| A. OUR COMMITMENT TO YOUR PRIVACY
Our practice is dedicated to maintaining the privacy of your individually identifiable health information (IIHI); otherwise, referred to as “Medical information”. In conducting our business, we will create records regarding you and the treatment and services we provide to you.
We are required by law to:
· make sure that medical information that identifies you is kept private
· provide you this notice of our legal duties and privacy practices with
respect to medical information about you
· follow the terms of the notice that is currently in effect.
WHO WILL FOLLOW THIS NOTICE.
This notice describes our practice’s privacy practices and that of:
· Any physician or health care professional authorized to enter information into
your medical chart.
· All departments and units of the practice.
· All employees, staff and other office personnel.
The terms of this notice apply to all records containing your medical information that are created or retained by our practice. We reserve the 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 practice will provide a copy of our current Notice upon patient request.
B. IF YOU HAVE QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT:
The Privacy Officer - Contact info listed below.
C. WE MAY USE AND DISCLOSE YOUR MEDICAL INFORMATION IN THE
FOLLOWING WAYS
The following categories describe different ways that we use and disclose medical information. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
Treatment. We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to the practice’s office personnel who are involved in taking care of you at the office or elsewhere. We also may disclose medical information about you to people outside our office who may be involved in your care after you leave the office, such as family members or others we use to provide services that are part of your care provided you have consented to such disclosure. These entities include third party physicians, hospitals, nursing homes, pharmacies or clinical labs with whom the office consults or makes referrals.
Payment. Our practice may use and disclose your medical information 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 medical information to obtain payment from third parties that may be responsible for such costs, such as family members. Also, we may use your medical information to bill you directly for services and items.
Health Care Operations. Our practice may use and disclose your medical information 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 medical information to evaluate the quality of care you received from us, or to conduct cost-management and business planning activities for our practice.
Appointment Reminders. Our practice may use and disclose your medical information to contact you and remind you of an appointment.
Treatment Options. Our practice may use and disclose your medical information to inform you of diagnostic results and/or potential treatment options or alternatives.
Health-Related Benefits and Services. Our practice may use and disclose your medical information to inform you of health-related benefits or services that may be of interest to you.
Release of Information to Family/Friends or Individuals Involved in Your Care or Payment for Your Care. With your written consent our practice may release your medical information to a friend or family member that is involved in your care, or who assists in taking care of you. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
Disclosures Required By Law. Our practice will use and disclose your medical information when we are required to do so by federal, state or local law.
To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
D. USE AND DISCLOSURE OF YOUR MEDICAL INFORMATION IN CERTAIN
SPECIAL CIRCUMSTANCES
The following categories describe unique scenarios in which we may use or disclose your identifiable health information:
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 disabilit
· notifying a person regarding potential exposure 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 information if the patient 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.
Health Oversight Activities. Our practice may disclose your medical information 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.
Lawsuits and Similar Proceedings. Our practice may use and disclose your medical information in response to a court or administrative order, if you are involved in a lawsuit or similar proceeding. We also may disclose your medical information 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.
Law Enforcement. We may release medical information 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
· About the victim of a crime if, under certain limited circumstances, we are unable
to obtain the person's agreement
· About a death we believe may be the result of criminal conduct
· About criminal conduct at the medical office
· In emergency circumstances to report a crime; the location of the crime or
victims; or the identity, description or location of the person who committed the
crime.
· To federal officials for intelligence and national security activities authorized by
law. We also may disclose your medical information to federal officials in order
to protect the President, other officials or foreign heads of state, or to conduct
investigations.
Deceased Patients. Our practice may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. If necessary, we also may release information to funeral directors as necessary to perform their duties.
Organ and Tissue Donation. Our practice may release your medical information 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.
Military. Our practice may disclose your medical information if you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate authorities.
Inmates. Our practice may disclose your medical information 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 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.
Workers’ Compensation. Our practice may release your medical information for workers’ compensation and similar programs.
YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION
All requests for the following must be in writing and addressed to:
Neil A. Patterson, M.D., P.A.
Privacy Officer
2984 Alafaya Trail Suite 2000
Oviedo, FL 32765
You have the following rights regarding the medical information that we maintain about you:
Right to Inspect and Copy. You have the right to inspect and copy medical information that may be used to make decisions about your care. If you request a copy of the information, you will be charged a fee for the costs of copying, mailing or other supplies associated with your request. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred. We may deny your request to inspect and copy in certain very limited circumstances.
Right to Amend. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the medical office. In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
· Was not created by us, unless the person or entity that created the information is
no longer available to make the amendment
· Is not part of the medical information kept by or for the medical office
· Is not part of the information which you would be permitted to inspect and copy
· Is accurate and complete.
Right to an Accounting of Disclosures. You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of medical information about you. Your written request must state a time period which may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a 12 month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Restrictions. You have the right to request a
restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend.
We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
In your written request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time.
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. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
F. OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.
G. CHANGES TO THIS NOTICE
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will provide a copy of the Notice upon patient request. The notice will contain on the first page, in the top right-hand corner, the effective date.
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