Notice Of HIPAA Privacy Practices

Online Notice Of HIPAA Privacy Practices

THIS NOTICE DESCRIBES HOW PERSONAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN RECEIVE ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This Notice of HIPAA Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations, and for other purposes that are permitted or required by law. It also describes your rights to access and control of your personal medical information. “Protected health information” includes demographic information and 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 care services.

We are required by law to: make sure that medical information that identifies you is kept private; give you this Notice of our legal duties and privacy practices with respect to medical information about you; and follow the terms of the Notice that is currently in effect.

Who Will Follow This Notice: This Notice applies to Mikhail Family Chiropractic & Sports Rehabilitation Center, LLC (referred to as “the clinic” throughout this document) and its doctors, employees, staff, and shadowing interns for which patient information is shared. This Notice also applies to other health care and service providers that provide services such as billing and marketing. As a condition to providing services to us, such providers must agree to comply with all of our policies including its policies relating to patient privacy.

How we may use and disclose personal health information about you: Your protected health information may 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, to pay your health care bills, to support the operation of the clinic, to support the education of health care interns and any other use required by law.

The following categories describe different ways that we use and disclose personal health information. For each category of uses or disclosures, we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

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 and different departments within the clinic. For example, we share medical information about you in order to coordinate different things you need, such as lab work and x-rays. Your protected health information may also be provided to another physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.

Payment: We may use and disclose your medical information about you so that the treatment and services you receive at the clinic may be billed to and payment may be collected from you, an insurance company or third party. For example, we may need to give your health plan information about treatment you received at the clinic so that your health plan will pay us or reimburse you for the treatment. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

Healthcare Operations: We may use and disclose your protected health information in order to support the clinic’s business activities. These uses and disclosure are necessary to run the clinic and make sure that all of our patients receive quality care. For example, we may use your medical information to review our treatment and services and to evaluate the performance of our staff and employees and in caring for you or we may send you a patient satisfaction survey. We may also combine medical information about many of our patients to decide what additional services we should offer, what services are not needed and whether certain new treatments are effective. We may also disclose information to doctors, technicians, staff, employee, and other clinic personnel for review and learning purposes. We may remove information that identifies you from this set of medical information so others may use it to study health care and health care delivery without learning who the specific patients are.

Waiting Room and Appointment Reminders: We may use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your physician. We may also call you by name in the waiting room when your physician is ready to see you. We may use and disclose your medical information as a reminder that you have an appointment at our clinic. If you complete paperwork online, or book your appointment online, we will send you automated appointment reminders.

Health-Related Benefits and Services: We may use and disclose your medical information to tell you about health related benefits, services, or wellness classes that may be of interest to you.

Individuals Involved in Your Care or Payment for Your Care: We may release medical information about you to individuals you designate as a care giver (a friend or family member). We may also give information to someone who helps pay for your care.

Workers’ Compensation: We may release medical information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Marketing Activities: We may use information about you to contact you in an effort to market the clinic, educational and health care operations. For these activities, the clinic may retain an outside agency for assistance. In this instance, we would only release contact information, such as your name, address and phone number and the dates you received treatment or services at the clinic. You must notify the clinic’s Privacy Officer (Dr. Mikhail) in writing if you do not want the clinic to use your contact information for its marketing activities.

Research: Under certain circumstances, we may use and disclose medical information about you for research purposes; such as publishing an interesting successful case or comparing the health and recovery of all patients who received certain treatment to those who received another, for the same condition. We will almost always ask for your specific permission if the researcher will have access to your name, address or other information that reveals who you are, or will be involved in your care at the clinic.

As Required By Law: We will disclose medical information about you when required to do so by federal, state or local law.

Public Health Risks (Health and Safety to you and/or others): We may disclose medical information about you for public health activities. We may use and disclose medical information about you to agencies when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. These activities generally include the following:  to prevent or control disease, injury or disability; to report child abuse or neglect; to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure when required or authorized by law.

Health Oversight Activities: We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with other laws. Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute.

Law Enforcement: We may release medical information about you if asked to do so by a law enforcement official in response to a court order, subpoena, warrant, summons or similar process.

Coroners, Medical Examiners and Funeral Directors: We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death.

Other uses of Medical Information: With your written permission and direction, other uses and disclosures of medical information not covered by this Notice or the laws that apply to us will be made. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

Your Rights Regarding Medical Information About You:

1. Right to Inspect and Copy: You have the following rights regarding medical information we maintain about you: To inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include mental health information. To inspect and copy medical information that may be used to make decisions about you, you must submit a request in writing to the clinic. If you request a copy of the information, we will be charged a fee for the costs of copying, mailing or other supplies associated with your request. We may deny your request to inspect and copy your medical information in certain very limited circumstances.

If you are denied access to medical information, you may request that the denial be reviewed. Then, another licensed health care professional chosen by the clinic will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

2. Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the clinic. To request an amendment, your request must be made in writing and submitted to the Chief of Staff (Dr. Mikhail). In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that: Was not created by us, unless the person or entity that created the information is no longer available to make the amendment; Is not part of the medical information kept by or for the clinic; Is not part of the information which you would be permitted to inspect and copy; or Is accurate and complete.

3. Right to an Accounting of Disclosures: You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of medical information about you to others except for purposes of treatment, payment and operations identified above, and other exceptions under federal and state law. To request this list or accounting of disclosures, you must submit your request in writing to the Chief of Staff. Your request must state a time period which may not be longer than six years. Your request should indicate in what form you want the list (for example, on paper, or; electronically). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

4. Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend.

5. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions, you must make your request in writing to the Chief of Staff (Dr. Mikhail). In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.

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