Privacy Policy
Administrator/Privacy Officer
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.
We understand the importance of privacy and are committed to maintaining the
confidentiality of your medical information. We make a record of the
medical care we provide and may receive such records from others. We use
these records to provide or enable other health care providers to provide
quality medical care, to obtain payment for services provided to you as
allowed by your health plan and to enable us to meet our professional and
legal obligations to operate this medical practice properly. We are required
by law to maintain the privacy of protected health information and to
provide individuals with notice of our legal duties and privacy practices
with respect to protected health information. This notice describes how we
may use and disclose your medical information. It also describes your
rights and our legal obligations with respect to your medical information.
If you have any questions about this Notice, please contact our Privacy
Officer listed above.
A. How this Medical Practice May Use or Disclose Your Health
Information
This
medical practice collects health information about you and stores it in a
chart and on a computer. This is your medical record. The medical record
is the property of this medical practice, but the information in the medical
record belongs to you. The law permits us to use or disclose your health
information for the following purposes:
1. Treatment
We use medical information about you to
provide your medical care. We disclose medical information to our employees
and others who are involved in providing the care you need. For example, we
may share your medical information with other physicians or other health
care providers who will provide services which we do not provide. Or we may
share this information with a pharmacist who needs it to dispense a
prescription to you, or a laboratory that performs a test. We may also
disclose medical information to members of your family or others who can
help you when you are sick or injured.
2. Payment
We use and disclose medical information
about you to obtain payment for the services we provide. For example, we
give your health plan the information it requires before it will pay us. We
may also disclose information to other health care providers to assist them
in obtaining payment for services they have provided to you.
3. Health Care Operations
We may use and disclose
medical information about you to operate this medical practice. For
example, we may use and disclose this information to review and improve the
quality of care we provide, or the competence and qualifications of our
professional staff. Or we may use and disclose this information to get your
health plan to authorize services or referrals. We may also use and
disclose this information as necessary for medical reviews, legal services
and audits, including fraud and abuse detection and compliance programs and
business planning and management. We may also share your medical
information with our "business associates", such as our billing service,
that perform administrative services for us. We have a written contract
with each of these business associates that contains terms requiring them to
protect the confidentiality of your medical information. Although federal
law does not protect health information which is disclosed to someone other
than another healthcare provider, health plan or healthcare clearinghouse,
under California law all recipients of health care information are
prohibited from re-disclosing it except as specifically required or
permitted by law. We may also share your information with other health care
providers, health care clearinghouses or health plans that have a
relationship with you, when they request this information to help them with
their quality assessment and improvement activities, their efforts to
improve health or reduce health care costs, their review of competence,
qualifications and performance of health care professionals, their training
programs, their accreditation, certification or licensing activities, or
their health care fraud and abuse detection and compliance efforts.
4. Appointment Reminders
We may use and disclose
medical information to contact and remind you about appointments. If you
are not home, we may leave this information on your answering machine or in
a message left with the person answering the phone.
5. Sign in sheet
We may use and disclose medical
information about you by having you sign in when you arrive at our office.
We may also call out your name when we are ready to see you.
6. Notification and communication with family
We may
disclose your health information to notify or assist in notifying a family
member, your personal representative or another person responsible for your
care about your location, your general condition or in the event of your
death. In the event of a disaster, we may disclose information to a relief
organization so that they may coordinate these notification efforts. We may
also disclose information to someone who is involved with your care or helps
pay for your care. If you are able and available to agree or object, we
will give you the opportunity to object prior to making these disclosures,
although we may disclose this information in a disaster even over your
objection if we believe it is necessary to respond to the emergency
circumstances. If you are unable or unavailable to agree or object, our
health professionals will use their best judgment in communication with your
family and others.
7. Marketing
We may contact you to give you
information about products or services related to your treatment, case
management or care coordination, or to direct or recommend other treatments
or health-related benefits and services that may be of interest to you, or
to provide you with small gifts. We may also encourage you to purchase a
product or service when we see you. We will not use or disclose your
medical information without your written authorization.
8. Required by law
As required by law, we will use and
disclose your health information, but we will limit our use or disclosure to
the relevant requirements of the law. When the law requires us to report
abuse, neglect or domestic violence, or respond to judicial or
administrative proceedings, or to law enforcement officials, we will further
comply with the requirement set forth below concerning those activities.
9. Public health
We may, and are sometimes required by
law to disclose your health information to public health authorities for
purposes related to: preventing or controlling disease, injury or
disability; reporting child, elder or dependent adult abuse or neglect;
reporting domestic violence; reporting to the Food and Drug Administration
problems with products and reactions to medications; and reporting disease
or infection exposure. When we report suspected elder or dependent adult
abuse or domestic violence, we will inform you or your personal
representative promptly unless in our best professional judgment, we believe
the notification would place you at risk of serious harm or would require
informing a personal representative we believe is responsible for the abuse
or harm.
10. Health oversight activities
We may, and are sometimes
required by law to disclose your health information to health oversight
agencies during the course of audits, investigations, inspections, licensure
and other proceedings, subject to the limitations imposed by federal and
California law.
11. Judicial and administrative proceedings
We may, and are sometimes required by law, to disclose your health
information in the course of any administrative or judicial proceeding to
the extent expressly authorized by a court or administrative order. We may
also disclose information about you in response to a subpoena, discovery
request or other lawful process if reasonable efforts have been made to
notify you of the request and you have not objected, or if your objections
have been resolved by a court or administrative order.
