Edwin S. Hart III, DPM
Notice of Privacy Practices
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 are required by federal regulation, known as the “HIPAA Privacy Rule” to
provide a detailed notice of our privacy practices to you in writing. We
know that this Notice is long. The HIPAA Privacy Rule requires us to address
many specific things in this Notice.
I. OUR COMMITMENT TO PROTECTING HEALTH INFORMATION ABOUT YOU
In this notice, we describe the ways that we may use and disclose health
information about our patients. The HIPAA Privacy Rule requires that we
protect the privacy of health information that identifies a patient, or
where there is a reasonable basis to believe the information can be used to
identify a patient. This information is called “protected health
information” or “PHI”. This notice describes your rights as our patient and
our obligations regarding the use and disclosure of PHI. We are required by
law to :
Maintain the privacy of PHI about you;
Give you this Notice of our legal duties and privacy
with respect to PHI; and
Comply with the terms of our Notice of Privacy that is
currently in effect.
We
reserve the right to make changes to this Notice and to make such changes
effective for all PHI we may already have about you. If and when this Notice
is changed, we will post a copy in our office in a prominent location. We
will also provide you with a copy of the revised Notice upon your request
made to our Privacy Official.
II. HOW WE MAY USE AND DISCLOSE PROTECTED HEALTH INFORMATION ABOUT YOU
USES AND DISCLOSURES FOR TREATMENT, PAYMENT AND HEALTH CARE OPERATIONS
The following categories describe ways we may use and disclose PHI for
treatment, payment or health care operations. The examples included with
each category do not list every type of use or disclosure that may fall
within that category.
Treatment: We may use and disclose PHI about you to
provide, coordinate or manage your health care and related services. We may
consult with other health care providers regarding your treatment and
coordinate and manage your health care with others. For example, we may use
and disclose PHI when you need a prescription, lab work, an x-ray, or other
health care services. In addition, we may use and disclose PHI about you
when referring you to another health care provider. For example, if you are
referred to another physician, we may disclose your PHI to your new
physician regarding whether you are allergic to any medications.
We may also disclose PHI about you for the treatment activities of another
health care provider. For example, we may send a report about your care from
us to a physician that we refer you to so that the other physician may treat
you.
Payment: We may use and disclose HPI so that we can bill
and collect payment for the treatment and services provided to you. Before
providing treatment or services, we may share details with your health plan
concerning the services you are scheduled to receive. For example, we may
ask for payment approval from your health plan before we provide care or
services. We may use and disclose HPI to find out if your health plan will
cover the cost of care and services we provide. We may use and disclose HPI
to confirm you are receiving the appropriate amount of care to obtain
payment for services. We may use and disclose HPI for billing, claims
management and collection activities. We may disclose PHI to insurance
companies providing you with additional coverage. We may disclose limited
PHI to consumer reporting agencies relating to collection of payments owed
to us.
We may also disclose PHI to another health care provider or to a company or
health care plan required to comply with the HIPAA Privacy Rule for the
payment activities of that health care provider, company, or health plan.
For example, we may allow a health insurance company to review PHI for the
insurance company’s activities to determine the insurance benefits to be
paid for your care.
Health Care Operations: We may use and disclose PHI in
performing business activities which are called health care operations.
Health care operations include doing things that allow us to improve the
quality of care we provide and to reduce health care costs. We may use and
disclose PHI about you in the following health care operations:
Reviewing and improving the quality, efficiency and
cost of care that we provide to our patients. For example, we may use PHI
about you to assist our physicians and staff in deciding how we can
improve the medical treatment we provided to others.
Improving health care and lowering costs for groups of
people who have similar health problems and helping to manage and
coordinate the care for these groups of people. We may use PHI to identify
groups of people with similar health problems to give them information,
for instance, about treatment alternatives and educational classes.
Reviewing and evaluating the skills, qualifications,
and performances of health care providers taking care of you and our other
patients.
