Download a printable PDF copy of this policy by clicking on this link: PDF Privacy Policy
Privacy
Policy:
This notice describes how medical information about you may be used and
disclosed and how you can gain access to this information. Please
review it carefully.
PHI, about you, is maintained as a record of your contacts or visits
for healthcare services with our practice. Specifically, protected
health information, “PHI,” is information about you, including
demographic information (i.e., name address, phone, etc.), that may
identify you and relates to your past, present or future physical or
mental health condition and related health care services.
Our practice is required to follow specific rules on maintaining the
confidentiality of your PHI, using your information, and disclosing or
sharing this information with other healthcare professionals involved
in your care and treatment. This Notice describes your rights to access
and control your PHI. It also describes how we follow applicable rules
and use and disclose your PHI to provide your treatment, obtain payment
for services you receive, manage our health care operations and for
other purposes that are permitted or required by law.
We are required to abide by the terms of this Notice of Privacy
Practices. We reserve the right to change the terms of our notice at
any time. The new notice will be effective for all PHI that we maintain
at that time. A copy of a revised Notice of Privacy Practices may be
obtained by calling the office and requesting that a revised copy be
sent to you in the mail, downloading/viewing a current copy from our
website
www.heartland.md, or asking for one at the time of your next
appointment.
Your Rights Under the Privacy Rule
Following is a statement of your rights, under the Privacy Rule, in
reference to your PHI. Please feel free to discuss any questions with
our staff. •
You have the right to receive, and we are required to
provide you with,
a copy of this Notice of Privacy of Practices
– We are required to
follow the terms of this notice. We reserve the right to change the
terms of our notice, at any time. If needed, new versions of this
notice will be effective for all PHI that we maintain at that time.
Upon your request, we will provide you with a revised Notice of Privacy
Practices if you call our office and request that a revised copy be
sent to you in the mail or ask for one at the time of your next
appointment. •
You have the right to authorize other use and disclosure
– This means
you have the right to authorize or deny any other use or disclosure of
PHI that is not specified within this notice. You may revoke an
authorization, at any time, in writing, except to the extent that your
Healthcare Provider or our office has taken an action in reliance on
the use of disclosure indicated in the authorization.
•
You have the right to designate a personal
representative
– This means
you may designate a person with the delegated authority to consent to,
or authorize the use or disclosure of PHI.
•
You have the right to inspect and copy your PHI
– This means you may
inspect and obtain a copy of PHI about you that is contained in your
patient record. We have the right to charge a reasonable fee for copies
as established by professional, state, or federal guidelines.
•
You have the right to request a restriction of your PHI
– This means
you may ask us, in writing, not to use or disclose any part of your PHI
for the purpose of treatment, payment or healthcare operations. You may
also request that any part of your PHI not be disclosed to family
members or friends who may be involved in your care or for notification
purposes as described in this Notice of Privacy Practices. In certain
cases, we may deny your request for a restriction. •
You may have the right to request an amendment to your
PHI
– This means
you may request an amendment of your PHI for as long as we maintain
this information. In certain cases, we may deny your request for an
amendment.
•
You have the right to request a disclosure
accountability
– This means
that you may request a listing of disclosures that we have made, of
your PHI, to entities or persons outside of our office other than for
the purposes of treatment, payment, healthcare operations, or a purpose
authorized by you.
ager.
How We May Use or Disclose PHI (protected healthcare
information)
Following are examples of uses and disclosures of your protected health
care information that we are permitted to make. These examples are not
meant to be exhaustive, but to describe the types of uses and
disclosures that may be made by our office.
•
Treatment
– We may use and disclose your PHI to provide, coordinate, or
manage your healthcare and any related services. This includes the
coordination or management of your healthcare with a third party that
is involved in your care and treatment, For example, we would disclose
your PHI, as necessary, to a pharmacy that would fill your
prescriptions. We will also disclose PHI to other Healthcare Providers
who may be involved in your care and treatment.
We may also call you by name in the waiting room when your Healthcare
Provider is ready to see you. We may use or disclose your PHI, as
necessary, to contact you to remind you of your appointment. We may
contact you by phone or other means to provide results from exams or
tests and to proved information that describes or recommend treatment
alternatives regarding your care. Also, we may contact you to provide
information about health related benefits and services offered by our
office.
•
Payment
– Your PHI will be used, as needed, to obtain payment for your
healthcare services. This may include activities such as; making a
determination of eligibility or coverage for insurance benefits,
reviewing services provided to you for medical necessity, and
undertaking utilization review activities.
