Health Information Privacy Act
It
is necessary for us to communicate with you the new Federal Health
Insurance Portability and Accountability Act (HIPAA) laws written
to protect the confidentiality of your health information. We do
not want you to be concerned that your personal information might
be unnecessarily made available to others outside of our office.
We are committed to maintaining the complete confidentiality of
our patient's health information. When we use the term "personal
information," we mean financial, health, and other information
about you that is nonpublic, which we obtain so we can provide you
with health care. When we use "health information," we
mean information that identifies you and relates to your medical
history (i.e., the health care you receive or the amounts paid for
that care). This notice will become effective on April 14, 2003.
Due to the use
of telephone answering and fax machines, computers and the Internet,
the government has sought to standardize and protect the privacy
of the electronic exchange of your health information. We are required
by law to put in writing, the policies, and procedures we will use
to ensure the protection of your health information everywhere that
it is used. Copies of our privacy policy will be provided free of
charge to any patient who requests a copy.
We will use
and communicate your health information only for the purposes of
providing your treatment, obtaining payment, and conducting health
care operations. Your health information will not be used for other
purposes unless we have asked for and been voluntarily given your
written permission.
Stuart B. Tollen, D.C., C.C.S.P.
How
your health information may be used:
Limits
on health care information
We will use
your health information within our office to provide you with the
best health care possible. This may include sharing your information
with referring physicians, clinical and pathology laboratories,
or other health care personnel providing you treatment. We must
always limit the amount of a patient's health care information that
is disclosed to the "minimum necessary" to accomplish
the intended purpose. When another provider requests the patient's
health care records, the "minimum necessary" rule does
not apply and the entire clinical record may be sent.
We may include
your health information with an invoice used to collect payment
for treatment you receive in our office. We may do this with insurance
forms filed for you in the office or sent electronically. We will
be sure to only work with companies with a similar commitment to
the security of your health information. When an insurance company
requests the patient's records, it is likely that they will specify
the dates for which they require records. If the insurer is specific
as to the dates of information they would like, we do not have to
verify that this is the "minimum necessary" information.
If the insurance company does not specify the dates they need to
review, then only the clinical records that are related to the patient's
current problem should be sent.
Before any records
are released to an attorney, we must have a signed release from
the patient. Because the HIPAA privacy laws require us to send the
"minimum necessary" health information, the authorization
from the patient must specifically state the dates for which records
should be sent.
Because we believe
regular care is very important to your general health, we will remind
you of a scheduled appointment, or that it is time for you to contact
us and make an appointment. Additionally, we may contact you to
follow up on your care and inform you of treatment options or services
that may be of interest to you or your family. This contact may
be in the form of postcards, letters, telephone reminders, or electronic
reminders, such as e-mail (unless you tell us that you do not want
to receive these reminders).?
We may share your health information with those that you tell us
will be helping you with your home care, treatment, or payment.
We will be sure to ask your permission first. In the case of an
emergency, where you are unable to tell us what you want, we will
use our best judgement when sharing your health information when
it will be important to those participating in providing your care.
Permitted
uses and disclosures without your consent or authorization
Under federal
law, we are also permitted or required to use or disclose your health
information without your consent or authorization in these following
circumstances:
- We are permitted
to use or disclose your health information if we are providing
health care services based on the orders of another health care
provider.
- We are permitted
to use or disclose your health information if we provide health
care services to you as an inmate.
- We are permitted
to use or disclose your health information if we provide health
care services to you in an emergency.
- We are permitted
to use or disclose your health information if we are required
by law to treat you and we are unable to obtain your consent after
attempting to do so.
- We are permitted
to use or disclose your health information if there are substantial
barriers to communicating with you, but in our professional judgement
we believe that you intend for us to provide care.
Other than the
circumstances described in the preceding five examples, any other
use or disclosure of your health information will only be made with
your written authorization.
Patient
Rights:
You have the
right to request restrictions on certain uses and disclosures of
your health information. Our office will make every effort to honor
reasonable restriction preferences from our patients. You have the
right to request that we only communicate your health information
privately with no other family members present or through mailed
communications that are sealed. We will make every effort to honor
your reasonable requests for confidential communications.
Patient's
right to access their health records
You have the
right to read, review, and copy your health information, including
your complete chart, x-rays and billing records. If you would like
a copy of your information, please let us know. We may need to charge
you a reasonable fee to duplicate and assemble your copy. You may
not take the original records or x-rays because the law requires
that we retain them for seven years,
Right
to amend your health information
You have the
right to ask, in writing to update or modify your records if you
believe your health information records are incomplete or incorrect.
Your request may be denied if the health information record in question
was not created by our office, is not part of your records or if
the records containing your information are determined to be accurate
and complete.
Deceased
Patients
All of the privacy
rules apply to deceased patients. Before we can release any information,
we must have an authorization from the deceased patient's personal
representative.
Your
right to revoke your authorization.
You may revoke
your authorization to us at any time; however, your revocation must
be in writing. There are two circumstances under which we will not
be able to honor your revocation request:
- If we have
already released your health information before we receive your
request to revoke your authorization. 164.508(b)(5)(I).
- If you were
required to give your authorization as a condition of obtaining
insurance, the insurance company may have a right to your health
information if they decide to contest any of your claims. If you
wish to revoke your authorization, please write to us at: Jenkintown
Chiropractic Center, Inc., 435 Johnson Street, Jenkintown, PA
19046.
Your
right to obtain a paper copy of this notice.
You have the
right to obtain a copy of this Notice of Privacy Practices directly
from our office at any time. Call us and we will mail or e-mail
a copy to you.
Your
right to receive an accounting of the disclosures we have made of
your records.
You have the
right to request that we give you an accounting of the disclosures
we have made of your health information for the last six years before
the date of your request. The accounting will include all disclosures
except:
- those disclosures
required for your treatment, to obtain payment for your services,
or to run our practice
- those disclosures
made to you
- those disclosures
necessary to maintain a directory of the individuals in our facility
or to individuals involved with your care.
- those disclosures
for national security or intelligence purposes.
- those disclosures
made to correctional officers or law enforcement officers.
- those disclosures
that were made before the effective date of the HIPAA privacy
law.
We will provide
the first accounting within any 12-month period without charge.
There is a fee for any additional requests during the next 12 months.
When you make your request we will tell you the amount of the fee
and you will have the opportunity to withdraw or modify your request.
Our
Duties
We are required
by law to maintain the privacy of your health information and to
provide you with this Notice of Privacy Practices. We are required
to practice the policies and procedures described in this notice
but we re-serve the right to change the terms described in this
Notice. If we change our privacy practices, we will be sure to place
the revised Notice on public display and make the notice available
to patients on request. We will retain a copy of each of our notices
for the six years required by the law.
Re-disclosure
Information
that we use or disclose may be subject to re-disclosure by the person
to whom we provide the information and may no longer be protected
by the federal privacy rules.
Complaints
from patients
You have the
right to express complaints to us or to the Secretary of Health
and Human Services if you believe your privacy rights have been
compromised. We encourage you to express any concerns you may have
regarding the privacy of your information. Please let us know of
your concerns or complaints in writing. While you may make an oral
complaint at any time, written complaints should be addressed to:
Jenkintown Chiropractic
Center, Inc.
Stuart B. Tollen, D.C.
435 Johnson Street
Jenkintown, PA 19046
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