Notice of Privacy Practices Effective June 7, 2004
In order to comply with HIPAA’s Privacy Rule, it is the policy of this office to:
1. Distribute a Notice of Privacy Practices (NPP) to every patient at his or her first appointment, or similar encounter on or after June 7, 2004.
- The NPP to use is attached to this Policy. Only the privacy officer has authority to change this NPP.
- The receptionist is responsible to distribute the NPP.
- The receptionist must give the patient a copy of the NPP when checking in for an appointment.
- The receptionist must ask the patient to sign an acknowledgement of receipt of the NPP (“AOR”). The AOR to use is attached to this Policy. Put all signed AORs in the patient’s chart.
- If the patient opts not to sign the AOR, the receptionist must make a note of the fact that the patient was asked, and that the patient refused. Put this note in the patient’s chart.
- It is not necessary to give a NPP to a patient every time they come in after June 7, 2004 unless we change the NPP.
- At every patient encounter, the receptionist must look in the patient’s chart to determine if the patient has previously signed an AOR.
- If yes, it is not necessary to give that patient another NPP unless we have changed our NPP since the date of the AOR. Our most current NPP will always have an effective date on the front.
- If no, then it is necessary to distribute a NPP and ask for a signature on an AOR.
2. Post a copy of our NPP in Gilead Healing Center privacy guide.
3. Keep a stack of copies of the NPP with the receptionist so that patients and visitors can take one if they wish.
4. Redistribute our NPP as above whenever we change it.
5. We will use and disclose protected health information in a manner that is consistent with HIPAA and with our NPP. If we change our NPP, the revised NPP will apply to all protected health information that we have, not just protected health information that we generate or obtain after we have changed the NPP.
NOTICE OF PRIVACY PRACTICES
Contact Person: Barbara Norris
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSEDAND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS INFORMATION CAREFULLY.
We respect our legal obligation to keep health information that identifies you private. We are obligated by law to give you notice of our Privacy Policy Practices. This Notice describes how we protect your health information and what rights you have regarding it.
TREATMENT, PAYMENT AND HEALTH CARE OPTIONS
TREATMENT: The most common reason why we use or disclose your health information is for treatment, payment or health care options. Examples of how we use or disclose information for treatment purposes are: setting up an appointment for you, calling in prescription medications, or faxing them to be filled; referring you to another doctor, or clinic, or getting copies of your health information from another professional that you may have already seen.
PAYMENT: Examples of how we use or disclose your health information for payment purposes are, preparing and sending bills, and collecting unpaid amounts (either ourselves or through a collection agency or attorney).
HEALTHCARE OPERATIONS: “Health care operations” mean those administrative and managerial functions that we have to do in order to run our office. Examples of how we use or discloses your health information for health care operations are: financial or billing audits; internal quality assurance; personnel decisions, defense of legal matters, business planning and storage of our records.
OTHER PERMITTED AND REQUIRED USES AND DISCLOSURES
When a state of federal law mandates that certain health information be reported for a specific purpose;
For public health purposes, such as contagious disease reporting, investigation or surveillance; and notices to and from the Federal Food and Drug Administration regarding drugs or medical devices;
We may disclose protected health information to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose protected health information to a funeral director; as authorized by law, in order to permit the funeral director to carry out his/her duties. Protected health information may be used and disclosed for cadaveric organ, eye, or tissue donation purposes;
Disclosures to governmental authorities about victims of suspected abuse, neglect or domestic violence.
For Military Activity-When the appropriate conditions apply, we may disclose protected health information of individuals who are Armed Forces personnel;
Uses and disclosures such as for the licensing of doctors; for audits, or for the investigation of possible violations of health care laws;
Disclosures for judicial and administrative proceedings, such as in response to subpoenas or orders of courts or administrative agencies;
Disclosures for law enforcement purposes; such as to provide information about someone who is, or is suspected to be a victim of a crime; to provide information about a crime in our office; or to report a crime that has happened somewhere else;
Uses or disclosures for health related research;
Uses and disclosures to prevent a serious threat to health or safety;
Disclosures relating to worker’s compensation programs;
Disclosures of a “limited data set: for research, public health, or health care options;
Incidental disclosures that are an unavoidable by-product of permitted uses or disclosures;
Disclosures to “business associates” who perform health care operations for us; and who commit to respect the privacy of your health information.
