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Medical Privacy
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.
Privacy Officer: Paul Hamer
Contact: phamer@southeasthoustoncardiology.com
(281) 338-4004
530 Orchard St.
Webster, TX
77598
This Privacy Notice is being provided to you as a requirement of
a federal law, the Health Insurance Portability and Accountability
Act (HIPAA). This Privacy Notice describes how we may use and disclose
your protected health information to carry out treatment, payment
or health care operations and for other purposes that are permitted
or required by law. It also describes your rights to access and
control your protected health information in some cases. Your "protected
health information" means any written and oral health information
about you, including demographic data that can be used to identify
you. This is health information that is created or received by your
health care provider, and that relates to your past, present or
future physical or mental health or condition.
I. Uses and Disclosures of Protected Health Information
The physician may use your protected health information for purposes
of providing treatment, obtaining payment for treatment, and conducting
health care operations. Your protected health information may be
used or disclosed only for these purposes unless the physician office
staff has obtained your authorization or the use or disclosure is
otherwise permitted by the HIPAA privacy regulations or state law.
Disclosures of your protected health information for the purposes
described in this Privacy Notice may be made in writing, orally,
or by facsimile.
A. Treatment. We will use and disclose your protected health information
to provide, coordinate, or manage your health care and any related
services. This includes the coordination or management of your health
care with a third party for treatment purposes. For example, we
may disclose your protected health information to a pharmacy to
fill a prescription or to a laboratory to order a blood test. We
may also disclose protected health information to physicians who
may be treating you or consulting with the physician office with
respect to your care. In some cases, we may also disclose your protected
health information to an outside treatment provider for purposes
of the treatment activities of the other provider.
B. Payment. Your protected health information will be used, as
needed, to obtain payment for the services that we provide. This
may include certain communications to your health insurance company
to get approval for the procedure that we have scheduled. For example,
we may need to disclose information to your health insurance company
to get prior approval for the surgery. We may also disclose protected
health information to your health insurance company to determine
whether you are eligible for benefits or whether a particular service
is covered under your health plan. In order to get payment for the
services we provide to you, we may also need to disclose your protected
health information to your health insurance company to demonstrate
the medical necessity of the services or, as required by your insurance
company, for utilization review. We may also disclose patient information
to another provider involved in your care for the other provider's
payment activities.
C. Operations. We may use or disclose your protected health information,
as necessary, for our own health care operations to facilitate the
function of the physician's office and to provide quality
care to all patients. Health care operations include such activities
as: quality assessment and improvement activities, employee review
activities, training programs including those in which students,
trainees, or practitioners in health care learn under supervision,
accreditation, certification, licensing or credentialing activities,
review and auditing, including compliance reviews, medical reviews,
legal services and maintaining compliance programs, and business
management and general administrative activities.
In certain situations, we may also disclose patient information
to another provider or health plan for their health care operations.
D. Other Uses and Disclosures. As part of treatment, payment and
health care operations, we may also use or disclose your protected
health information for the following purposes: to remind you of
your appointment, to inform you of potential treatment alternatives
or options, to inform you of health-related benefits or services
that may be of interest to you, or to contact you to raise funds
for an institutional foundation related to the physician office.
If you do not wish to be contacted regarding fundraising, please
contact our Privacy Officer.
II. Uses and Disclosures Beyond Treatment, Payment, and Health
Care Operations Permitted Without Authorization or Opportunity to
Object
Federal privacy rules allow us to use or disclose your protected
health information without your permission or authorization for
a number of reasons including the following:
A. When Legally Required. We will disclose your protected health
information when we are required to do so by any federal, state
or local law.
B. When There Are Risks to Public Health. We may disclose your
protected health information for the following public activities
and purposes:
To prevent, control, or report disease, injury or disability as
permitted by law.
To report vital events such as birth or death as permitted or required
by law.
To conduct public health surveillance, investigations and interventions
as permitted or required by law.
To collect or report adverse events and product defects, track
FDA regulated products, enable product recalls, repairs or replacements
to the FDA and to conduct post marketing surveillance.
To notify a person who has been exposed to a communicable disease
or who may be at risk of contracting or spreading a disease as authorized
by law.
To report to an employer information about an individual who is
a member of the workforce as legally permitted or required.