Providing training programs for students, trainees,
health care providers, or non-health care professionals (for example,
billing personnel) to help them practice or improve their skills.
Cooperating with outside organizations that assess the
quality of the care that we provide.
Cooperating with outside organizations that evaluate,
certify, or license health care providers or staff in a particular field
or specialty. For example, we may use or disclose HPI so that one of our
nurses may become certified as having expertise in a specific field of
nursing.
Cooperating with various people who review our
activities. For example, PHI may be seen by doctors reviewing the services
provided to you, and by accountants, lawyers and others who assist us in
complying with the law and managing our business.
Assisting us in making plans for our practice’s future
operations.
Resolving grievances within our practice.
Reviewing our activities and using or disclosing PHI
in the event that we sell our practice to someone else or combine with
another practice.
Business planning and development, such as
cost-management analyses.
Business management and general administrative
activities of our practice, including managing our activities related to
complying with the HIPAA Privacy Rule and other legal requirements.
Creating “de-identified” information that is not
identifiable to any individual.
If another
health care provider, company or health plan that is required to comply with
the HIPAA Privacy Rule has or once had a relationship with you, we may
disclose PHI about you for certain health care operations of that health
care provider or company. For example, such health care operations may
include: reviewing and improving the quality, efficiency and cost of care
provided to you; reviewing and evaluating the skills, qualifications, and
performance of health care providers; providing training programs for
students, trainees, health care providers, or non-health care professionals;
cooperating with outside organizations that evaluate, certify, or license
health care providers or staff in a particular field or specialty; and
assisting with legal compliance activities of that health care provider or
company.
We may also disclose PHI for the health care operations of an “organized
health care arrangement” in which we participate. An example of an
“organized health care arrangement” is the joint care provided by a hospital
and the doctors who see patients at the hospital.
Communication From Our Office: We may contact you to remind
you of appointments and to provide you with information about treatment
alternatives or other health related benefits and services that may be of
interest to you.
OTHER USES AND DISCLOSURES WE CAN MAKE WITHOUT YOUR WRITTEN
AUTHORIZATION
Uses and Disclosures For Which You Have The Opportunity To Agree or Object
We may use and disclose PHI about you in some situations where you have the
opportunity to agree or object to certain uses and disclosures of PHI about
you. If you do not object, then we may make these types of uses and
disclosures of PHI.
Individuals Involved in Your Care or Payment for Your
Care: We may disclose PHI about you to your family member, close friend,
or any other person identified by you if that information is directly
relevant to the person’s involvement in your care or payment for your
care. If you are present and able to consent or object (or if you are
available in advance), then we may only use or disclose PHI if you do not
object after you have been informed of your opportunity to object. If you
are not present or you are unable to consent or object, we may exercise
professional judgment in determining in determining whether the use or
disclosure of PHI is in your best interests. For example, if you are
brought into this office and are unable to communicate normally with your
physician for some reason, we may find it is in your best interest to give
your prescription and other medical supplies to the friend or relative who
brought you in for treatment. We may also use and disclose PHI to notify
such persons of your location, general condition, or death. We also may
coordinate with disaster relief agencies to make this type of
notification. We also may use professional judgment and our experience
with common practice to make reasonable decisions about your best
interests in allowing a person to act on your behalf to pick up filled
prescriptions, medical supplies, x-rays, or other things that contain PHI
about you.
OTHER
USES AND DISCLOSURES WE CAN MAKE WITHOUT YOUR WRITTEN AUTHORIZATION OR
OPPORTUNITY TO AGREE OR OBJECT
We may use and disclose PHI about you in the following circumstances without
your authorization or opportunity to agree or object, provided that we
comply with certain conditions that may apply
Required by Law: We may use and disclose PHI as required by
federal, state, or local law. Any disclosure complies with the law and is
limited to the requirements of the law.
