Privacy Notice
HIPAA Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This Notice of privacy practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. "Protected health information" is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services.
Statement of Our Duties
Our office is fully committed to compliance with HIPAA (Health Insurance Portability and Accountability Act) guidelines. We are committed to maintaining the privacy of your personal health information and complying with all state and federal privacy laws. We are required to:
- maintain the privacy of protected health information;
- provide you with this notice of our legal duties and privacy practices with respect to your health information;
- abide by the terms of this notice;
- notify you if we are unable to agree to a requested restriction on how your information is used or disclosed;
- accommodate reasonable request that you may make to communicate health information by alternative means or at alternative locations; and
- obtain written authorization to use or disclose your health information for reasons other than those identified in this notice and permitted under law.
We reserve the right to change our information practices and to make the new provisions effective for all protected health information we maintain. Revised notices may be provided to you by mail.
Statement of Your Rights
You have the right to know how we may use or disclose your personal health information. This notice informs you of those uses and disclosures. There are certain uses and disclosures of your personal health information that we are permitted or required to make by law without your permission. For all other uses and disclosures, we first must obtain your permission. In addition, you have the following rights:
The right to request that we place additional restrictions on our uses and disclosures of your protected health information. This means you may ask us not to disclose any part of your protected health information to family members or friends who may be involved in your care. You may also request that your protected health information not be disclosed for treatment, payment or healthcare operations. Your request must be in writing, and state the specific restriction requested and to whom you want the restriction to apply. However, we are not obligated to agree to impose any such additional restrictions. If we believe it is in your best interest to permit use and disclosure of your protected health information, your protected health information will not be restricted. You then have the right to use another healthcare professional.
The right to access, inspect and copy the protected information pertaining to you that we maintain in our files. However, under federal law, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and protected health information that is subject to laws that prohibits access to protected health information. You have the right to have us correct or amend any information that we create in error. Request to access or amend your health information should be sent to the Privacy Committee at the address provided in Section 7 of this notice. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.
You have the right to receive an accounting of the disclosures of your personal health information that we make for purposes other than activities related to your treatment or our payment functions or other health care operations.
You have the right to request that you receive confidential communications of personal health information from us by alternative means or at an alternative location. You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice alternatively i.e. electronically.
Information We Collect About You
We collect the following categories of information about you from the following sources:
- Information that we obtain directly from you, in conversations or on forms that you fill out.
- Information that we obtain as a result of our transactions with you.
- Information that we obtain from your medical records or from medical professionals.
- Information that we obtain from other entities, such as health care providers or other insurance companies, in order to service your policy or carry out other insurance-related needs.
Permissible Uses and Disclosures of Protected Information
Your protected health information may be used and disclosed by your physician, other health care providers, (i.e., Radiologist, Radiology Department and the Laboratory), our office staff and others outside of our offices that are involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operation of physician's practice, and any other use required by law.
To carry out treatment functions. 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. For example, we would disclose your protected health information, as necessary, to a home health agency that provides care to you. For example, your protected health information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to treat you.
To carry out payment functions. We may use or disclose your health information without your permission to carry out activities relating obtaining reimbursement for your health care, determining coverage, and benefits under your policy. Such functions may include reviewing health care services with respect to medical necessity, appropriateness of care, or justification of charges. 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.
To carry out certain health care operations. We may use of 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, and conducting or arranging for other business activities. For example, we may disclose your protected health information to medical students that see patients at our offices. 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 to remind you of your appointment.
We would like to inform you that we use an outside agency to conduct patient satisfaction surveys. Only demographic information is disclosed to them and no health information except your doctor's name is given. If you do not wish to receive these surveys in the future, please let us know in writing at the address given in Section 7. Please include your name, address, and date of birth so we can insure we have the correct account. Also, we bill on family accounts, which means that other family members in your household will be able to access account information either by statements or our website. If you would like to be moved to your own personal account, please send us a request in writing along with your name, address, phone number, and insurance information. We will need this information to verify we have the correct patient, and to set up the new account.
In situations permitted or required by law. We also may use or disclose your protected health information without your written permission for other purposes permitted or required by law, including the following:
- As authorized by and to the extent necessary to comply with workers compensation or other no-fault laws.
- To a health oversight agency for activities including audits or civil, criminal or administrative proceedings.
- To a public health authority for purposes of public health activities (such as to the Food and Drug Administration to report consumer product defects).
- To a law enforcement official for law enforcement purposes or in response to a court order or in the course of any judicial or administrative proceeding.
- To organ procurement organizations, or to other entities for approved research purposes.
- To a government authority, including a social service or protective services agency, authorized to receive reports of abuse, neglect or domestic violence.
For Purposes For Which We Have Obtained Your Written Permission. All other uses or disclosures of your protected health information will be made only with your written permission, and you may revoke any permission that you give us 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.
Complaints About Misuse of Health Information
You may complain to us or to the Secretary of Health and Human Services if you believe that your rights with respect to our protection of your health information have been violated. You may file a complaint with us by submitting a complaint in writing to the address in Section 7. Your complaint should include as many details (such as names and dates) as possible. You will not be retaliated against in any way for filing a complaint.
Our Practices Regarding Confidentiality and Security
We restrict access to nonpublic personal information about you to those employees who need to know that information in order to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.
Contact Information For Filing Complaints or Obtaining Further Information
If you have any questions or complaints, please contact:
Children's Health, PC
Privacy Officer
1139 Heatherstone Drive
Fredericksburg, VA 22407
Phone: 540-785-9595
or
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, DC 20201
Phone: 1-800-368-1019