C. To Report Suspended Abuse, Neglect Or Domestic Violence. We
may notify government authorities if we believe that a patient is
the victim of abuse, neglect or domestic violence. We will make
this disclosure only when specifically required or authorized by
law or when the patient agrees to the disclosure.
D. To Conduct Health Oversight Activities. We may disclose your
protected health information to a health oversight agency for activities
including audits; civil, administrative, or criminal investigations,
proceedings, or actions; inspections; licensure or disciplinary
actions; or other activities necessary for appropriate oversight
as authorized by law. We will not disclose your health information
under this authority if you are the subject of an investigation
and your health information is not directly related to your receipt
of health care or public benefits.
E. In Connection With Judicial And Administrative Proceedings.
We may disclose your protected health information in the course
of any judicial or administrative proceeding in response to an order
of a court or administrative tribunal as expressly authorized by
such order. In certain circumstances, we may disclose your protected
health information in response to a subpoena to the extent authorized
by state law if we receive satisfactory assurances that you have
been notified of the request or that an effort was made to secure
a protective order.
F. For Law Enforcement Purposes. We may disclose your protected
health information to a law enforcement official for law enforcement
purposes as follows:
As required by law for reporting of certain types of wounds or
other physical injuries.
Pursuant to court order, court-ordered warrant, subpoena, summons
or similar process.
For the purpose of identifying or locating a suspect, fugitive,
material witness or missing person.
Under certain limited circumstances, when you are the victim of
a crime.
To a law enforcement official if the physician office has a suspicion
that your health condition was the result of criminal conduct.
In an emergency to report a crime.
G. To Coroners, Funeral Directors, and for Organ Donation. We may
disclose protected health information to a coroner or medical examiner
for identification purposes, to determine cause of death or for
the coroner or medical examiner to perform other duties authorized
by law. We may also disclose protected health information to a funeral
director, as authorized by law, in order to permit the funeral director
to carry out their duties. We may disclose such information in reasonable
anticipation of death. Protected health information may be used
and disclosed for cadaveric organ, eye or tissue donation purposes.
H. For Research Purposes. We may use or disclose your protected
health information for research when the use or disclosure for research
has been approved by an institutional review board that has reviewed
the research proposal and research protocols to address the privacy
of your protected health information.
I. In the Event of a Serious Threat to Health or Safety. We may,
consistent with applicable law and ethical standards of conduct,
use or disclose your protected health information if we believe,
in good faith, that such use or disclosure is necessary to prevent
or lessen a serious and imminent threat to your health or safety
or to the health and safety of the public.
J. For Specified Government Functions. In certain circumstances,
federal regulations authorize the physician office to use or disclose
your protected health information to facilitate specified government
functions relating to military and veterans activities, national
security and intelligence activities, protective services for the
President and others, medical suitability determinations, correctional
institutions, and law enforcement custodial situations.
K. For Worker's Compensation. The physician office may release
your health information to comply with worker's compensation laws
or similar programs.
III. Uses and Disclosures Permitted without Authorization but with
Opportunity to Object
We may disclose your protected health information to your family
member or a close personal friend if it is directly relevant to
the person's involvement in your treatment or payment related
to your treatment. We can also disclose your information in connection
with trying to locate or notify family members or others involved
in your care concerning your location, condition or death.
You may object to these disclosures. If you do not object to these
disclosures or we can infer from the circumstances that you do not
object or we determine, in the exercise of our professional judgment,
that it is in your best interests for us to make disclosure of information
that is directly relevant to the person's involvement with
your care, we may disclose your protected health information as
described.
IV. Uses and Disclosures which you Authorize
Other than as stated above, we will not disclose your health information
other than with your written authorization. You may revoke your
authorization in writing at any time except to the extent that we
have taken action in reliance upon the authorization.
V. Your Rights
You have the following rights regarding your health information:
A. The right to inspect and copy your protected health information.
You may inspect and obtain a copy of your protected health information
that is contained in a designated record set for as long as we maintain
the protected health information. A "designated record set"
contains medical and billing records and any other records that
your surgeon and the physician office uses for making decisions
about you.
Under federal law, however, you may not inspect or copy the following
records: psychotherapy notes; information compiled in reasonable
anticipation of, or for use in, a civil, criminal, or administrative
action or proceeding; and protected health information that is subject
to a law that prohibits access to protected health information.
Depending on the circumstances, you may have the right to have a
decision to deny access reviewed.
