Notice of Information Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS

Understanding Your Health Record Information

Each time you visit a hospital, physician, or other healthcare provided, the provider makes a record of your visit. Typically, this record contains your health history, current symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your 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 you actually received the services billed for.
• A tool in medical education.
• A source of information for public health officials charged with improving the health of the regions they serve.
• A tool to assess the appropriateness and quality of care you received.
• A tool to improve the quality of healthcare and achieve better patient outcomes.

Understanding what is in your health records and how your health information is used helps you to:

• Ensure its accuracy and completeness.
• Understand who, what, where, why and how others may access your health information.
• Make informed decision about authorizing disclosure to others.
• Better understand the health information rights detailed below.

Your Rights Under the Federal Privacy Standard

Although your health records are physical property of the healthcare provider who completed it, you have certain rights with regard to the information contained therein. You have a right to:

• Request restriction on uses and disclosures of your health information for treatment, payment, and health care operation. “Health care operations consist of activities that are necessary to carry out the operations of the provider, such as quality assurance and peer review. The right to request restriction does not extend to uses or disclosures permitted or required under State Statue 164.512 (uses and disclosures not requiring a consent or an authorization). This would include disclosures required by law, like mandatory communicable disease reporting. In those cases, you do not have a right to request restriction. The consent to use and disclose your individually identifiable health information provides the ability to request restriction.
• Obtain a copy of this notice of information practices. Although we have posted a copy in prominent locations throughout the facility, you have a right to a hard copy upon request.
• Inspect and copy your health information upon request. Again, this right is not absolute. In certain situations, such as if access would cause harm, we can deny access. You do not have a right of access to the following:
  
  1. Psychotherapy notes. Such notes comprise those that are recorded in any medium by a healthcare provider who is a mental health professional documenting or analyzing a conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of your medical record.
  2. Information compiled in a reasonable anticipation of or for use in civil, criminal, or administrative actions or proceedings.
  3. Information that was obtained by someone other than a healthcare provider under a promise of confidentiality and the access requested would be reasonably likely to reveal the source of the information.

In other situations, the provider may deny you access but, if it does, the provider must provide you with a review of the decision denying access. These “reviewable” grounds for denial include:

• Licensed healthcare professional has determined, in the exercise of professional judgment, that the access is reasonably likely to endanger the life or physical safety of the individual or another person.
• Your personal health information makes reference to another person (other than a healthcare provider) and a licensed healthcare provider has determined, in the exercise of professional judgment, that the access is reasonably likely to cause substantial harm to such other person.
• The request is made by the individual’s personal representative and a licensed healthcare professional has determined, in the exercise of professional judgment, that the provider of access to such personal representative is reasonably likely to cause substantial harm to the individual or another person.

For these reviewable grounds, another licensed professional must review the decision of the provider denying access within 60 days. If we deny you access, we will explain why and what your rights are, including how to seek review.

We reserve the right to charge a reasonable, cost-based fee for making copies.

Request amendment/correction of your health information. We do not have to grant the request if:

• We did not create the record. If, as in the case of a consultation report from another provider, we did not create the record, we cannot know whether it is accurate or not. Thus, in such cases, you must seek amendment/correction from the party creating the record. If they amend or correct the record, we will put the corrected record in our records.
• The records are not available to you as discussed immediately above.
• The record is accurate and complete.

If we deny your request for amendment/correction, we will notify you why, how you can attach a statement of disagreement to your records (which we may rebut), and how you can file a complaint. If we grant the request, we will make the correction and distribute the correction to those who need it and those you identify to us that you want to receive the corrected information.

