HIPAA Privacy Notice
DESCRIBES HOW YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED AND
HOW YOU CAN GET ACCESS TO THIS INFORMATION
PLEASE REVIEW IT CAREFULLY
OUR DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION
We are required by applicable state and federal law to
maintain the privacy of your health information. We are also required to give you this
Notice about our privacy practices, our legal duties, and your rights concerning your
health information. We reserve the right to make changes in our privacy practices and
change the terms of our Notice effective for all health information we maintain, create or
receive. Before we make a significant change in our privacy practices, we will change this
Notice and make the new Notice available.
We reserve the right to change our private practices and
the terms of this Notice at any time, provided such changes are permitted by applicable
law. We reserve the right to make the changes in our privacy practices and the new terms
of our Notice effective for all health information that we maintain, including health
information we received or created before we made the changes. Before we make a
significant change in our privacy practices, we will change this Notice and make the new
notice available upon request.
You may request a copy of our Notice at any time. For
more information about our privacy practices please contact us using the information at
the end of this Notice.
USES AND DISCLOSURES OF PROTECTED HEALTH IFORMATION
Your Protected Health Information (PHI) is the
information we create and obtain in providing our services to you and includes all
"individually identifiable health information."
We may use and disclose your (PHI) for treatment,
payment, and healthcare operations:
Treatment: We may use or disclose your (PHI) to a
physician or other healthcare provider providing treatment to you. We may also use or
disclose your (PHI) to provide or receive a referral from another healthcare provider.
Payment: We may use and disclose your (PHI) to
obtain payment for services provided to you, for example: to insurance companies or
Medicare, on a super bill with diagnosis and charge or to insurers to get treatment,
authorizations and referrals.
Healthcare Operations: We may use and disclose
your (PHI) in connection with our healthcare operations. Healthcare Operations may
include: quality assessment and improvement activities, reviewing the competence or
qualifications of healthcare professionals, evaluating practitioner and provider
performance, conducting training programs, accreditation, certification, licensing or
Your Authorization: In addition to our use of your
(PHI) for treatment, payment or healthcare operations, you may give us written
authorization to use your (PHI) or to disclose it to anyone for any purpose. If you give
us an authorization, you may revoke it in writing at any time. Your revocation will not
affect any use or disclosures permitted by your authorization while it was in effect,
unless you give us a written authorization. We cannot use or disclose your (PHI) for any
reason except those described in this Notice.
To Your Family and Friends: We must disclose your
health information to a family member, friend or other person to the extent necessary to
help with your healthcare or with payment for your healthcare, but only if you agree that
we may do so.
Persons Involved with Care: We may use or disclose
health information to notify, or assist in the notification of a family member, your
personal representative or another person responsible for your care. If you are present,
then prior to such use or disclosure of your health information, we will provide you with
an opportunity to object to such uses or disclosures. In the event of your incapacity or
in emergency circumstances, we will disclose health information based on a determination
using our professional judgment and using only health information that is directly
relevant to the persons involvement in your healthcare. We will also use our
professional judgment and our experience with common practice to make reasonable
inferences in your best interest in allowing a person to pick up prescriptions, medical
supplies, x-rays, or other similar forms of health information.
Required by Law: We may use or disclose your (PHI)
when we are required to do so by law. Examples: disclosures regarding victims of abuse or
neglect, health oversight to avert serious threats to health or safety, for judicial and
administrative proceedings and the like.
Research, Public Health or Healthcare Operations: We
may rely on professional ethics and best judgments in deciding which of these permissive
uses and disclosures to make.
Appointment Reminders: We may use or disclose your
(PHI) to provide you with appointment reminders (such as voicemail messages, postcards, or
letters, etc.) unless otherwise directed by you.
Access: You have the right to look at or get copies
of your (PHI), with limited exceptions. You may request that we provide copies in a format
other than photocopies. We will use the format you request unless we cannot practicably do
so. We will charge a cost based fee for providing your PHI in that format.
Disclosure Accounting: You have the right to
receive a list of circumstances in which we or our business associates disclosed your
health information for purposes other than treatment, payment or healthcare operations and
certain other activities, for the last 6 years, but not before April 14, 2003. If you
request this accounting more than once in a 12-month period, we may charge you a
reasonable cost-based fee for responding to these additional requests.
Restriction: You have the right to request that we
place additional restrictions on our use or disclosure of your PHI but if we do we will
abide by our agreement(except in an emergency).
Alternative Communication: You have the right to
request that we communicate with you about your health information by alternative means or
to alternative locations. You must make your request in writing. Your request must specify
how and where communication should be made.
Right to Amend: If you believe that there is a
mistake or missing information in our record of your (PHI) you may request that we add or
correct the record. Your request must be in writing, and must explain why the
information should be amended. It is in our discretion as to whether we will deny or
approve your request. Any denial will state the reasons for the denial. If approved the
changes will be made and you will be informed of such changes.
Electronic Notice: You may receive this
Notice on our website or by electronic mail (e-mail), you are also entitled to receive
this Notice in written form.
QUESTIONS AND COMPLAINTS
If you have any questions, concerns, or complaints about
your privacy rights you should direct your comments in writing to:
Attn: Practice Manager, HIPAA
Arthritis & Rheumatic Care Center
6141 Sunset Drive, Suite 501
Phone: (305) 661-6615
Fax: (305) 661-6619
You may also submit a written complaint to the
Secretary of the U.S Department of Health and Human Services at the Office of Civil
Rights. We support your right to the privacy of your PHI. We will take no retaliatory
action against you if you make such complaints.