disclosures: You have the right to
request an "accounting" of certain disclosures that we have made of
PHI about you. This is a list of disclosures made by us during a specified
period of up to six years other than disclosures made: for treatment,
payment, and health care operations; for use in our related to facility
directory; to family members or friends involved in your care; to
you directly; pursuant to an authorization of you or your personal
representative, or for certain notification purposes (including national
security, intelligence, correctional, and law enforcement purposes)
and disclosures made before April 14, 2003. If you wish to make such
a request, please contact our Privacy Official identified on the last
page of the Notice. The first list that you request in a 12-month
period will be free, but we may charge you for our reasonable costs
of providing additional lists in the same 12-month period. We will
tell you about these costs, and you may choose to cancel your request
at any time before costs are incurred.
Right
to a Paper Copy of this Notice: You have a right to receive a
paper copy of this Notice at any time. You are entitled to a paper
copy of the Notice even if you have previously agreed to receive the
Notice electronically. To obtain a paper copy of the Notice, please
contact our Privacy Official listed on the last page of the Notice.
IV.
COMPLAINTS
If you
believe your privacy rights have been violated, you may file a complaint
with us or the Secretary of United States Department of Health and
Human Services. To file a complaint with our office, please contact
our Privacy Official at the address and number listed below. We will
not take action against you for filing a complaint.
V.
QUESTIONS
If you
have questions about this Notice, please contact our Privacy Official
at the address and telephone number listed below.
VI.
PRIVACY OFFICIAL CONTACT INFORMATION
You may
contact our Privacy Official at the following address and phone number:
Lisa
Hamilton, Privacy Official
1400 Highway 61, Suite 230
Festus, MO 63028
This
notice was published and first became effective on April 14, 2003.
Premier
Surgical Associates
1400 Highway 61, Suite 230
Festus, MO 63028
Phone: (636) 937-6601
Fax: (636) 931-6619
Toll Free: 1-800-858-2488
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