HIPAA Notice of Privacy Practice
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.
This Notice of Privacy Practice describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
Uses and Disclosures of Protected Health Information
Your protected health information may be used and disclosed by your audiologist, 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, pay your health care bills, to support the operation of Hearcare, P.C., and any other use required by law.
Treatment: Our practice may use your health care information for treatment purposes. For example, audiological test results may be sent (via email, facsimile or mail) to a physician who may determine that medical treatment is necessary. Any of our employees may come in contact with your health information in order to provide administrative and clinical office procedures designed to optimize scheduling and coordination of care between the audiologist and the business office staff. We may share your health information with referring physicians, hearing aid manufacturers or other health care personnel providing you treatment and rehabilitative therapy.
Payment: We may use or disclose medical information about your treatment and services to bill and collect payment from you, your insurance company or a third party payer.
Healthcare Operations: In order to operate our business, we may use and disclose your health care information to another party, known as a “business associate”, to assist us to carry our functions and activities such as (but not limited to) legal, accounting, consulting, accreditation or financial services. We will disclose your health information only as permitted by the agreements or as permitted by law, and under which the business associate also agrees to comply with provisions of law relating to the use of your health information. Other health care providers may have access to your health care information in order to assist in their health care operations. For example, we may want to evaluate the quality of care you receive from us and business planning strategies for cost effectiveness. We may use or disclose your protected health information in the following situations without your authorization.
These situations include: as Required By Law, Public Health issues as required by law. Communicable Diseases, Health Oversight, Abuse or Neglect: Food and Drug Administration requirements: Legal Proceedings: Law Enforcement: Coroners, Funeral Directors and Organ Donations. Research: Criminal Activity: Military Activity and National Security: Workers Compensation: Inmates: Required Uses and Disclosures: Marketing- these communications are an important part of our philosophy of partnering with our patients to be sure they receive quality hearing health care. They may include postcards, letters and telephone reminders. Under the laws, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500.
Other Permitted and Required Uses and Disclosures Will Be Made Only with Your Consent, Authorization or Opportunity to Object unless required by law.
You may revoke this authorization, at any time, in writing, except to the extent that Hearcare, P.C. has taken an action in reliance on the use or disclosure indicated in the authorization.
Following is a statement of your rights with respect to your protected health information.
You have the right to inspect and copy your protected health information. 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.
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 purpose of treatment, payment or healthcare operations. You may also request that any 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 this Notice of Privacy Practices. Your request must state the specific restrictions requested and to whom you want the restriction to apply.
Hearcare, P.C. is not required to agree to a restriction that you may request. If Hearcare, P.C. believes it is in your best interest to permit use and disclosure of your protected health information, your protected health information will not be restricted. You then have the right to use another Healthcare Professional.
You have the right to request to receive confidential communications from us by alternative means or at an alternative location. 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 alternatively i.e. electronically.
You may have the right to have Teter Audiology P.C. amend your protected health information. 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.
You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information.
We reserve the right to change the terms of this notice and will inform you by mail of any changes. You then have the right to object or withdraw as provided in this notice. All requests must be in writing and addressed to the Privacy Officer at the address below. There may be a fee for copying, postage and time involvement.
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 officer of your complaint. We will not retaliate against you for filing a complaint.
This notice was published and becomes effective on/or before April 14, 2009.
We are required by law to maintain the privacy of, and provide individuals with, this notice of our legal duties and privacy practices with respect to protected health information. If you have any objections to this form, please ask to speak with our HIPAA Privacy Officer in person or by phone at our Main Phone Number.