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Notice of Privacy
Practice for Neurosurgical Associates PSC
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. Neurosurgical
Associates PSC is required by law to maintain the privacy of protected
health information and to provide individuals with notice of its legal
duties and privacy practices with respect to protected health information.
This Notice
describes how we may use or disclose your “protected health information”
for various purposes. It also
describes your rights to access and control your protected health
information. “Protected
health information” is information about you that may identify you and
relates to your past, present or future physical or mental health or
condition and related health services.
Neurosurgical
Associates, PSC is required to abide by the terms of the Notice of Privacy
Practices currently in effect. We
reserve the right to change the terms of this Notice and to make the new
Notice provisions effective for all protected health information that we
maintain. Upon your request, we
will provide you with any revised Notice of Privacy Practices by mail.
Uses and
Disclosures of Protected Health Information Based Upon Your Written Consent
We will ask you to
sign a consent form. Once you
sign that form, you have consented to the use and disclosure of that
protected health information for treatment, payment and health care
operations. Your protected
health information may then be used and disclosed by your physician, our
office staff, and others outside of our office that are involved in your
care and treatment for the purpose of providing health care services to you.
Your protected health information may also be used and disclosed to
pay your health care bills and to support the operation of this practice.
Following are examples of the types of uses and disclosures of your
protected health care information that the practice is permitted to make
once you have signed our consent form.
These examples are not meant to be exhaustive, but to describe the
types of uses and disclosures that may be made by our office once you have
provided consent.
Treatment:
We will use and disclose your protected health information 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 that has already obtained your permission to have access to
your protected health information. For
example, we would disclose your protected health information, as necessary,
to a home health agency that provides care to you.
We will also disclose protected health information to other
physicians who may be treating you when we have the necessary permission
from you to disclose you protected health information.
For example, your protected health information 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.
In addition, we may disclose your protected health information from
time-to time to another physician or health care provider (e.g. a
specialist, laboratory or another facility) who, at the request of your
physician, becomes involved in your care by providing assistance with your
health care diagnosis or treatment.
Payment:
Your protected health information will be used, as needed t for your
health care services. This may include certain activities that your health plan may
undertake before it approves or pays for the health care services we
recommend for you such as: making a determination of eligibility or coverage
for insurance benefits, reviewing services provided to you for medical
necessity, and undertaking utilization review activities.
For example, obtaining approval for hospitalization may require that
your relevant protected health information be disclosed to the health plan
to obtain approval for the hospital admission.
Healthcare
Operation: We may use or
disclose, as needed, your protected health information in order to support
the business activities of this practice.
These activities include, but are not limited to, quality assessment
activities, employee review activities, training of staff, licensing,
marketing and other business activities of our practice as well as
conducting or arranging for other business activities.
For example, we may use a sign in sheet at the registration desk
where you will be asked to sign your name and indicate your physician or
time of appointment. We may
also call you by name in the waiting room when your physician is ready to
see you. We may use or disclose
your protected health information as necessary, to contact you to remind you
of your appointment.
We will share your
protected health information with third party “business associates” that
perform various activities (e.g. billing, transcription services) for the
practice. Whenever an
arrangement between our office and a business associate involves the use or
disclosure of your protected health information, we will have a written
contract that contains terms that will protect the privacy of your protected
health information.
We may use or disclose your protected health information, as
necessary, to provide you with other health-related benefits and services
that may be of interest to you. For example, your name and address may be
used to send you a newsletter about our practice and the services we offer.
We may also send you information about products or services that we
believe may be beneficial to you. You
may contact our Privacy Contact to request that these materials not be sent
to you
We may use or disclose
your demographic information and the dates that you received treatment from
your physician, as necessary, in order to contact you for fundraising
activities supported by our office. If
you do not want to receive these materials please contact our Privacy
Contact.
Uses and
Disclosures that may be made with your written authorization
Other uses and
disclosures of your protected health information will be made only with your
written authorization, unless otherwise permitted or required by law as
described below. You may revoke
such an authorization, at any time, in writing, except to the extent that
your physician or the practice has taken an action in reliance on the use or
disclosure indicated in the authorization.