Public Health Activities: We may use or disclose PHI to
public health authorities or other authorized persons to carry out certain
activities related to public health, including the following activities:
To prevent or control disease, injury, or disability;
To report disease, injury, birth, or death;
To report child abuse or neglect;
To report reactions to medications or problems with
products or devices regulated by the federal Food and Drug Administration
or other activities related to qualify, safety, or effectiveness of
FDA-regulated products or activities;
To locate and notify persons of recalls of products
they may be using;
To notify a person who may have been exposed to a
communicable disease in order to control who may be at risk of contracting
or spreading the disease; or
To report to your employer, under limited
circumstances, information related primarily to workplace injuries or
illness, or workplace medical surveillance.
Abuse, Neglect, or Domestic Violence: We may disclose PHI in
certain cases to proper government authorities if we reasonably believe that
a patient has been a victim of domestic violence, abuse, or neglect.
Health Oversight Activities: We may disclose PHI to a health
oversight agency for oversight activities including, for example, audits,
investigations, inspections, licensure and disciplinary activities and other
activities conducted by health oversight agencies to monitor the health care
system, government health care programs, and compliance with certain laws.
Lawsuits and Other Legal Proceedings: We may use or
disclose PHI when required by a court or administrative tribunal order. We
may use or disclose PHI in response to subpoenas, discovery requests, or
other required legal process when efforts have been made to advise you of
the request or to obtain an order protecting the information requested.
Law Enforcement: Under certain conditions, we may disclose
PHI to law enforcement officials for the following purposes where the
disclosure is:
About a suspected crime victim if, under certain
limited circumstances, we are unable to obtain a person’s agreement
because of incapacity or emergency;
To alert law enforcement of a death that we suspect
was the result of criminal conduct;
Required by law;
In response to a court order, warrant, subpoena,
summons, administrative agency request, or other authorized process;
To identify or locate a suspect, fugitive, material
witness, or missing person;
About a crime or suspected crime committed at our
office; or
In response to a medical emergency not occurring at
the office, if necessary to report a crime, including the nature of the
crime, the location of the crime or the victim, and the identity of the
person who committed the crime.
Coroners, Medical Examiners, Funeral Directors: We may disclose PHI
to a coroner or medical examiner to identify a deceased person and determine
the cause of death. In addition, we may disclose PHI to funeral directors,
as authorized by law, so that they may carry out their jobs.
Organ and Tissue Donation: If you are a organ donor, we may
use of disclose PHI to organizations that help procure, locate, and
transport organs in order to facilitate an organ, eye, or tissue donation
and transplantation.
Research: We may use and disclose PHI about you for
research purposes under certain limited circumstances. We must obtain a
written authorization to use and disclose PHI about you for research
purposes except in situations where a research project meets specific,
detailed criteria established by the HIPAA Privacy Rule to ensure the
privacy of PHI.
To Avert a Serious Threat to Health or Safety: We may use
or disclose PHI about you in limited circumstances when necessary to prevent
a thereat to the health or safety of a person or to the public. This
disclosure can only be made to the person who is able to help with the
threat.
Specialized Government Functions: Under certain
circumstances we may disclose PHI:
For certain military and veteran activities, including
determination of eligibility for veterans for veterans benefits and where
deemed necessary by military command authorities;
For national security and intelligence activities;
To help provide protective services for the president
and others;
For the health or safety of inmates and others at
correctional institutions or other law enforcement custodial situations
for the general safety and health related to corrections facilities.
Disclosures required by HIPAA Privacy Rule: We are required to
disclose PHI to the Secretary of the United States Department of Health and
Human Services when requested by the Secretary to review our compliance with
the HIPAA Privacy Rule. We are also required in certain cases to disclose
PHI to you upon your request to access PHI or for an accounting of certain
disclosures of PHI about you (those requests are described in Section III of
this Notice).
OTHER USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION REQUIRE
YOUR AUTHORIZATION
Workers’ Compensation: We may disclose PHI as authorized by
workers’ compensation laws or other similar programs that provide benefits
for work-related injuries or illness.
