Notice of Privacy Regulations created as a result
of the Health Insurance Portability and Accountability Act of 1996
(HIPAA)
Susan DiNenna 2705 Dekalb Pike (610) 277-6400
C.
WE MAY
USE AND DISCLOSE YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION (IIHI)
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 a laboratory test (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 work for our practice - including,
but limited to, our doctors and nurses-may use or disclose your IIHI to
others who may assist in your care, such as your spouse, children or parents. Finally,
we may also disclose your IIHI to other health care providers for purposes
related to your treatment.
2.
Payment. Our practice may use or 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 benefits
(and for what range of benefits), and we may provide your insurer with
details regarding your treatment to determine if your insurer will cover,
or pay for, your treatment. We also
may use and disclose your IIHI to obtain payment from third parties that
may be responsible for such costs, such as family members. Also,
we may use your IIHI to bill you directly for services and items. We may disclose your IIHI to other health care
providers and entities to assist in their billing and collection efforts.
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. We may disclose your IIHI to other health careproviders
and entities to assist in their health care operations.
4.
Appointment
Reminders. Our practice may
use and disclose your IIHI to contact you and remind you about 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 Services. 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/Friends. Our
practice may release your IIHI to a friend or family member that is involved
in your care, or who assists in taking care of you. For example a parent or guardian may ask that
a babysitter may have access to this child's medical information.
8.
Disclosures
Required By Law. Our practice
will use and disclose your IIHI when we are required to do so by federal,
state or local law.
9.
Photographs. We will display a picture of a child on our
bulletin board when the parent or guardian has provided the picture to
us.
10.
Lab Results. Our practice will
use and disclose your IIHI when we leave a message at your home with the
result of a lab test (such as a throat culture).
D.
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 IIHI 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 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 potential abuse or neglect of an adult patient
(including domestic violence): however, we will only disclose this information
if the parent agrees or we are required or authorized by law to disclose
this information
·
Notifying your employer under limited circumstances
related primarily to workplace injury or illness or medical surveillance
2.
Health
Oversight Activities. Our practice
may disclose your IIHI to a health oversight agency for activities authorized
by law. Oversight activities can
include, for example, investigations, inspections, audits, surveys, licensure
and disciplinary actions: civil, administrative, and criminal procedures
or actions; or other activities necessary for the government to monitor
government programs, compliance with civil rights laws and the health care
system in general.
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 requested.
4.
Law Enforcement. We may release IIHI
if asked to do so by a law enforcement official:
·
Regarding a crime victim in certain situations, if
we are unable to obtain the person's agreement
·
Concerning a death we believe has resulted from criminal
conduct
·
Regarding criminal conduct in our offices
·
In response to a warrant, summons, court order, subpoena
or similar legal process
·
To identify/locate a suspect, material witness, 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
necessary, we also may release information in order for funeral directors
to perform their jobs.
6.
Organ
and Tissue Donation. Our practice
may release your IIHI to organizations that handle organ, eye or tissue
procurement or transplantation, 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 an Internal Review
Board or Privacy Board has determined that the waiver of your authorization
satisfies the following: (I) the use or disclosure involves no more than
a minimal risk to your privacy based on the following: (A) an adequate
plan to protect the identifiers from improper use and disclosure; (B) an
adequate plan to destroy the identifiers at the earliest opportunity consistent
with the research (unless there is a health or research justification for
retaining the identifiers or such retention is otherwise required by law);
and (C) adequate written assurances that the PHI will not be re-used or
disclosed to any other person or entity (except as required by law) for
authorized oversight of the research study, or for other research for which
the use or disclosure would otherwise be permitted; (ii) the research could
not practicably be conducted without access to use of the PHI.
8.
Serious
Threats to Health or Safety. 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.
Military. Our practice may disclose your IIHI if you
are a member of
10.
National
Security. Our practice may
disclose your IIHI to federal officials for intelligence and national security
activities by law. We may also disclose
your IIHI to federal officials in order to protect the President, other
officials or foreign heads of state, or to conduct investigations.
11.
Inmates. Our practice may disclose your IIHI to correctional
institutions or to law enforcement officials if you are an inmate or are
under custody of a law enforcement official. Disclosure for these purposes would 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. Our practice may
release your IIHI for workers' compensation and similar programs.
E.
YOUR RIGHTS
REGARDING YOUR IIHI You have the following rights regarding the IIHI that we
maintain about you:
1.
Confidential
Communications. You have
the right to request that our practice communicate with you about your
health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you
at home, rather than at work. In
order to request a type of confidential communication, you must make a
written request to Susan DiNenna (contact information on front page), specifying
the requested method of contact, or the location where you wish to be contacted. Our
practice will accommodate reasonable 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 or friends. We are
not required to agree to 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 necessary to treat you. In order to request a restriction in our use
or disclosure of your IIHI, you must make your request in writing to Susan
DiNenna. Your request must describe in a clear and concise fashion:
·
The information you wish restricted;
·
Whether you are requesting to limit our practice's
use, disclosure or both; and
·
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 request in writing to
Molly Gatto in order to inspect and/or obtain a copy of your IIHI. Our practice may charge a fee for the costs
of copying, mailing, labor 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. Another
licensed health 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 request an amendment
for as long as the information is kept by or for our practice. To request an amendment, your request must
be made in writing and submitted to Susan DiNenna. You must provide us
with a reason that supports your request for amendment. Our practice 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 that 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 information.
5.
Accounting
of Disclosures. All of
our patients have a 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, non-payment or non-operations purposes. Use of your IIHI as part of the routine 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 information to file
your insurance claim. In order to
obtain an accounting of disclosures, you must submit your request in writing
to Susan DiNenna. All requests for an "accounting of disclosures" must
state a time period, which may not be longer than six (6) years from the
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 request,
and you may withdraw your request before you incur any costs.
6.
Right
to a Paper Copy of This Notice. You are entitled to receive a
paper copy of our privacy practices.
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 Secretary of the Department of Health and Human Services. To
file a complaint with our practice, contact Susan DiNenna. 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 that 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 in writing.
9.
After
you revoke your authorization, we will no longer use or disclose your IIHI
for the reasons described in the authorization. Please note, we are required to retain records
of your care. Again, if you have any questions regarding this notice or
our health information privacy policies, please contact Susan DiNenna. Effective April 11, 2003
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