HIPAA Notice of Privacy Practices

As required by the Privacy Regulations created as a result of the Health Insurance Portability and Accountability Act of 1996

(HIPAA)

This notice describes how health information about you can may be used and disclosed, and how you can get access to this information.

Our pledge regarding your privacy: This notice describes how we may use and disclose your protected health information.(PHI) for  treatment, payment, or healthcare operations and for other purposes permitted or required by law. It describes your rights to access and control your protected health information. PHI is information about you, including vital information 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 committed to maintaining the privacy of your PHI. The law requires us to keep your health information private, provide you with our policy of privacy practices, and follow the guidelines of the notice that is in use. We may revise or amend the terms of this notice at any time. The new notice will apply to all PHI that we may create or maintain in the future. We will post our current notice in our lobby in a visible location at all times and upon your request, we will provide you with a revised notice.

We may use and disclose your PHI in the following ways:

1. Treatment. We will use your health information to provide you with medical treatment or services. This includes the coordination of care with a third party. For example, we may ask you to have lab tests, and we may use the results to help us reach a diagnosis. We might use your PHI to write or order a prescription for you. Many of employees, including, but not limited to, our doctors and nurses may use or disclose your PHI to treat you or to assist others in your treatment. We may also disclose your PHI to other health care providers for purposes related to your treatment.
2. Payment. Your PHI will be used as needed, to obtain payment  for   your health care services. This may include activities by your health  insurance   to approve or pay for health care services. This may also include determining eligibility or coverage for insurance benefits, reviewing services for medical necessity, and utilization review activities.
3. Health Care Operations. We may disclose your PHI to support the business activities of our practice. This may include quality assessment activities, employee reviews, licensing, and conducting other business activities. For example, we may use a sign in sheet at the registration desk. We may also call you by name in the waiting room. We may also share your PHI with third party “ business associates” that perform various activities , for example billing services, for our practice. When an arrangement between our office and a business associate involves the disclosure of your PHI, we will have a written contract that contains terms that protect your privacy.
4. Appointment Reminders or Follow–ups. We may use and disclose your PHI to remind you of an appointment or follow- up with you after appointment.
5. Treatment Options. We may use and disclose your PHI to inform you of potential treatment options or alternatives.
6. Health-Related Benefits and Services. We may use and disclose your PHI to inform you of health-related benefits or services that may be of interest to you.
7. Release of Information to Family or Friends. Unless you object  we   may disclose to a member of your family, a relative, a close friend or any other persons you identify, your PHI that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment.  We may disclose PHI to notify or assist in notifying a family member, personal representative or any other person that is responsible for your location, general condition, or death.
8. Disclosure Required by Law. We will use and disclose your PHI to extent necessary when required by federal, state or local law.

Use and disclosure of your PHI in Special Circumstances.

1. Public Health Risk. We may disclose your PHI to public health authorities that are authorized by law to collect information for the purpose of preventing or controlling disease, injury or disability, reporting child or elder abuse or neglect, reporting reactions to medications, notifying people of product recalls, notifying a person who may have been exposed to a disease or may be at risk to contract or spread a disease or condition, and reporting appropriate government authorities regarding potential abuse or neglect of an adult patient, including domestic violence ( only if patient agrees or required by law).
2. Health Oversight Activities. We may disclose your PHI to health oversight agencies for activities authorized by law. Oversight activities can include audits, investigations, inspections, and licensure. These are necessary for the government to monitor the healthcare system, government programs, and compliance with civil rights laws.
3. Lawsuits and Disputes. We may disclose your PHI in response to a court or administrative order. We may disclose your PHI in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if efforts have been made to inform you of the request or obtain an order protecting the information requested.
4. Law Enforcement. We may release PHI if asked to do so by a law enforcement official in response to a warrant, summons court order, subpoena or legal process, about a crime victim in certain situations, if we are unable to obtain the persons agreement. We may also release PHI about criminal conduct involving our practice, and in an emergency situation to report a crime, or details of the crime, including location of the person who committed the crime.
5. Serious Threats to Health or Safety. We may use and disclose your PHI to reduce or prevent a serious threat to your health and safety or the health and safety of the public or another person.
6. Military. If you are a member of the armed forces, we may release PHI about you as required by military authorities. We may also release  health  information about you to federal offices for Intelligence, counterintelligence, or other national security activities authorized by law.
7. Workers Compensation. PHI may be released about you for workers compensation. These programs provide benefits for work-related injuries or illness. Release of such information is controlled by state and /or federal law.

Your  Rights  Regarding your PHI.

1. Confidential Communication. You have the right to ask that we communicate with you about medical matters in a certain way or at a certain location. For instance, you can ask that we only contact you at home or by mail. To request confidential communications, you must make your request in writing to our Privacy Officer. We will not ask you for a reason fro your request. Your request must specify how or where you wish to be contacted.
2. Requesting Restrictions. You have the right to request a restriction or limitation on the PHI we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the health insurance information we disclose about you to someone who is involved in your care or in the payment for your care, such as a family member or friend. For example, you could ask that we not use or disclose information about your medical history. 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 our privacy officer. In your request, you must tell us all the information you wish restricted, whether you are requesting to limit or use, disclosure or both, and to whom you want the limits to apply.
3. Inspections and Copies. You have the right to inspect and copy PHI that may be used to make decisions about your care. Usually, this includes patient medical records and billing records. To inspect and /or copy your PHI, you must submit your request in writing to our privacy officer. I you request a copy of this information, we may charge a fee for the costs of copying, mailing or other expenses associated with your request. We may deny your request to inspect and/or copy records in certain limited circumstances. If you are denied access to health information, you may request a review of the denial. Another licensed health care professional chosen by us will review your request and our denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
4. Right to Amend. If you believe that PHI we have on you is incorrect or incomplete, you may ask to change the information. You have the right to request an amendment for as long as the information is kept by our or for our patients. Your request for amendment must  be made in writing and submitted to our privacy officer. You must provide us with 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: (a) was not created by us, unless the person or entity that created the information is no longer available to make the amendment: (b) Is not part of the PHI kept by or for the facility; (c) not part of the PHI which you would be permitted to inspect and copy; or (d) is accurate and complete.
5. Right to Paper Copy of this Notice. You are entitled to receive a paper copy of this notice at any time. To obtain a copy, contact our privacy officer.
6. Right to file a Complaint. If you believe your privacy rights have been violated, you may file a complaint with our practice by asking for our privacy officer, or with the Office for Civil Rights, U.S. Department of Health and Human Services, 1301 Young St. Suite 1169, Dallas, Tx.75202. All complaints must be in writing. You will not be penalized for filing a complaint.
7. Right to Provide an Authorization for Other Uses and Disclosures. Other uses and disclosures of PHI not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose your PHI, you may revoke that permission in writing at any time. If revoked, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to revoke any disclosures that have already been made with your permission, and that we are required to retain our records of the care that we provided to you.

If you have any questions regarding this Notice of our health information policies, please contact our Privacy Officer.

Norman Endoscopy Center
1515 N Porter Suite 100
Norman, OK 73071
405-366-0969