OTHER USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION REQUIRE
YOUR AUTHORIZATION
All other uses and disclosures of PHI about you will only be made
with your written authorization. If you have authorized us to use or
disclose PHI about you, you may revoke your authorization at any time,
except to the extent we have taken action based on the authorization.
III. YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION ABOUT YOU
Under federal law, you have the following rights regarding PHI
about you:
Right to request Restrictions: You have the right to
request additional restrictions on the PHI that we may use for treatment,
payment and health care operations. You may also request additional
restrictions on our disclosure of PHI to certain individuals involved in
your care that otherwise are permitted by the Privacy Rule. We are not
required to agree to your request. If we do agree to your request, we are
required to comply with our agreement except in certain cases, including
where the information is needed to treat you in the case of an emergency. To
request restrictions, you must make your request in writing to our Privacy
Official. In your request, please include (1) the information that you want
to restrict; (2) how you want to restrict the information (for example,
restricting use to this office, only restricting disclosure to persons
outside this office, or both); and (3) to whom you want those restrictions
to apply.
Right to Receive Confidential Communications: You have the
right to request that you receive communications regarding PHI in a certain
manner or at a certain location. For example, you may request that we
contact you at home, rather than at work. You must make your request in
writing to our Privacy Official. You must specify how you would like to be
contacted (for example, by regular mail to your post office box and not your
home). We are required to accommodate reasonable requests.
Right to Inspect and Copy: You have the right to request
the opportunity to inspect and receive a copy of PHI about you in certain
records that we maintain. This includes your medical and billing records but
does not include psychotherapy notes or information gathered or prepared for
a civil, criminal, or administrative proceeding. We may deny your request to
inspect and copy PHI only in limited circumstances. To inspect and copy PHI
please contact our Privacy Official. If you request a copy of PHI about you,
we may charge you a reasonable fee for the copying, postage, labor and
supplies used in meeting your request.
Right to Amend: You have the right to request that we amend
PHI about you as long as such information is kept by or for our office. To
make this type of request you must submit your request in writing to ou
Privacy Official. You must also give us a reason for your request. We may
deny your request in certain cases, including if it is not in writing or if
you do not give us a reason for the request.
Right to Receive an Accounting of Disclosures: You have the
right to request an “accounting” of certain disclosures that we have made of
PHI about you This is a list of disclosures made by us during a specified
period of up to six years other than disclosures made: for treatment,
payment, and health care operations; for use in or related to a facility
directory; to family members or friends involved in your care; to you
directly; pursuant to an authorization of you or your personal
representative, or for certain notification purposes (including national
security, intelligence, correctional, and law enforcement purposes) and
disclosures made before April 14, 2003. If you wish to make such a request,
please contact our Privacy Official identified on the last page of this
Notice. The first list that you request in a 12-month period will be free,
but we may charge you for our reasonable costs of providing additional lists
in the same 12-month period. We will tell you about these costs, and you may
choose to cancel your request at any time before costs are incurred.
Right to a Paper Copy of this Notice: You have a right to
receive a paper copy of this Notice at any time. You are entitled to a paper
copy of this Notice even if you have previously agreed to receive this
Notice electronically.
To obtain a
paper copy of this Notice, please contact our Privacy Official listed on
the last page of this Notice
IV.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a
complaint with us or with the Secretary of the United States Department of
Health and Human Services. To file a complaint with our office, please
contact our Privacy Official at the address and number listed below. We will
not be retaliate or take action against you for filing a complaint.
V. QUESTIONS
If you have any questions about this Notice, please contact our Privacy
Official at the address and telephone number listed below.
VI. PRIVACY OFFICIAL CONTACT INFORMATION
You may contact our Privacy Official at the following address and phone
number.
2305 Easton Avenue
Bethlehem, Pennsylvania 18017
Telephone (610) 868-4300 - Fax (610) 691-7624
This
Notice was published and first became effective on April 14, 2003.