To others involved in your healthcare-Unless you object, we may disclose to a member of your family; a relative, a close friend, or any other person YOU IDENTIFY, your protected health information that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We may use or disclose protected health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care, general condition or death. If you are not present or able to agree or object to the use of disclosure of the protected health information, then your physician may use professional judgment; determine whether the disclosure is in your best interest. In this case, only the protected health information that is relevant to your health care will be disclosed.
APPOINTMENT REMINDERS
We may call, or leave a message, or write, to remind you of scheduled appointments, or that it is time to make an appointment. We may leave you a reminder message on your home answering machine or with someone who answers your phone if you are not home. We may also call or write to notify you of other treatments or services available at our office that might help you.
OTHER USES AND DISCLOSURES
We will not make any other uses of disclosures of your health information unless you sign a written “authorization form.” The content of an “authorization form” is determined by federal law. Sometimes, we may initiate the authorization process if the use of disclosure is our idea. Sometimes you may initiate the process if it is your idea for us to send your information to someone else. Typically in this situation, you will give us a properly completed authorization form, or you can use one of ours.
If we initiate the process and ask you to sign an authorization for, you do not have to sign it. If you do not sign the authorization, we cannot make the use or disclosure. If you do sign one, you may revoke it at any time unless we have already acted in reliance upon it. Revocations must be in writing. Send this information to the office contact person named at the beginning of this Notice.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
The law gives you many rights regarding your health information. You can:
Ask us to restrict our uses and disclosures for purposes of treatment (except emergency treatment), payment or health care operations. We do not have to agree to do this, but if we agree, we must honor the restrictions that you want. To ask for a restriction, send a written request to the office contact person at the address, or fax at the beginning of this Notice.
Ask us to communicate with you in a confidential way, such as phoning you at work rather than at home, by mailing health information to a different address, or by using email to your personal email address. We will accommodate these requests if they are reasonable, and if you pay us for any additional cost. If you want to ask for confidential communication, send a written request to the office contact person at the address, or fax at the beginning of this Notice.
Ask to see or get photocopies of your health information. By law, there are a few limited situations in which we can refuse to permit access of copying. For the most part, however, you will be able to review or have a copy of your health information within 30 days of asking us (or 60 days if the information is stored off site). You may have to pay for photocopies in advance. If we deny your request, we will send you a written explanation, and instructions about how to get an impartial review of our denial if one is legally available. By law, we can have one 30-day extension of the time for us to give you access of photocopies if we send you a written notice of the extension. If you want to review or get photocopies of your health information send a written request to the office contact person at the address, or fax shown at the beginning of this Notice.
Get a list of the disclosures that we have made of your health information within the past six years (or a shorter period if you want). By law, the list will not include: disclosures for purposes of treatment, payment or health care operations; disclosures with your authorization; incidental disclosures, disclosures required by law; and some other limited disclosures. You are entitles to one such list per year without charge. If you want more frequent list, you will have to pay for them in advance. We will usually respond to your request within 60 days of receiving it, but by law we can have one 30-day extension of time if we notify you of the extension in writing. If you want a list, send a written request to the office contact person at the address, fax or E-mail show at the beginning of this Notice.
OUR NOTICE OF PRIVACY PRACTICES
By law, we must abide by the terms of this Notice of Privacy Practice until we choose to change it. We reserve the right to change this notice at any time as allowed by law. If we change this Notice, the new privacy practices will apply to your health information that we already have as well as to such information that we may generate in the future. If we change our Notice of Privacy Practices, we will post the new notice in our office, have copies available in our office.
COMPLAINTS
If you think that we have not properly respected the privacy of your health information, you are free to complain to the U.S. Department of Health and Human Services Office or us for Civil Rights. We will not retaliate against you if you make a complaint. If you want to complain to us, send a written complaint to the office contact person at the address, fax or E-mail shown at the beginning of the Notice. If you prefer, you can discuss your complaint in person or by phone. Effective 7/6/04
|
