Privacy Policy

1. Uses and Disclosures of Protected Health Information

Uses and Disclosures of Protected HealthInformation Based Upon Your Written Consent

You will be asked by your physician to sign a consent form. Once you have consented to use and disclosure of your protected health information for treatment,  payment  and health  care operations by signing the consent form, your physician will use or disclose your protected health information as described in this Section 1. Your protected health information may be used and disclosed by your physician, our office staff and  others outside of our  office that are involved  in your care and treatment for the purpose of providing health care services to you. Your protected health information may also be used and disclosed to pay your health care bills and to support the operation of the physicians practice.

The nature of patient treatment requires the doctor and or associates to identify you by name to assure proper delivery of services. This being the case, by being a patient of this practice your identity (your name) will be known to the doctor, staff and possibly patients in the waiting room or office who know you.

Following are  examples of the  types of uses and disclosures of your protected  health care information that the physician’s office is permitted to make once you have signed our consent form. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office once you have provided  consent. We may remind you of important medical appointments, messages or information by any  method you provide to us including answering machine, text message, email or regular mail.

Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party that hasalready obtained your permission to have access to your protected healthinformation. For example, we would disclose your protected health information, as necessary, to a home health agency that provides care to you.

We will also disclose protected health information to other physicians who may be treating you whenwe have the necessary permission from you to disclose your protected health information. For example, your protected health information may be provided toa physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.

In addition, we may disclose your protected health information from time-to-time to another physician or health care provider (e.g., a specialist or laboratory) who, at the request of your physician, becomes involved in your care by providing assistance with your health care diagnosis or treatment to your physician.

Payment: Your protected health information will be used, as needed, to obtain payment for your health care services. This may include certain activities  that your health insurance  plan may undertake before it approves or pays for the health care services we recommend for you 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. For example, obtaining approval for a hospital stay may require that your relevant protected health information  be disclosed to the health plan to obtain approval for the hospital admission.

Healthcare Operations: We may use or disclose, as-needed, your protected health information in order to support the business activities of your physician’s practice. These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical students, licensing, marketing and fundraising activities, and conducting or arranging for other business activities.

For example, we may disclose your protected health information to medical school students that see patients at our office. In addition, we may use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your physician.

We may also call you by name in the waiting room when your physician is ready to see you. We may use or disclose your protected health information, as necessary, to contact you toremind you of your appointment.

We will share your protected health information with third party “business associates” that perform various activities (e.g., billing, transcription services) for the practice. Whenever an arrangement between our office and a business associate involves the use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy of your protected health information.

We may use or disclose your protected health information, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may also use and disclose your protected health information for other marketing activities. For example, your name and address may be used to send you a newsletter about our practice and the services we offer. We may also send you information about products orservices that we believe may be beneficial to you. You may contact our Privacy Contact to request that these materials not be sent to you.

We may use or disclose your demographic information and the dates that you received  treatment from your physician, as necessary, in order to contact you for fundraising activities supported by our office. Ifyou do not want to receive these materials, please contact our Privacy Contact and request that these fundraising materials not be sent to you.

Uses and Disclosures of Protected Health Information Based upon Your Written Authorization

Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described  below. You may revoke this authorization, at any time, in writing, except to the extent that your physician or the physician’s practice has taken an action in reliance on the use or disclosure indicated in the authorization.

Other Permitted and Required Uses and Disclosures That May Be Made With Your Consent, Authorization or Opportunity to Object

We may use and dis close your protected health information in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of your protected health information .

 If you are not present or able to agree or object to the use or disclosure of the protected health information, then your physician may, using professional  judgment, determine whether the disclosure isin your best interest. In this case, only the protected health information  that is relevant to your health care will bedis closed .

Facility Directories: Unless you object, we will use and disclose in our facility directory your name, the location at which you are receiving care, your condition (in general terms), and your religious affiliation. All of this information, except religious affiliation, will be disclosed to people that ask for you by name. Members of the clergy will be told your religious affiliation.

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 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 protected health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition or death. Finally, we may use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and  disclosures to family or  other individuals  involved in your healthcare.

Emergencies: We may use or disclose your protected health information in an emergency treatment situation. If this happens, your physician shall try to obtain your consent as soon as reasonably practicable after the delivery of treatment. If your physician or another physician in the practice is required by law to treat you and the physician has attempted to obtain your consent but is unable to obtain yourconsent, he or she  may still use ordisclose your protected  healthinformation  to treat you.

 Communication Barriers: We may use and disclose your protected health information if your physician or another physician in the practice attempts to obtain consent from you but is unable to do so due to substantial communication barriers and the physiciandetermines, using professional judgment, that you intend to consent to use ordisclosure under the circumstances. 

Other Permitted and Required Uses and Disclosures That May Be Made Without Your Consent, Authorization or Opportunityto Object

We may use or disclose your protected healthinformation in the following situations without your consent or authorization.These situations include:

 Required By Law:We may use or disclose your protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made incompliance with the  law and will be limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures.

Public Health: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collector receive the information. The disclosure will be made for the purpose of controlling disease, injury or disability. We may also disclose your protected health information, if directed by the public health authority, to a foreign government agency that is collaborating with the public health authority.

Communicable Diseases : We may disclose your protected health information, if authorized by law, to aperson who may have been exposed to a communicable disease or may otherwise beat risk of contracting or spreading the disease or condition.

Health Oversight : We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.

Abuse or Neglect: We may disclose your protected health information  to a public health authority that isauthorized  by law to receive reports ofchild abuse or neglect. In addition, we may disclose your protected healthinformation if we believe that you have been a victim of abuse, neglect ordomestic violence to the governmental entity or agency authorized  to receive such information.  In this case, the disclosure will be madeconsistent with the requirements of applicable federal and state laws.

 Food and Drug Administration:We may disclose your protected health information to a person or companyrequired by the Food and Drug Administration to report adverse events, productdefects or problems, biologic product deviations, track products; to enableproduct recalls; to make repairs or replacements, or to conduct post marketingsurveillance, as required.

 Legal Proceedings:We may disclose protected health information in the course of any judicial oradministrative proceeding, in response to an order of a court or administrativetribunal (to the extent such disclosure is expressly authorized), in certainconditions in response to a subpoena, discovery request or other lawfulprocess.

Law Enforcement:We may also disclose protected health information, so long as applicable legalrequirements are met, for law enforcement purposes. These law enforcementpurposes include (1) legal processes and otherwise required  by law, (2) limited  information  requests for identification and locationpurposes, (3) pertaining to victims of a crime, (4) suspicion that death hasoccurred as a result of criminal conduct, (5) in the event that a crime occurson the premises of the practice, and

(6) medical emergency (not on the Practice’spremises) and it is likely that a crime has occurred.

Coroners, Funeral Directors, and Organ Donation: 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 their duties. We may disclose such information  in reasonable  anticipation of death. Protected health information may be used and disclosed for cadaveric organ, eye or tissue donation purposes.

Research : We may disclose your protected health information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.

Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information, 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 protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.

Military Activity and National Security : When the appropriate conditions apply, we may use or disclose protected health information 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 services.

We may also disclose your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.

Workers’ Compensation:  Your protected health information may be disclosed by us as authorized to comply with workers’ compensation laws and other similar legally-established programs.

Inmates: We may use or disclose your protected health information if you are an inmate of a correctional facility and your physician created or received your protected health information in the course of providing care to you.

Required Uses and Disclosures : Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500 et. seq.