HIPAA Notice of Privacy Practices
Warm Springs Medical Center
5995 Spring Street
Warm Springs, GA 31830
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 is being provided to you as a requirement of the Health
Insurance Portability and Accountability Act (HIPAA). This Notice describes how
we may use and disclose your protected health information (PHI) to carry out
treatment, payment or health care operations and for other purposes that are
permitted or required by law. It also describes your right to access and control
your health information in some cases. Your “protected health information”
means any of your written and oral health information, including demographic
data, which can be used to identify you. This is health information that is
created or received by your health care provider, and relates to your past,
present, or future physical or mental health or condition. This information may
be stored in either a paper or electronic format, or both.
Uses
and Disclosures of Protected Health Information (PHI)
Your
PHI may be used or disclosed by your physician or other primary care provider
(collectively referred to as “provider”), our office staff and others
outside of office 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 the provider’s practice, and any other use required
by law.
Treatment:
We will use and disclose
your PHI 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 PHI, as necessary, to a home
health agency that provides care to you. For example, your PHI may be provided
to a physician to whom you have been referred to ensure that the physician has
the necessary information to diagnose or treat you.
Payment:
Your PHI will be used, as needed, to obtain payment for your health care
services. For example, obtaining approval for a hospital stay may require that
your relevant PHI be disclosed to the health plan to obtain approval for the
hospital admission.
Health
Care Operation: We may use or disclose, as needed, your PHI in order to support the
business activities of your provider’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 PHI 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 may be asked to sign your name and
indicate your provider. We may also call you by name in the waiting room when
your provider is ready to see you. We may use or disclose your PHI, as
necessary, to contact you to remind you of an appointment.
We may use or
disclose your PHI in the following situations without your authorization. These
situations include: As required by law; Public health issues required by law,
including communicable diseases; Health Oversight; Abuse or neglect; Food or
Drug Administration requirements; Legal proceedings; To law enforcement; To
Coroners, Funeral Directors and Organ Donation Programs; Research; Criminal
Activity; Military Activity and National Security; Worker’s Compensation; For
inmates.
Other permitted
and required uses and disclosures will be made upon receipt of your consent or
authorization. You may revoke this authorization at any time, in writing, except
to the extent that your provider or the provider’s practice has taken action
in reliance on the user or disclosure indicated in the authorization. Under the
law, we must make disclosures to you upon request and when requested by the
Secretary of the Department of Health and Human Services to investigate or
determine our compliance with the requirements of 45 CFR § 164.500.
Your
Rights
Following
is a statement of you rights with respect to your protected health information
(PHI).
You
have the right to inspect and request copies of your PHI.
Under federal law, however, 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 PHI that is subject to law that
prohibits access to such PHI. To receive a copy of your records, a written
authorization must be completed. You may request to receive in an electronic
format any of your records that are stored and readily producible in an
electronic format.
You
have the right to request a restriction of your PHI.
This means you may ask us not to use
or disclose any part of your PHI for the purposes of treatment, payment or
health care operations. You may restrict the disclosure of your PHI to your
health plan if services are paid for in full. 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 the Notice of Privacy
Practices. Your request must state the specific restriction and to whom you want
the restriction applied. With exception of the aforementioned restriction to
your health plan, your provider is not required to agree to a restriction that
you may request. If the provider believes it is in your best interest to permit
use and disclosure of your PHI, your PHI will not be restricted. You then have
the right to choose another health care provider.
You
have the right to request to receive confidential communications 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.
You
have the right to request to have your provider amend your PHI.
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 certain disclosure we have made, if
any, of your PHI.
You
will receive notification in the event of a breach that affects your unsecured
PHI.
You
have the right to 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 Officer in person, by
phone, or by mail. We will not
retaliate against you for filing a complaint.
We are required
by law to maintain the privacy of, and provide individuals with, this notice of
our legal duties and privacy practices with respect to protected health
information. If you have any objections to this form, please ask to speak with
our HIPAA Privacy Officer in person or by phone at our main phone number.