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HOW
WE MAY USE AND DISCLOSE INFORMATION ABOUT YOU
We may use and
disclose personal and identifiable health
information about you for a variety of purposes. All of
the types of uses and disclosures of information
are described below, but not every use or
disclosure in a category is listed.
Required
Disclosures. We are required to disclose health
information about you to the Secretary of Health
and Human Services, upon request, to determine our
compliance with HIPAA and to
you, in accordance with your right to access and
right to receive an accounting of
disclosures, as described below.
For Treatment. We
may use health information about you in your
treatment. For example, we may use
your medical history, such as any presence or
absence of diabetes, to assess
the health of your body.
For Payment. We may
use and disclose health information about you to
bill for our services and to
collect payment from you or your insurance
company. For example, we may need to give a
payer information about your current medical
condition so that it will pay us for the examinations or other services that we have
furnished you. We may also need to inform
your payer of the treatment you are going to
receive in order to obtain prior
approval or to determine whether the service is
covered.
For Health Care
Operations. We may use and disclose information
about you for the general operation
of our business. For example, we sometimes arrange
for auditors or other consultants
to review our practices, evaluate our operations,
and tell us how to improve our
services. Or, for example, we may use and disclose
your health information to
review the quality of services provided to you.
Public Policy Uses
and Disclosures. There are a number of public
policy reasons why we may disclose
information about you which are described below.
We may disclose
health information about you when we are required
to do so by federal, state, or
local law.
We may disclose
protected health information about you in
connection with certain public health reporting
activities.
We may disclose
protected health information about you in
connection with certain public health reporting
activities. For instance, we may disclose such
information to a public health authority
authorized to collect or receive PHI for the
purpose of preventing or controlling
disease, injury or disability, or at the direction
of a public health authority, to an official of a
foreign government agency that is acting in
collaboration with a public health authority.
Public health authorities include state health
departments, the Center for Disease Control,
the Food and Drug Administration, the Occupational
Safety and Health Administration and
the Environmental Protection Agency, to name a
few.
We are also
permitted to disclose protected health information
to a public health authority or other government
authority authorized by law to receive reports of
child abuse or neglect.
Additionally we may disclose protected health
information to a person subject to the Food and
Drug Administration’s power for the following
activities: to report adverse events, product
defects or problems, or biological product
deviations; to track products; to enable product
recalls; repairs or replacements; to conduct post
marketing surveillance. We
may also disclose a patient’s health information
to a person who may have been exposed
to a communicable disease or to an employer to
conduct an evaluation relating
to medical surveillance of the workplace or to
evaluate whether an individual has a
work-related illness or injury.
We may disclose a
patient’s health information where we reasonably
believe a patient is a victim of abuse,
neglect or domestic violence and the patient
authorizes the disclosure or it is required
or authorized by law.
We may disclose
health information about you in connection with
certain health oversight activities of
licensing and other health oversight agencies
which are authorized by law.
Health oversight
activities include audit, investigation,
inspection, licensure or disciplinary
actions, and civil, criminal, or administrative
proceedings or actions or any
other activity
necessary for the oversight of 1) the health care
system, 2) governmental benefit programs
for which health information is relevant to
determining beneficiary eligibility, 3)
entities subject to governmental regulatory
programs for which health information is
necessary for determining compliance with program
standards, or 4) entities subject to
civil rights laws for which health information is
necessary for determining
compliance.
We may disclose
your health information as required by law,
including in response to a warrant, subpoena,
or other order of a court or administrative
hearing body or to assist law enforcement
identify or locate a suspect, fugitive, material
witness or missing person. Disclosures
for law enforcement purposes also permit use to
make disclosures about victims of
crimes and the death of an individual, among
others.
We may release a
patient’s health information (1) to a coroner or
medical examiner to identify a deceased
person or determine the cause of death and (2) to
funeral directors.
We also may release
your health information to organ procurement
organizations, transplant centers,
and eye or tissue banks, if you are an organ
donor.
We may release your
health information to workers’ compensation or
similar programs, which provide
benefits for work-related injuries or illnesses
without regard to fault.
Health information
about you also may be disclosed when necessary to
prevent a serious threat to
your health and safety or the health and safety of
others.
We may use or
disclose certain health information about your
condition and treatment for research purposes
where an Institutional Review Board or a similar
body referred to as a Privacy Board
determines that your privacy interests will be
adequately protected in the study. We may also
use and disclose your health information to
prepare or analyze a research protocol
and for other research purposes.
If you are a member
of the Armed Forces, we may release health
information about you for activities
deemed necessary by military command authorities.
We also may release health information
about foreign military personnel to their
appropriate foreign military authority.