Uses and
Disclosures that may be made unless you object
We may also use and
disclose your protected health information in the following instances.
In these instances, you have the opportunity to agree or object to
the use or disclosure of all or part of your protected health information.
If you are not present or able to agree or object to the use or
disclosure of the protected health information, then your physician may,
using professional judgment, determine whether the disclosure is in your
best interest. In this case,
only the protected health information that is relevant to your health care
will be disclosed.
Others involved in
your healthcare: Unless you
object we may disclose to a member of your family, a relative, a close
friend or any other person you identify, your protected health information
that directly relates to that person’s involvement in your health care.
If you are unable to agree to object to such a disclosure, we may
disclose such information as necessary if we determine that it is in your
best interest based on our professional judgment.
We may use or disclose your protected health information to notify or
assist in notifying a family member, personal representative or any other
person that is responsible for your care.
Disaster Relief:
We may us or disclose your protected health information to an
authorized public or private entity to assist in disaster relief efforts and
to coordinate uses and disclosures to family or other individuals involved
in your health care.
Disclosures that
may be made without your consent, authorization or opportunity to object
We may use or disclose your protected health information in
the following situations without your consent or authorization. These
situations include:
Required by Law:
We may use or disclose your protected health information to the
extent that the use or disclosure is required by law.
The use or disclosure will be made in compliance with the law and
will be limited to the relevant requirements of the law.
Public Health:
We may disclose you protected health information for public health
activities and purposes to a public health authority that is permitted by
law to collect or receive the information.
The disclosure will be made for the purpose of controlling disease,
injury or disability. We may
also disclose your protected health information, if directed by the public
health authority, or to a foreign government agency that is collaborating
with the public health authority.
Communicable Diseases:
We may disclose your protected health information, if authorized by
law, to a person who may have been exposed to a communicable disease or may
otherwise be at risk of contracting or spreading the disease or condition.
Health Oversight:
We may disclose protected health information to a health oversight
agency for activities authorized by law, such as audits, investigations, and
inspections. Oversight agencies
seeking this information include government agencies that oversee the health
care system, government benefit programs, other government regulatory
programs and civil rights laws.
Abuse or Neglect:
We may disclose your protected health information to public officials
who are authorized by law to receive reports of abuse, neglect or domestic
violence.
Food & Drug
Administration: We may disclose
your protected health information to a person or company required by the
Food and Drug Administration to report adverse events, product defects or
problems, biologic product deviations, track products to enable product
recalls; to make repairs or replacements, or to conduct post marketing
surveillance, as required.
Legal Proceedings:
We may disclose protected health information in the course of any
judicial or administrative proceeding, in response to an order of a court or
administrative judicial or administrative proceeding, in response to an
order of a court or administrative tribunal (to the extent such disclosure
is expressly authorized), and in certain conditions in response to a
subpoena, discovery request or other lawful process.
Law Enforcement:
We may also disclose protected health information for law enforcement
purposes. These law enforcement
purposes include (1) legal processes and those otherwise required by law,
(2) requests for limited information for identification and location
purposes, (3) requests pertaining to victims of a crime and (4) alerting law
enforcement officials when (a) there is suspicion that death has occurred as
a result of criminal conduct, (b) in the event that a crime occurs on the
Practice’s premises, or (c) a medical emergency exits (not on the
Practice’s premises) and it is likely that a crime has occurred
Coroners, Funeral
Directors, and Organ Donation: We
may disclose protected health information to a coroner or medical examiner
for identification purposes, determining cause of death or for the coroner
or medical examiner to perform other duties authorized by law.
We may also disclose protected health information to a funeral
director, as authorized by law, in order to permit the funeral director to
carry out their duties. We may
also disclose such information in reasonable anticipation of death.
Protected health information may be used and disclosed for cadaveric
organ, eye or tissue donation purposes.