We may deny your request to inspect or copy your protected health
information if, in our professional judgment, we determine that
the access requested is likely to endanger your life or safety or
that of another person, or that it is likely to cause substantial
harm to another person referenced within the information. You have
the right to request a review of this decision.
To inspect and copy your medical information, you must submit a
written request to the Privacy Officer whose contact information
is listed on the last page of this Privacy Notice. If you request
a copy of your information, we may charge you a fee for the costs
of copying, mailing or other costs incurred by us in complying with
your request. Please contact our Privacy Officer if you have questions
about access to your medical record.
B. The right to request a restriction on uses and disclosures of
your protected health information. You may ask us not to use or
disclose certain parts of your protected health information for
the purposes of treatment, payment or health care operations. You
may also request that we not disclose your health information to
family members or friends who may be involved in your care or for
notification purposes as described in this Privacy Notice. Your
request must state the specific restriction requested and to whom
you want the restriction to apply.
The physician office is not required to agree to a restriction
that you may request. We will notify you if we deny your request
to a restriction. If the physician office does agree to the requested
restriction, we may not use or disclose your protected health information
in violation of that restriction unless it is needed to provide
emergency treatment. Under certain circumstances, we may terminate
our agreement to a restriction. You may request a restriction by
contacting the Privacy Officer.
C. The right to request to receive confidential communications
from us by alternative means or at an alternative location. You
have the right to request that we communicate with you in certain
ways. We will accommodate reasonable requests. We may condition
this accommodation by asking you for information as to how payment
will be handled or specification of an alternative address or other
method of contact. We will not require you to provide an explanation
for your request. Requests must be made in writing to our Privacy
Officer.
D. The right to request amendments to your protected health information.
You may request an amendment of protected health information about
you in a designated record set for as long as we maintain this information.
In certain cases, we may deny your request for an amendment. If
we deny your request for amendment, you have the right to file a
statement of disagreement with us and we may prepare a rebuttal
to your statement and will provide you with a copy of any such rebuttal.
Requests for amendment must be in writing and must be directed to
our Privacy Officer. In this written request, you must also provide
a reason to support the requested amendments.
E. The right to receive an accounting. You have the right to request
an accounting of certain disclosures of your protected health information
made by the physician office. This right applies to disclosures
for purposes other than treatment, payment or health care operations
as described in this Privacy Notice. We are also not required to
account for disclosures that you requested, disclosures that you
agreed to by signing an authorization form, disclosures for a physician
office directory, to friends or family members involved in your
care, or certain other disclosures we are permitted to make without
your authorization. The request for an accounting must be made in
writing to our Privacy Officer. The request should specify the time
period sought for the accounting. We are not required to provide
an accounting for disclosures that take place prior to April 14,
2003. Accounting requests may not be made for periods of time in
excess of six years. We will provide the first accounting you request
during any 12-month period without charge. Subsequent accounting
requests may be subject to a reasonable cost-based fee.
F. The right to obtain a paper copy of this notice. Upon request,
we will provide a separate paper copy of this notice even if you
have already received a copy of the notice or have agreed to accept
this notice electronically.
VI. Our Duties
The physician office is required by law to maintain the privacy
of your health information and to provide you with this Privacy
Notice of our duties and privacy practices. We are required to abide
by terms of this Notice as may be amended from time to time. We
reserve the right to change the terms of this Notice and to make
the new Notice provisions effective for all future protected health
information that we maintain. If the physician office changes its
Notice, we will provide a copy of the revised Notice by sending
a copy of the revised Notice via regular mail or through in-person
contact.
VII. Complaints
You have the right to express complaints to the physician office
and to the Secretary of Health and Human Services if you believe
that your privacy rights have been violated. You may complain to
the physician office by contacting the physician office's
Privacy Officer verbally or in writing, using the contact information
below. We encourage you to express any concerns you may have regarding
the privacy of your information. You will not be retaliated against
in any way for filing a complaint.
VIII. Contact
Information
Information regarding matters covered by this Notice can be requested
by contacting our office. If you feel that your privacy rights have
been violated by this physician office you may submit a complaint
to our Privacy Officer.
Privacy Officer: Paul Hamer
Contact: phamer@southeasthoustoncardiology.com
(281) 338-4004
530 Orchard St.
Webster, TX
77598
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