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NOTICE OF
PRIVACY PRACTICES
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.
This practice 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. This notice describes our
privacy practices. You can request a copy of this
notice at any time. For more information about this
notice or our privacy practices and policies, please
contact the person listed below.
Treatment,
Payment, Health Care Operations
Treatment
We are permitted to use and disclose your medical
information to those involved in your treatment.
For example, the physician in this practice is a
specialist. When we provide treatment, we may
request that your primary care physician share your
medical information with us. Also, we may provide
your primary care physician information about your
particular condition so that he or she can
appropriately treat you for other medical
conditions, if any.
Payment
We are permitted to use and disclose your medical
information to bill and collect payment for the
services provided to you. For example, we may
complete a claim form to obtain payment from your
insurer or HMO. The form will contain medical
information, such as a description of the medical
service provided to you, that your insurer or HMO
needs to approve payment to us.
Health Care
Operations
We are permitted to use or disclose your medical
information for the purposes of health care
operations, which are activities that support this
practice and ensure that quality care is delivered.
For example, we may engage the services of a
professional to aid this practice in its compliance
programs. This person will review billing and
medical files to ensure we maintain our compliance
with regulations and the law.
Disclosures
That Can Be Made Without Your Authorization
There are situations
in which we are permitted by law to disclose or use
your medical information without your written
authorization or an opportunity to object. In other
situations we will ask for your written
authorization before using or disclosing
information, you can later revoke that
authorization, in writting, to stop future uses and
disclosures. However, any revocation will not apply
to disclosures or uses already made or taken in
reliance on that authorization.
Public Health,
Abuse or Neglect, and Health Oversight
We may disclose your medical information for
public health activities. Public health activities
are mandated by federal, state, or local government
for the collection of information about disease,
vital statistics (like births and death), or injury
by a public health authority. We may disclose
medical information, if authorized by law, to a
person who may have been exposed to a disease or may
be at risk for contracting or spreading a disease or
condition. We may disclose your medical information
to report reactions to medications, problems with
products, or to notify people of recalls of products
they may be using.
We may also disclose
medical information to a public agency authorized to
receive reports of child abuse or neglect. Texas
law requires physicians to report child abuse or
neglect. Regulations also permit the disclosure of
information to report abuse or neglect of elders or
the disabled.
We may disclose your
medical information to a health oversight agency for
those activities authorized by law. Examples of
these activities are audits, investigations,
licensure applications and inspections which are all
government activities undertaken to monitor the
health care delivery system and compliance with
other laws, such as civil rights laws.
Legal Proceedings
and Law Enforcement
We may disclose your medical information in the
course of judicial or administrative proceedings in
response to an order of the court (or the
administrative decision-maker) or other appropriate
legal process. Certain requirements must be met
before the information is disclosed.
If asked by a law
enforcement official, we may disclose your medical
information under limited circumstances provided
that the information:
- Is released
pursuant to legal process, such as a warrant or
subpoena;
- Pertains to a
victim of crime and you are incapacitated;
- Pertains to a
person who has died under circumstances that may
be related to criminal conduct;
- Is about a
victim of crime and we are unable to obtain the
person's agreement;
- Is released
because of a crime that has occurred on these
premises; or
- Is released to
locate a fugitive, missing person, or suspect.
We may also release
information if we believe the disclosure is
necessary to prevent or lessen an imminent threat to
the health or safety of a person.
Workers'
Compensation
We may disclose your medical information as
required by the Texas workers' compensation law.
Inmates
If you are an inmate or under the custody of law
enforcement, we may release your medical information
to the correctional institution or law enforcement
official. This release is permitted to allow the
institution to provide you with medical care, to
protect your health or the health and safety of
others, or for the safety and security of the
institution.
Military,
National Security and Intelligence Activities,
Protection of the President
We may disclose your medical information for
specialized governmental functions such as
separation or discharge from military service,
requests as necessary by appropriate military
command officers (if you are in the military),
authorized national security and intelligence
activities, as well as authorized activities for the
provision of protective services for the President
of the United States, other authorized government
officials, or foreign heads of state.
Research, Organ
Donation, Coroners, Medical Examiners, and Funeral
Directors
When a research project and its privacy protections
have been approved by an Institutional Review Board
or privacy board, we may release medical information
to researchers for research purposes. We may
release medical information to organ procurement
organizations for the purpose of facilitating organ,
eye, or tissue donation if you are a donor. Also,
we may release your medical information to a coroner
or medical examiner to identify a deceased or a
cause of death. Further, we may release your
medical information to a funeral director where such
a disclosure is necessary for the director to carry
out his duties.
Required by Law
We may release your medical information where
the disclosure is required by law.
Your Rights
Under Federal Privacy Regulations
The United States
Department of Health and Human Services created
regulations intended to protect patient privacy as
required by the Health Insurance Portability and
Accountability Act (HIPPA). Those regulations
create several privileges that patients may
exercise. We will not retaliate against a patient
that exercises their HIPPA rights.