You also have a right to:

• Revoke your consent or authorization to use or disclose health information except to the extent that we have already taken action in reliance on the consent or authorization.
• Obtain an accounting of “non-routine” uses and disclosures-those other than for treatment, payment, and health care operations. We do not need to provide an accounting for:
  
  1. For the facility directory or to persons involved in the individual’s care or other notification purposes as provided in statue 164.510 (uses and disclosures requiring an opportunity for the individual to agree or to object, including notification to family members, personal representatives, or other persons responsible for the care of the individual, of the individual’s location, general condition, or death).
  2. For national security or intelligence purposes under statue 164.512(k)(2) (disclosures not requiring consent, authorization, or an opportunity to object, see chapter 16).
  3. To correctional institutions or law enforcement officials under statue 164.512(k)(5) (disclosures not requiring consent, authorization, or an opportunity to object).
  4. That occurred before April 14, 2003.

We must provide the accounting within 60 days. The accounting must include:

1. Date of disclosure.
2. Name and address of the organization or person who received the protected health information.
3. Brief description of the information disclosed.
4. Brief statement of the purpose of the disclosure that reasonably informs you of the basis for the disclosure or, in lieu of such statement, a copy of your written authorization, or a copy of the written request for disclosure.
   

The first accounting in any 12 month period is free. Thereafter, we reserve the right to charge a reasonable, cost-based fee.

Our Responsibilities under the Federal Privacy Standard

In addition to providing you your rights, as detailed above, the federal privacy standard requires us to:

• Maintain the privacy of your health information, including implementing reasonable and appropriate physical, administrative, and technical safeguards to protect the information.
• Provide you with this notice as to our legal duties and privacy practices with respect to individually identifiable health information we collect and maintain about you.
• Abide by the terms of this notice.
• Train our personnel concerning privacy and confidentiality.
• Implement a sanction policy to discipline those who breach privacy/confidentiality or our policies with regard thereto.
• Mitigate (lessen the harm of) any breach of privacy/confidentiality.

WE RESERVE THE RIGHT TO CHANGE OUR PRACTICES AND TO MAKE THE NEW PROVISIONS EFFECTIVE FOR ALL INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION WE MAINTAIN. SHOULD WE CHANGE OUR INFORMATION PRACTICES, WE WILL MAIL A REVISED NOTICE TO THE ADDRESS YOU HAVE SUPPLIED US.

We will not use or disclose your health information without your consent or authorization, except as described in this notice or otherwise required by law.

How to Get More Information or to Report a Problem

If you have questions and/or would like additional information, you may contact the Medical Records Department at 893-0526.

Examples of Disclosures for Treatment, Payment, and Health Operations

We will use your health information for treatment.

Example: Each time you visit a record is made of your visit. This includes: reason for visit, vital signs, lab results, topics you have discussed with the doctor or nurse and the findings of the doctor during his/her exam.

We will also provide other healthcare professionals, or a subsequent healthcare provider with copies of your records to assist them in treating you once we are no longer treating you.

We will use your health information for payment.

We may send a bill to you or a third-party payer, such as an insurance company. The information on or accompanying the bill will include information that identifies you, your diagnosis, treatment received, and supplies used.

Business associates: We provide some services through contracts with business associates. Examples include certain diagnostic tests, laboratory and pathology. When we use these services, we may disclose your health information to the business associate so that they can perform the function(s) we have contracted with them to do and bill you or your third-party payer for services rendered. 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, your location, and general condition.

Communication with family: Unless you object, 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 their research have been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

Funeral directors: We may disclose health information to funeral directors consistent with applicable law to enable them to carry out their duties.

Marketing/continuity of care: 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 effects/events with respect to food, drugs, supplements, product or 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.

Correctional institution: Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals.

Law enforcement: We may disclose health information purposes as required by law or in response to a valid subpoena.

Health oversight agencies and public health authorities: If a member of our work force or a business associate believes in good faith that we have engaged in unlawful conduct or otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public, they may disclose your health information to health oversight agencies and/or public health authorities, such as the department of health.

The Federal Department of Health and Human Services (DHHS): Under the privacy standards, we must disclose your health information to DHHS as necessary for them to determine our compliance with those standards.

Effective Date: April 1, 2003

Connie Wittkopp, CMA
Medical Records Custodian
Plymouth Family Physicians