Notice of HIPAA Privacy Practices

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

Understanding Your Health Record/Information

Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made.

Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as:

·         a basis for planning your care and treatment

·         a way for the many health professionals who contribute to your care to communicate

·         a tool with which we can assess and continually work to improve the care we render and the outcomes we achieve

·         a legal document describing the care you received

·         a means by which you or a third-party payer (such as your insurance carrier, Medicare, or Medicaid) can verify that services billed were actually provided

·         a tool for educating heath professionals

·         a source of data for medical research

·         a source of information for public health officials

·         a source of data for facility planning and marketing

Understanding what is in your record and how your health information is used helps you to:

·         ensure its accuracy

·         better understand who, what, when, where, and why others may access your health information; and

·         make more informed decisions when authorizing disclosure to others.

Your Health Information Rights

Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you.  We will not use or disclose your health information without your authorization, except as described in this notice.

You may request a restriction on certain uses and disclosures of your information (as provided in 45 CFR 164.522).  While we are not required to agree to any requested restriction, if we agree to a restriction, we are bound not to use or disclose your personal healthcare information in violation of such restriction, except in certain emergency situations.   We will not accept a request to restrict uses or disclosures that are otherwise required by law.  We require that this request be in writing.

You may also request to:

·         obtain a paper copy of the notice of information practices upon request

·         inspect and/or obtain a copy of your health records (as provided in 45 CFR 164.524)

·         amend or correct your health record (as provided in 45 CFR 164.526)

·         obtain an accounting of disclosures of your health information (as provided in 45 CFR 164.528)

·         revoke your authorization to use or disclose health information except to the extent that action has already been taken.

We require that each of those requests be in writing as well.

You may also request that confidential communications of your health information be delivered by alternative means or to alternative locations.  Attleboro GI requires these requests be in writing, unless there is a compelling reason that the request can not be made in writing. You are not required to give a reason for this request.

Our Responsibilities

Attleboro GI is required to:

·         maintain the privacy of your health information

·         provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you

·         abide by the terms of this notice

·         notify you if we are unable to agree to a requested restriction

·         accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

We may also, due to unforeseen circumstances, disclose you health information as dictated by common sense, in a manner consistent with federal and state laws, and in a way that will ensure to the greatest extent possible, your privacy.

Our privacy policies are subject to both federal and state laws.  In cases where state law places stricter limitations on the use or disclosure of health information, we are required to follow state law.

We reserve the right to change our practices for all protected health information we maintain. Should our information practices change, we will mail a revised notice to the address you have supplied us.

For More Information or to Report a Problem

If have questions and would like additional information, you may contact the privacy officer of Attleboro Gastroenterology, PC at:

Attleboro Gastroenterology, PC

Attn. Privacy Officer

150 Emory Street
Attleboro, MA 02703
Phone: (508) 222-2021
Fax: (508) 226-0134

If you believe your privacy rights have been violated, you can file a complaint with the privacy officer of Attleboro Gastroenterology, PC at:

Attleboro Gastroenterology, PC

Attn. Privacy Officer

150 Emory Street
Attleboro, MA 02703
Phone: (508) 222-2021
Fax: (508) 226-0134

You may also file a complaint with the Office for Civil Rights, United States Department of Health and Human Services at:

The Office for Civil Rights, Region I

U.S. Department of Health and Human Services

Government Center, J.F. Kennedy Federal Building--Room 1875

Boston, Massachusetts 02203

Phone: (617) 565-1340

Fax: (617) 565- 3809

 There will be no retaliation for filing a complaint.

Examples of Disclosures for Treatment, Payment and Health Operations

The most likely reason that this organization will use or disclose your healthcare information is for treatment, payment, and healthcare operations.  Examples of treatment, payment, and healthcare operations include:

Treatment:

·         Information obtained by a nurse, physician, or other member of your healthcare team is recorded in your chart and then used to determine your course of treatment.

·         Your nurse, physician, or other member of your healthcare team documents in your record his or her expectations of other members of your healthcare team.

·         If you are referred to a specialist or other provider, we will also provide that physician(s) or a provider with a copy of various reports and records to assist him or her in treating you.

Payment:

·         We bill may you or a third-party payer, and the information on or accompanying the bill  may identify you, your diagnosis, the procedures or services performed, and the supplies used, in order to prove that we are entitled to be paid.

Health care operations:

·         Members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team review your health record to assess the quality of care and outcomes in your case and others like it.  This information is used to continually improve the quality and effectiveness of the healthcare and service we provide.

Other Permitted or Required Uses and Disclosures

In addition to treatment, payment, and healthcare operations, we may use or disclose information for the following purposes:

In appointment reminders:

·         We may contact you via telephone or via U.S. mail to provide appointment reminders.

For notification purposes:

·         We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition.

To communicate with your family:

·         Health professionals, using their best judgment, may disclose to a member of your family, other relative, close personal friend or any other person you designate, health information relevant to that person’s involvement in your care or payment related to your care.

For workers compensation purposes:

·         We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

To business associates:

·         There are some services provided in our organization through contacts with business associates. Examples include certain laboratory tests and billing services. We may disclose your health information to our business associate so that they can perform the job we have asked them to do. To protect your health information, however, we require the business associate to appropriately safeguard your information.

For research:

·         We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

For marketing:

·         We may contact you to provide information about treatment alternatives or other health-related benefits and services that may be of interest to you.

To organ procurement organizations:

·         Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

For fund raising:

·         We may contact you as part of a fund-raising effort.

To the Food and Drug Administration (FDA):

·         We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

To protect the public health:

·         As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

To law enforcement:

·         We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.

For regulatory and oversight purposes:

·         Federal and state law makes provision for your health information to be released to an appropriate health oversight agency, regulatory agency, public health authority, or attorney, in cases where a work force member, investigative agency, business associate, or other person believes in good faith that we have engaged in unlawful conduct or have otherwise violated federal or states laws, professional standards, or clinical standards and are potentially endangering one or more patients, workers or the public.

Effective Date: April 14, 2003