12. Law enforcement
We may, and are sometimes required by
law, to disclose your health information to a law enforcement official for
purposes such as identifying of locating a suspect, fugitive, material
witness or missing person, complying with a court order, warrant, grand jury
subpoena and other law enforcement purposes.
13. Coroners
We may, and are often required by law, to
disclose your health information to coroners in connection with their
investigations of deaths.
14. Organ or tissue donation
We may disclose your health
information to organizations involved in procuring, banking or transplanting
organs and tissues.
15. Public safety
We may, and are sometimes required by
law, to disclose your health information to appropriate persons in order to
prevent or lessen a serious and imminent threat to the health or safety of a
particular person or the general public.
16. Specialized government functions
We may disclose
your health information for military or national security purposes or to
correctional institutions or law enforcement officers that have you in their
lawful custody.
17. Worker’s compensation
We may disclose your health
information as necessary to comply with worker’s compensation laws. For
example, to the extent your care is covered by workers' compensation, we
will make periodic reports to your employer about your condition. We are
also required by law to report cases of occupational injury or occupational
illness to the employer or workers' compensation insurer.
18. Change of Ownership
In the event that this medical
practice is sold or merged with another organization, your health
information/record will become the property of the new owner, although you
will maintain the right to request that copies of your health information be
transferred to another physician or medical group.
B. When This Medical Practice May Not Use or Disclose Your
Health Information
Except
as described in this Notice of Privacy Practices, this medical practice will
not use or disclose health information which identifies you without your
written authorization. If you do authorize this medical practice to use or
disclose your health information for another purpose, you may revoke your
authorization in writing at any time.
C. Your Health Information Rights
1. Right to Request Special Privacy Protections
You
have the right to request restrictions on certain uses and disclosures of
your health information, by a written request specifying what information
you want to limit and what limitations on our use or disclosure of that
information you wish to have imposed. We reserve the right to accept or
reject your request, and will notify you of our decision.
2. Right to Request Confidential Communications
You
have the right to request that you receive your health information in a
specific way or at a specific location. For example, you may ask that we
send information to a particular e-mail account or to your work address. We
will comply with all reasonable requests submitted in writing which specify
how or where you wish to receive these communications.
3. Right to Inspect and Copy
You have the right to
inspect and copy your health information, with limited exceptions. To
access your medical information, you must submit a written request detailing
what information you want access to and whether you want to inspect it or
get a copy of it. We will charge a reasonable fee, as allowed by California
law. We may deny your request under limited circumstances. If we deny your
request to access your child's records because we believe allowing access
would be reasonably likely to cause substantial harm to your child, you will
have a right to appeal our decision. If we deny your request to access your
psychotherapy notes, you will have the right to have them transferred to
another mental health professional.
4. Right to Amend or Supplement
You have a right to
request that we amend your health information that you believe is incorrect
or incomplete. You must make a request to amend in writing, and include the
reasons you believe the information is inaccurate or incomplete. We are not
required to change your health information, and will provide you with
information about this medical practice's denial and how you can disagree
with the denial. We may deny your request if we do not have the
information, if we did not create the information (unless the person or
entity that created the information is no longer available to make the
amendment), if you would not be permitted to inspect or copy the information
at issue, or if the information is accurate and complete as is. You also
have the right to request that we add to your record a statement of _self to
250 words concerning any statement or item you believe to be incomplete or
incorrect.
5. Right to an Accounting of Disclosures
You have a
right to receive an accounting of disclosures of your health information
made by this medical practice, except that this medical practice does not
have to account for the disclosures provided to you or pursuant to your
written authorization, or as described in paragraphs 1 (treatment), 2
(payment), 3 (health care operations), 6 (notification and communication
with family) and 16 (specialized government functions) of Section A of this
Notice of Privacy Practices or disclosures for purposes of research or
public health which exclude direct patient identifiers, or which are
incident to a use or disclosure otherwise permitted or authorized by law, or
the disclosures to a health oversight agency or law enforcement official to
the extent this medical practice has received notice from that agency or
official that providing this accounting would be reasonably likely to impede
their activities.
6. You have a right to a paper copy of this Notice of Privacy
Practices.
If you
would like to have a more detailed explanation of these rights or if you
would like to exercise one or more of these rights, contact our Privacy
Officer listed at the top of this Notice of Privacy Practices.
D. Changes to this Notice of Privacy Practices
We
reserve the right to amend this Notice of Privacy Practices at any time in
the future. Until such amendment is made, we are required by law to comply
with this Notice. After an amendment is made, the revised Notice of Privacy
Protections will apply to all protected health information that we maintain,
regardless of when it was created or received. We will keep a copy of the
current notice posted in our reception area. Copies are available in our
reception area. We will also post the current notice on our website. ( www.barteweb.com
).
E. Complaints
Complaints about this Notice of Privacy Practices or how this medical
practice handles your health information should be directed to our Privacy
Officer listed at the top of this Notice of Privacy Practices.
If you
are not satisfied with the manner in which this office handles a complaint,
you may submit a formal complaint to:
Department of Health and Human Services
Office
of Civil Rights
Hubert
H. Humphrey Bldg.
200
Independence Avenue, S.W.
Room
509F HHH Building
Washington,
DC 20201
You
will not be penalized for filing a complaint.
Brandi Hoyland
Administrator/Privacy Officer
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