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THIS
NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
Introduction
At
Skin and Cancer Associates, we are
committed to treating and using protected health information
about you responsibly. This
Notice of Health Information Practices describes the personal
information we collect, and how and when we use or disclose
that information. It
also describes your rights as they relate to your protected
health information. This
Notice is effective 04-15-03 and applies to all protected
health information as defined by federal regulations.
Understanding
Your Health Record/Information
Each
time you visit Skin and Cancer Associates, a record of your
visit is made. Typically, this record contains your symptoms,
examination and test results, diagnoses, treatment, and a plan
for future care or treatment. This information, often referred
to as your health or medical record, serves as a:
•
Basis for planning your care and treatment,
•
Means of communication among the many health
professionals who contribute to your care,
•
Legal document describing the care you received,
•
Means by which you or a third-party payer can verify
that services billed were actually provided,
•
A tool in educating heath professionals,
•
A source of data for medical research,
•
A source of information for public health officials
charged with improving the health of this state and the
nation,
•
A source of data for our planning and marketing,
•
A tool with which we can assess and continually work to
improve the care we render and the outcomes we achieve,
Understanding
what is in your record and how your health information is used
helps you to: ensure its accuracy, better understand who,
what, when, where, and why others may access your health
information, and make more informed decisions when authorizing
disclosure to others.
Your Health Information Rights
Although
your health record is the physical property of Skin and Cancer
Associates the information belongs to you. You have the right
to:
•
Obtain a paper copy of this notice of information
practices upon request,
•
Inspect and copy your health record as provided for in
45 CFR 164.524,
•
Request we amend your health record as provided in 45
CFR 164.528,
•
Obtain an accounting of certain disclosures of your
health information as provided in 45 CFR 164.528,
•
Request communications of your health information by
alternative means or at alternative locations,
•
Request a restriction on certain uses and disclosures
of your information as provided
by 45 CFR 164.522, and
•
Revoke your authorization to use or disclose health
information except to the
extent that action has already been taken.
Our
Responsibilities
Skin
and Cancer Associates is required to:
•
Maintain the privacy of your health information,
•
Provide you with this notice as to our legal duties and
privacy practices with respect to information we collect and
maintain about you,
•
Abide by the terms of this notice,
•
Notify you if we are unable to agree to a requested
restriction, and
•
Accommodate reasonable requests you may have to
communicate health information by alternative means or at
alternative locations.
We
reserve the right to change our practices and to make the new
provisions effective for all protected health information we
maintain. Should our information practices change, we will
post a revised notice.
We
will not use or disclose your health information without your
authorization, except as described in this notice.
We will also discontinue to use or disclose your health
information after we have received a written revocation of the
authorization according to the procedures included in the
authorization.
Examples
of Disclosures for Treatment, Payment and Health Operations
We
will use your health information for treatment.
For
example: Information obtained by a nurse, physician, or other member of
your health care team will be recorded in your record and used
to determine the course of treatment that should work best for
you. Your physician will document in your record his or her
expectations of the members of your health care team. Members
of your health care team will then record the actions they
took and their observations. In that way, the physician will
know how you are responding to treatment.
We
may also provide other physicians or subsequent health care
providers with copies of various reports that should assist
him or her in treating you.
We
will use your health information for payment.
For
example: A bill may be sent to you or a third-party payer. The information
on or accompanying the bill may include information that
identifies you, as well as your diagnosis, procedures, and
supplies used.
We
will use your health information for regular health
operations.
For
example: Your information may be used in an effort to continually improve
the quality and effectiveness of the healthcare and service we
provide.
Business
associates: There are some services provided in our organization through
contacts with business associates. When these services are
contracted, we may disclose your health information to our
business associate so that they can perform the job we’ve
asked them to do to protect your health information, however,
we require the business associate to appropriately safeguard
your information.
Notification:
We may use or disclose information to notify or assist in
notifying a family member, personal representative, or another
person responsible for your care, of your location, and
general condition. We may call to confirm appointments and
communicate lab results.
Communication
with family: Health professionals, using their best judgment, may disclose to
a family member, other relative, close personal friend or any
other person you identify, health information relevant to that
person’s involvement in your care or payment related to your
care.
Research:
We may disclose information to researchers when an
institutional review board that has reviewed the research
proposal and established protocols to ensure the privacy of
your health information has approved their research.
Marketing:
We may contact you to provide appointment reminders or
information about treatment alternatives or other
health-related benefits and services that may be of interest
to you.
Food
and Drug Administration (FDA): We may disclose to the
FDA health information relative to adverse events with respect
to food, supplements, product and product defects, or post
marketing surveillance information to enable product recalls,
repairs, or replacement.
Workers
compensation: We may disclose health information to the extent authorized by
and to the extent necessary to comply with laws relating to
workers compensation or other similar programs established by
law.
Public
health: As required by law, we may disclose your health information to
public health or legal authorities charged with preventing or
controlling disease, injury, or disability.
Law
enforcement: We may disclose health information for law enforcement purposes
as required by law or in response to a valid subpoena.
Federal
law makes provision for your health information to be released
to an appropriate health oversight agency, public health
authority or attorney, provided that a work force member or
business associate believes in good faith that we have engaged
in unlawful conduct or have otherwise violated professional or
clinical standards and are potentially endangering one or more
patients, workers or the public.
For
More Information or to Report a Problem
If
have questions and would like additional information, you may
contact the practice’s Privacy Officer, Darlene Tomlinson at
1-888-479-6415 Ext 636.
If
you believe your privacy rights have been violated, you can
file a complaint with the practice’s Privacy Officer, or
with the Office for Civil Rights, U.S. Department of Health
and Human Services. There will be no retaliation for filing a
complaint with either the Privacy Officer or the Office for
Civil Rights. The address for the OCR is listed below:
Office
for Civil Rights
U.S.
Department of Health and Human Services
200
Independence Avenue, S.W.
Room
509F, HHH Building
Washington, D.C. 20201
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