NOTICE
OF PRIVACY PRACTICES
Effective: April 14, 2003
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.
Associates of Pulmonary and Critical Care
Medicine ("APCCM") uses and discloses health information
about you for treatment, to obtain payment for treatment,
for administrative purposes, and to evaluate the quality
of care that you receive. Your health information is contained
in a medical record that is the physical property of APCCM.
How APCCM May Use
and Disclose Your Health Information
For Treatment. APCCM may use or
disclose your health information to provide you with medical
treatment or services. For example, a health care provider,
such as a physician, nurse, or other person providing health
services to you, will record information in your record
that is related to your treatment. This information is necessary
for health care providers to determine what treatment you
should receive. Health care providers will also record actions
taken by them in the course of your treatment and note how
you respond to the actions. APCCM may also disclose your
health information to or share your health information with
other healthcare providers to coordinate your care. This
might include, but is not limited to, pharmacies, other
physicians and hospitals.
For Payment. APCCM may use or disclose
your health information to others for purposes of receiving
payment for treatment and services that you receive. For
example, a bill may be sent to you or a third-party payor,
such as an insurance company or health plan. The information
on the bill may contain information that identifies you,
your diagnosis, and treatment or supplies used in the course
of treatment.
For Health Care Operations. APCCM
may use or disclose health information about you for operational
purposes. For example, your health information may be disclosed
to members of our medical staff, risk or quality improvement
personnel and others to:
- evaluate the performance of our staff;
- assess the quality of care and outcomes in your cases
and similar cases;
- learn how to improve our facilities and services;
and
- determine how to continually improve the quality and
effectiveness of the health care we provide.
Appointments and Information. APCCM
may use or disclose your health information to provide appointment
reminders or information about treatment alternatives or
other health-related benefits and services that may be of
interest to you.
Required by Law. APCCM may use
or disclose information about you as required by law. For
example, APCCM may disclose information for the following
purposes:
- For judicial and administrative proceedings pursuant
to legal authority;
- To report information related to victims of abuse,
neglect or domestic violence; and to assist law enforcement
officials in their law enforcement duties.
Public Health. Your health information
may be disclosed for public health activities such as assisting
public health authorities or other legal authorities to
prevent or control disease, injury, or disability, or for
other health oversight activities.
Decedents. Health information may
be disclosed to funeral directors or coroners to enable
them to carry out their lawful duties.
Organ/Tissue Donation. Your health
information may be used or disclosed for cadaveric organ,
eye or tissue donation purposes.
Research. APCCM may use or disclose
your health information for research purposes when an institutional
review board or privacy board that has reviewed the research
proposal and established protocols to ensure the privacy
of your health information has approved the research.
Health and Safety. Your health
information may be used or disclosed to avert a serious
threat to the health or safety of you or any other person
pursuant to applicable law.
Government Functions. Your health
information may be disclosed for specialized government
functions such as protection of public officials or reporting
to various branches of the armed services.
Workers' Compensation. Your health
information may be disclosed in order to comply with laws
and regulations related to Workers' Compensation.
Other Uses. Other uses or disclosures
will be made only with your written authorization and you
may revoke the authorization except to the extent APCCM
has taken action in reliance on such.
Your Health Information
Rights
You have the right to:
- request a restriction on certain uses and disclosures
or your information as provided by 45 CFR 164.522; however,
APCCM is not required to agree to a requested restriction;
- obtain a paper copy of this Notice of Privacy Practices
upon request;
- inspect and obtain a copy of your health record as
provided for in 45 CFR 164.524;
- amend your health record as provided in 45 CFR 164.526;
- request communications of your health information
by alternative means or at alternative locations;
- revoke your authorization to use or disclose health
information except to the extent that action has already
been taken; and
- receive an accounting of disclosures made of your
health information as provided by 45 CFR 164.528.
Complaints
You may complain to APCCM and to the Department of Health
and Human Services if you believe your privacy rights have
been violated. You will not be retaliated against for filing
a complaint.
Obligations of APCCM
APCCM is required to:
- maintain the privacy of protected health information;
- provide you with this Notice of its legal duties and
privacy practices with respect to your health information;
- abide by the terms of this Notice;
- notify you if we are unable to agree to a requested
restriction on how your information is used or disclosed;
- accommodate reasonable requests you may make to communicate
health information by alternative means or at alternative
locations; and
- obtain your written authorization to use or disclose
your health information for reasons other than those
listed above and permitted under law.
APCCM reserves the right to change its
privacy practices, to revise the terms of its Notice of
Privacy Practices and to make the new provisions effective
for all Protected Health Information it maintains including
Protected Health Information it created or received prior
to issuing a revised Notice of Privacy Practices. APCCM
will promptly revise and re-distribute its Notice whenever
there is a material change to the uses and disclosures,
the rights of individuals, the legal duties of APCCM or
other privacy practices stated in the Notice. Revised Notices
will be made available to you by posting the revised Notice
in a prominent location within our office and providing
you with a copy of the revised Notice upon request.
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