Research:
We may disclose your protected health information to researchers when
their research has been approved by an institutional review board that has
reviewed the research proposal and established protocols to ensure the
privacy of your protected health information.
Threatening
Activity: Consistent with all
applicable federal and state laws we may disclose your protected health
information, if we believe that the use or disclosure is necessary to
prevent or lessen a serious and imminent threat to the health or safety of a
person or the public. We may
also disclose protected health information if it is necessary for law
enforcement authorities to identify or apprehend an individual.
Military Activity
and National Security: When the
appropriate conditions apply, we may use of disclose protected health
information of individuals who are Armed Forces personnel (1) for activities
deemed necessary by appropriate military command authorities; (2) for the
purpose of a determination by the Department of Veterans Affairs of your
eligibility for benefits, or (3) to foreign military authority if you are a
member of that foreign military service branch. We may also disclose your
protected health information to authorized federal officials for conducting
national security and intelligence activities, including for the provision
of protective services to the President or others legally authorized.
Workers’
Compensation: We may disclose
your protected health information as authorized to comply with workers’
compensation laws and other similar legally established programs.
Inmates:
We may use or disclose your protected health information if you are
an inmate of a correctional facility and your physician created or received
your protected health information in the course of providing care to you.
Required Uses and
Disclosures: Under the law we
must make disclosures to your and when required by the Secretary of the
Department of Health & Human Services to investigate or determine our
compliance with the privacy standards applicable to your protected health
information.
Your rights
regarding your protected health information
Following is a
statement of your rights with respect to your protected health information
and a brief description of how you may exercise these rights.
·
You have the right to inspect and copy your protected health
information. This means you may
inspect and obtain a copy of protected health information about you that is
contained in a designated record set for as long as we maintain the
protected health information. A
“designated record set” contains medical and billing records and any
other records that your physician and the practice use for making decisions
about you. 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 protected health
information that is subject to law that prohibits access to protected health
information. Depending on the
circumstances, a decision to deny access may be reviewable.
In some circumstances, you may have a right to have this decision
reviewed. Please contact our
Privacy Contact if you have questions about access to your medical record.
·
You have the right to request a restriction of your protected
health information. This means
you may ask us not to use or disclose any part of your protected health
information for the purposes of treatment, payment or healthcare operations.
You may also request that may part of your protected health
information 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 requested and to whom you want
the restriction to apply. Your
physician is not required to agree to a restriction that you may request.
If your physician does agree to the requested restriction, we may not
use or disclose your protected health information in violation of that
restriction unless it is needed to provide emergency treatment. With this in mind, please discuss any restriction you wish to
request with your physician. You
may request a restriction by contacting the Privacy Contact
·
You have the right to request to receive confidential
communications from us by alternative means or at an alternative location.
We will accommodate reasonable requests.
We may also condition this accommodation by asking us for information
as to how payment will be handled or specification of an alternative address
or other method of contract. We
will not request an explanation from you as to the basis for the request.
Please make this request in writing to our Privacy Contact.
·
You may have the right to have your physician amend your
protected health information. this
means you may request an amendment of protected health information about you
in a designated record set for as long as we maintain this information.
In certain cases we may deny your request for an amendment.
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.
Please contact our Privacy Contact to determine if you have questions
about amending your medical record.
·
You have the right to receive an accounting of certain
disclosures we have made, if any, of your protected health information.
This right applies to disclosures for purposes other than treatment,
payment or healthcare operations as described in this Notice of Privacy
Practices It excludes disclosures we may have made to you, for a facility
directory, to family members or friends involved in your care, or regarding
these disclosures that occurred after April 14, 2003.
You may request a shorter timeframe.
The right to receive this information is subject to certain
exceptions, restrictions and limitations.
·
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
electronically
Making a Complaint:
You may 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 Contact of
your complaint. We will not
retaliate against you for filing a complaint.
You may contact our Privacy Contact at (859) 260-2725 or by writing
to Privacy Contact P O Box 8448, Lexington, KY
40533.
This notice was
published and becomes effective on April 14, 2003.
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