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Westside Health
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 CAREFULLY.
The Health Insurance Portability &
Accountability Acct of 1996 (HIPAA) is a federal program that requires
that all medical records and other individually identifiable health
information used or disclosed by us in any form, whether
electronically, on paper, or orally, are kept properly confidential.
The act gives you, the patient, significant new rights to understand
and control how your health information is used.
As required by HIPAA, we have prepared
this explanation of how we are required to maintain the privacy of
your health information and how we may use and disclose your health
information.
We may use and disclose your medical
records only for each of the following purposes: treatment, payment,
and health care operations.
Treatment means providing,
coordinating, or managing health care and related services by one or
more health providers. We may telephone or fax medication
prescriptions to a pharmacy. We may mail “re-call” letters to you
when it is time for a repeat procedure or follow up appointment. We
may contact a PCP’s office to obtain referrals in order to facilitate
pre-certification of procedures (if your insurance plan requires that
we do so).
Payment means such activities as
obtaining reimbursement for services, confirming coverage, billing or
collection activities, and utilization review. An example of this
would be sending a bill for your visit to your insurance company for
payment. We may call your insurance company if payment is denied.
Health Care Operations include the
business aspects of running our practice, such as conducting quality
assessment and improvement activities, auditing functions,
cost-management analysis, and customer service. An example would be
an internal audit review.
We may also create and distribute
de-identified health information by removing all references to
individually identifiable information.
Any other uses and disclosures will be
made only with your written authorization. You may revoke such
authorization in writing and we are required to honor and abide by
that written request, except to the extent that we have already taken
actions relying on your authorization.
You have the following rights with
respect to your protected health information, which you can exercise
by presenting a written request to the Privacy Officer:
· The
right to request restrictions on certain uses and disclosures of
protected health information, including those related to disclosures
to family members, other relatives, close personal friends, or any
other person identified by you. We are, however, not required to
agree to a requested restriction. If we do agree to a restriction, we
must abide by it unless you agree in writing to have it removed.
· The
right to reasonable requests to receive confidential communications of
protected health information from us by alternative means or at
alternative locations.
· The
right to amend your protected health information.
· The
right to inspect and to a copy of your protected health information.
· The
right to receive an accounting of disclosures of protected health
information.
· The
right to obtain a paper copy of this notice from us upon request.
We are required by law to maintain the
privacy of your protected health information and to provide you with
notice of legal duties and privacy practices with respect to protected
health information.
This notice is effective as of April
14, 2003 and we are required to abide by the terms of the Notice of
Privacy Practices currently in effect. We reserve the right to change
the terms of our Notice of Privacy Practices and to make the new
notice provisions effective for all protected health information that
we maintain. We will post, and you may request, a written copy of a
revised Notice of Privacy Practices from this office.
You have recourse if you feel that
your privacy protections have been violated. You have the right
to file a written complaint with our office, or with the Department of
Health & Human Services, Office of Civil Rights, about violations of
the provisions of this notice or the polices and procedures of our
office. We will not retaliate against you for filing a complaint.
·
Questions or concerns
should be directed to:
Sarah Noonan
Westside Health
(302) 655-5576 ext. 272
·
For HIPAA information or
to file a complaint, please contact:
The US Department of Health & Human
Services
Office of Civil Rights
200 Independence Ave SW, Rm 509F
Washington, DC 20201
1-877-696-6775 |
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