•
We may use or disclose, as-needed, your PHI in
order to support the business activities of our practice. This
includes, but is not limited to business planning and development,
quality assessment and improvement, medical review, legal services, and
auditing functions. It also includes education, provider credentialing,
certification, underwriting, rating, or other insurance-related
activities. Additionally, it includes business administrative
activities such as customer service, compliance with privacy
requirements, internal grievance, procedures, due diligence in
connection with the sale or transfer of assets, and creating
de-identified information.
Other Permitted and Required Uses and Disclosures
We may also use and disclose your PHI in the following instances as
outlined below. You have the opportunity to agree or object to the use
or disclosure of all or part of your PHI. •
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, that you identify, your PHI that directly relates to that
person’s involvement in your healthcare. 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 PHI 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 or
disclosure of the PHI, then your Healthcare Provider may, using
professional judgment, determine whether the disclosure is in your best
interest. In this case, only the PHI that is relevant to your
healthcare will be disclosed.
•
As Required By Law
– We may use or disclose your PHI to the extent that
is required by law.
•
For Public Health
– We may disclose your PHI for public health
activities and purposes to a public health authority that is permitted
by law to collect or receive the information.
•
– We may disclose your PHI, if authorized by
law, to a person who may have been exposed to a communicable disease or
may otherwise be at risk of contracting or spreading the disease or
condition.
•
For Health Oversight
– We may disclose PHI to a health oversight agency
for activities authorized by law, such as audits, investigations, and
inspections.
•
In Cases of Abuse or Neglect
– We may disclose your PHI to a public
health authority that is authorized by law to receive reports of child
abuse or neglect. In addition, we may disclose your PHI if we believe
that you have been a victim of abuse, neglect or domestic violence to
the governmental entity or agency authorized to receive such
information. In this case, the disclosure will be made in a manner that
is consistent with the requirements of applicable federal and state
laws.
•
To the Food and Drug Administration
– We may disclose your PHI to a
person or company required by the Food and Drug Administration to
report adverse events, to monitor product defects or problems, to
report biological product deviations, to track products, to enable
product recalls, to make repairs or replacements, or to conduct
post-marketing surveillance, as required.
•
For Legal Proceedings
– We may disclose PHI in the course of any
judicial or administrative proceeding, in response to an order of a
court or administrative tribunal (to the extent such disclosure is
expressly authorized), in certain conditions in response to a subpoena,
discovery request or other lawful process.
•
To Law Enforcement
– We may also disclose PHI, as long as applicable
legal requirements are met, for law enforcement purposes.
•
To Coroners, Funeral Directors, and Organ Donation
– We may disclose
PHI 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 PHI to a
funeral director, as authorized by law, in order to permit the funeral
director to carry out his/her duties. PHI may be used and disclosed for
cadaveric organ, eye or tissue donation purposes.
•
For Research
– We may disclose your PHI to researchers when an
institutional review board has reviewed and approved the research
proposal and established protocols to ensure the privacy of your PHI.
•
In Cases of Criminal Activity
– Consistent with applicable federal and
state laws, we may disclose your PHI if we believe that the use or
disclosure is necessary to prevent or lessen a serious and imminent
threat to the health or safety of a person or the public. We may also
disclose PHI, if it is necessary for law enforcement authorities, to
identify or apprehend an individual.
•
For Military Activity and National Security
– When the appropriate
conditions apply, we may use or disclose PHI of individuals who are
Armed Forces Personnel: (1) for activities deemed necessary by
appropriate military command authorities; (2) for the purpose of a
determination by the Department of Veterans Affairs of your eligibility
for benefits; or (3) to foreign military authority if you are a member
of that foreign military service.
•
For Workers’ Compensation
– Your PHI may be disclosed as authorized
to comply with workers’ compensation laws and other similar legally –
established programs.
•
When an Inmate
– We may use or disclose your PHI if you are an inmate
of a correctional facility and your Healthcare Provider created or
received your PHI in the course of providing care to you.
•
Required Uses and Disclosures
– Under the law, we must make disclosures
about you when required by the Secretary of the Department of Health
and Human Services to investigate or determine our compliance with the
requirements of the Privacy Rule.
Complaints:
You may complain to us or to the Secretary of Health and Human
Services if you believe your privacy rights have been violated by us.
You may file a complaint with us by notifying our Privacy Manager of
your complaint.