We may disclose
your protected health information for legal or
administrative proceedings that
involve you. We may release such information upon
order of a court or administrative
tribunal. We may also release protected health
information in the absence of such an order
and in response to a discovery or other lawful
request, if efforts have been made to notify
you or secure a protective order.
If you are an
inmate, we may release protected health
information about you to a correctional
institution where you are incarcerated or to law
enforcement officials in certain situations
such as where the information is necessary for
your treatment, health or safety, or the
health or safety of others.
Finally, we may
disclose protected health information for national
security and intelligence
activities and for the provision of protective
services to the President of the United States and
other officials or foreign heads of state.
Our Business
Associates. We sometimes work with outside
individuals and businesses that help us
operate our business successfully. We may disclose
your health information to
these business associates so that they can perform
the tasks that we hire them to do. Our
business associates must promise that they will
respect the confidentiality of
your personal and identifiable health information.
Disclosures to
Persons Assisting in Your Care or Payment for Your
Care. We may disclose
information to individuals involved in your care
or in the payment for your care.
This includes
people and organizations that are part of your
"circle of care" -- such as your spouse, your
other doctors, or an aide who may be providing
services to you. We may also use and
disclose health information about a patient for
disaster relief efforts and to notify persons
responsible for a patient’s care about a
patient’s location, general condition or death.
Generally, we will obtain your verbal agreement
before using or disclosing health
information in this way. However, under certain
circumstances, such as in an emergency
situation, we may make these uses and disclosures
without your agreement.
Appointment
Reminders. We may use and disclose medical
information to contact you as a reminder that
you have an appointment or that you should
schedule an appointment.
Treatment
Alternatives. We may use and disclose your
personal health information in order to tell you
about or recommend possible treatment options,
alternatives or health related services that may
be of interest to you.
Marketing
Information. We may use and disclose your personal
health information in order to tell you
about media items related to our practice that may
be of interest to you.
OTHER
USES AND DISCLOSURES OF PERSONAL INFORMATION
We are required to
obtain written authorization from you for any
other uses and disclosures of medical information
other than those described above. If you provide
us with such permission, you may
revoke that permission, in writing, at any time.
If you revoke your permission, we will
no longer use or disclose personal information
about you for the reasons covered by your
written authorization, except to the extent we
have already relied on your original
permission.
INDIVIDUAL
RIGHTS
You have the right
to ask for restrictions on the ways we use and
disclose your health information for
treatment, payment and health care operation
purposes. You may also request that we
limit our disclosures to persons assisting your
care or payment for your care.
We will consider
your request, but we are not required to accept
it.
You have the right
to request that you receive communications
containing your protected health information
from us by alternative means or at alternative
locations. For example, you may ask that we
only contact you at home or by mail.
Except under
certain circumstances, you have the right to
inspect and copy medical, billing and other records
used to make decisions about you. If you ask for
copies of this information, we may
charge you a fee for copying and mailing.
If you believe that
information in your records is incorrect or
incomplete, you have the right to ask us to correct
the existing information or add missing
information. Under certain circumstances, we
may deny your request, such as when the
information is accurate and complete.
You have a right to
receive a list of certain instances when we have
used or disclosed your medical
information. We are not required to include in the
list uses and disclosures for your treatment, payment
for services furnished to you, our health care
operations, disclosures to you, disclosures
you give us authorization to make and uses and
disclosures before April 14, 2003, among
others. If you ask for this information from us
more than once every twelve months, we may
charge you a fee.
You have the right
to a copy of this notice in paper form. You may
ask us for a copy at any time.
To
exercise any of your rights, please contact us in
writing at Gaffney
Family Physicians 101
Professional Park Gaffney, SC 29340.
When making a request for
amendment, you must state a reason for making the
request.
CHANGES
TO THIS NOTICE
We reserve the
right to make changes to this notice at any time.
We reserve the right to make the revised notice
effective for personal health information we have
about you as well as any information we
receive in the future. In the event there is a
material change to this notice, the revised notice will
be posted. In addition, you may request a copy of
the revised notice at any time.
COMPLAINTS/COMMENTS
If you have any
complaints concerning our privacy practices, you
may contact the Secretary of
the Department of
Health and Human Services, at 200 Independence
Avenue, S.W., Room 509F, HHH Building,
Washington, D.C. 20201 (e-mail: ocrmail@hhs.gov).
You also may contact us at Gaffney Family
Physicians 101 Professional Park Gaffney, SC 29340
864-489-1446.
You will not be
retaliated against or penalized by us for filing a
complaint.
To
obtain more information concerning this notice,
you may contact our Privacy Officer at
864-489-1446.
This notice is
effective as of April 14, 2003.
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