INTERNAL MEDICINE SPECIALISTS, INC.
NOTICE OF PRIVACY PRACTICES
This Notice is effective on September 23, 2013
THIS HOW YOU CAN GET ACCESS TO THIS INFORMATION. ABOUT YOU MAY BE USED AND DISCLOSED AND NOTICE DESCRIBES HOW MEDICAL INFORMATION PLEASE REVIEW IT CAREFULLY.
WE ARE REQUIRED BY LAW
TO PROTECT MEDICAL INFORMATION ABOUT YOU
We are required by law to protect the privacy of medical information about you and that identifies you. This medical information may be information about health care we provide to you or payment for health care provided to you. It may also be information about your past, present, or future medical condition.
We are also required by law to provide you with this Notice of Privacy Practices explaining our legal duties and privacy practices with respect to medical information. We are legally required to follow the terms of this Notice. In other words, we are only allowed to use and disclose medical information in the manner that we have described in this Notice.
We may change the terms of this Notice in the future. We reserve the right to make changes and to make the new Notice effective for all medical information that we maintain. If we make changes to the Notice, we will:
• Post the new Notice in our waiting area
• Have copies of the new Notice available upon request (you may always contact our Privacy Officer at (504) 648-2542 to obtain a copy of the current Notice)
The rest of this Notice will:
• Discuss how we may use and disclose medical information about you
• Explain your rights with respect to medical information about you
• Describe how and where you may file a privacy-related complaint
1 Meaning of "you," "we," “us,” and "our." In this notice, when we say “we”, “us”, or “our”, we mean our office and all of its employees, staff, volunteers, and providers. When we say “you,” “your”, or “yours,” we mean you as an individual and/or your designated personal representative.
Understanding Your Personal Health Information. Personal health information is any information created and used by us, or received from a health care provider, about your health care. Information may include your name, address, birth date, phone number, social security number, health insurance policies, health information, your diagnoses, and the medical treatments you received.
How We Use Your Personal Health Information. Except as explained in this notice, we will only use or share your personal health information with your written authorization. Most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes, and disclosures for the sale of information require your authorization. If you authorize us to share your personal health information with anyone, you may revoke your authorization at any time and we will no longer share information with that person or entity. Please note that if you choose to revoke an authorization, we may have already relied on your consent to share information and your revocation of consent will only apply once it is received by us.
We may use your personal health information for treatment, payment, and health care operations without your written authorization. We may perform other treatment, payment, or healthcare operations not specifically listed below in which we may use your health information. The following is intended to serve as examples of the types of activities in which your health information may be used. “Treatment” refers to the care we provide to you, including coordinating and managing your care with other providers. Uses for “payment” include our activities to collect amounts owed for the services provided to you. These activities may include, for example, sending a bill to your insurance company for services covered under your insurance plan, managing your account internally or with associated businesses we may contract with for the collection of payment, and/or sending statements to collect remaining amounts owed. “Health care operations” means activities related to assessing the quality of care we provide, developing care guidelines, coordinating care, contacting other providers or you to discuss care options, training our workforce, business management and administrative activities, customer service, and investigation and resolution of complaints.
We may also use or disclose your personal health information to:
• Keep you informed about appointments, program information, and benefits and services that may be of interest to you;
• Notify another person responsible for your care if necessary;
• Communicate with any person you identify about that person's involvement in your care or payment for your care;
• Business associates that perform functions on our behalf;
• Other agencies as required for oversight activities such as license, inspections, investigations, audits, or Facility Accreditation;
• Law enforcement personnel for specific purposes, including reporting any suspected child abuse or neglect;
• Staff or research projects that ensure the continued privacy and protection of protected health information;
• Public health agencies to prevent or control disease and for statistical reporting, to the Food and Drug Administration for reporting reactions to medications, to Workplace Safety and Insurance (formerly known as Workers Compensation) for benefit coordination, to government agencies in cases of national security or for military purposes, or to correctional institutions;
• Remind you of appointments, inform you of treatment options or other services that may be of interest to you;
• Comply with any law, regulation, or code that requires us to report certain information;
• Respond to a court order, or subpoena if efforts have been made to tell you about the request or to obtain an order protecting the information requested; and
• Share with our business partners who perform case management, coordination of care, other assessment activities, or payment activities, and who must abide by the same confidentiality requirements.
Your Health Information Rights. You have the following rights regarding your personal health information maintained by our office:
• You may request restriction on certain uses and disclosure of your information. If you request we restrict disclosures of your information for payment or operations purposes to your health plan AND selfpay in full for the services you ask be restricted, we must agree to your request unless sharing the information is required by law. You may request other restrictions on the use and disclosure of your information, but we are not required to agree to those requests. If your request is approved, we will abide by it except in an emergency treatment situation or as required by law;
• If you feel that some information our office has created about you is wrong, you may ask that we change that information. You must send us your request to change or correct your information in writing to the Privacy Officer listed at the bottom of this notice and include an explanation of why you would like the information to be changed. In certain situations, we may deny your request. We will notify you if we deny your request and tell you how to request a review of the denial;
• You may inspect and obtain a copy of your personal health information in our possession. We may limit or deny you access only in very limited circumstances. You have the right to request a review of most denials. We will notify you if we deny your request and tell you how to request a review of the denial. We will charge a fee for copies you request for personal use;
• You may obtain a paper or electronic copy of this notice upon request;
• You may revoke a signed authorization for the use or disclosure of your protected health information except to the extent we have already acted based on your authorization;
• If you request, we will account for disclosures we have made of your protected health information made by us, except for disclosures made to you, under an authorization, for treatment, payment, or health operations purposes, and a limited other situations. We will not charge for the first accounting given to you in a twelve-month period. We may charge a fee for an additional accounting requested in that twelve-month period for the cost of producing the accounting of disclosures for you;
• You may request that we contact you about personal health care matters only in a certain way (phone, e-mail, in writing) and at a certain location (home, office, at an address you have given).
• If there has been a breach of your health information, you will be notified unless we determine, after thorough risk analysis, that there is a low probability your information has been compromised.
For More Information or to Report a Problem. If you have questions, complaints, or concerns related to our privacy practices, please contact the Privacy Officer whose contact information is provided below. It is our policy to take questions, complaints, and concerns seriously and you will not be retaliated or discriminated against, or penalized in any way if you choose to communicate your concerns about our privacy practices with us.
Internal Medicine Specialists, Inc.
3525 Prytania Street, Suite 526
New Orleans, La. 70115
You may also file a complaint with the Secretary of the Department of Health and Human Services. Visit the Department of Health and Human Service’s Health Information Privacy website, or contact the Office for Civil Rights to file a complaint.