Requested
Restrictions
You may request that we restrict or limit how your
protected health information is used or disclosed
for treatment, payment, or healthcare operations.
We do NOT have to agree to this restriction, but if
we do agree, we will comply with your request execpt
under emergency circumstances.
To request a
restriction, submit the following in writing: (a)
The information to be requested, (b) what kind of
restriction you are requesting (i.e. on the use of
information, disclosure of information or both), and
(c) to whom the limits apply. Please send the
request to the address and person listed below.
You may also request
that we limit disclosure to family members, other
relatives, or close personal friends that may or may
not be involved in your care.
Receiving
Confidential Communications by Alternative Means
Your may request that we send communications of
protected health information by alternative means or
to an alternative location. This request must be
made in writing to the person listed below. We are
required to accommodate only reasonable
requests. Please specify in your correspondence
exactly how you want us to communicate with you and,
if you are directing us to send it to a particular
place, the contact/address information.
Inspection and
Copies of Protected Health Information
You may inspect and/or copy health information that
is within the designated record set, which is
information that is used to make decisions about
your care. Texas law requires that requests for
copies be made in writing and we ask that requests
for inspection of your health information also be
made in writing. Please send your request to the
person listed below.
We can refuse to
provide some of the information you ask to inspect
or ask to be copied if the information:
- Includes
psychotherapy notes.
- Includes the
identity of a person who provided information if
it was obtained under a promise of
confidentiality.
- Is subject to
the Clinical Laboratory Improvements Amendments
of 1988.
- Has been
compiled in anticipation of litigation.
We can refuse to
provide access to or copies of some information for
other reasons, provided that we provide a review of
our decision on your request. Another licensed
health care provider who we not involved in the
prior decision to deny access will make any such
review.
Texas law requires
that we are ready to provide copies or a narrative
within 15 days of your request. We will inform you
of when the records are ready or if we believe
access should be limited. If we deny access, we
will inform you in writing.
HIPAA permits us to
charge a reasonable cost based on fee. The Texas
State Board of Medical Examiners (TSBME) has set
limits on fees for copies of medical records that
under some circumstances may be lower than the
charges permitted be HIPAA. In any event, the
lower of the fee permitted by HIPAA or the fee
permitted by the TSBME will be charged.
Amendment of
Medical Information
You may request an amendment of your medical
information in the designated record set. Any such
request must be made in writing to the person listed
below. We will respond within 60 days of your
request. We may refuse to allow an amendment if the
information:
- Wasn't created
by this practice or the physicians here in this
practice.
- Is not part of
the Designated Record Set?
- Is not
available for inspection because of an
appropriate denial.
- If the
information is accurate and complete.
Even if we refuse to
allow an amendment you are permitted to include a
patient statement about the information at issue in
your medical record. If we refuse to allow an
amendment we will inform you in writing. If we
approve the amendment, we will inform you in
writing, allow the amendment to be made and tell
others that we know the incorrect information.
Accounting of
Certain Disclosures
The HIPAA privacy regulations permit you to
request, and us to provide, an accounting of
disclosures that are other than for treatment,
payment, health care operations, or made via an
authorization signed by you or your representative.
Please submit any request for an accounting to the
person listed below. Your first accounting of
disclosures (within a 12 month period) will be
free. For additional requests within that period we
are permitted to charge for the cost of providing
the list. If there is a charge we will notify you
and you may choose to withdraw or modify your
request before any costs are incurred.
Appointment
Reminders, Treatment Alternatives, and Other
Health-related Benefits
We may contact you
by telephone, mail, or both to provide appointment
reminders, information about treatment alternatives,
or other health-related benefits and services that
may be of interest to yor.
Complaints
If you are concerned
that your privacy rights have been violated, you may
contact the person listed below. You may also send
a written complaint to the United States Department
of Health and Human Services. We will not retaliate
against you for filing a complaint with the
government or us. The contact information for the
United States Department of Health and Human
Services is:
U.S. Department of
Health and Human Services
HIPAA Complaint
7500 Security Blvd., C5-24-04
Baltimore, MD 21244
Our Promise to
You
We are required by
law and regulation to protect the privacy of your
medical information, to provide you with this notice
of our privacy practices with respect to protected
health information, and to abide by the terms of the
notice of privacy practices in effect.
Questions and
Contact Person for Requests
If you have any
questions or want to make a request pursuant to the
rights described above, please contact:
Lindsay Cole
Pathology Associates of Tyler, PA
1726 S. Beckham
Tyler, TX 75701
903-593-0481
This notice is
effective on the following date: April 1, 2003.
We may change our
policies and this notice at any time and have those
revised policies apply to all the protected health
information we maintain. If or when we change our
notice, we will post the new notice in the office or
online where it can be seen. |
