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Privacy Policy – Section 1

How we may use and disclose protected health information about you: Section 1

We are not obligated to have your consent when using or disclosing protected health information for the following purposes:

A. For Treatment

We may use and disclose your health information to provide, coordinate or manage your health care and any related services. We may disclose information about you to doctors, dentists, nurses, technicians, office staff or other personnel who are involved in taking care of you and your health.

For example:

  • If we schedule a test, therapy or surgery for you, we must provide information about you in order to complete the scheduling. This includes your name, demographic and insurance information and the reason for the test.
  • Your doctor may share your medical information with another doctor who is also involved in your care so that both may have all the information to make the best treatment decisions for you.
  • We may share information with a pharmacy so that they can fill or refill a prescription for you.
  • We may share information about you with another provider who is on call in the absence of your provider.
B. For Payment

We may use and disclose your information to obtain payment for services you receive. If you pay in full for service out of pocket you have the right to restrict your information being given to any health plan.

For example:

  • We may use or disclose your information to determine eligibility for insurance or benefits.
  • We may use the name of your insurance carrier and your identification numbers in order to file a claim for you.
  • We may disclose your information about your conditions or reasons for seeking care and the care that is provided to your insurance carrier so that they may process and pay your claim.
  • We may disclose information about your conditions to your insurance carrier to seek approval as necessary for recommended tests and treatment.
  • We may provide information about your services to a health care clearinghouse so that they may distribute a claim to your insurance carrier on our behalf.
  • If we refer you to another facility or provider we may provide them with your insurance information to expedite your registration and assure that they are participants in your insurance plan.
C. For Health Care Operations

We may use or disclose protected health information about you in order to evaluate our care for you or to meet a business need of the organization. These activities include quality assessment activities, employee review activities, training students, compliance audits by your insurance carrier, and conducting or arranging for other business activities.

For example:

  • We may use information about you to evaluate the performance of our staff in caring for you.
  • We may use your information to evaluate our efficiency.
  • We may use your information to evaluate and respond to a patient complaint.
  • We may share your health information with students or residents who are learning to care for patients.

We may also use or disclose protected health information to our Business Associates in the performance of health care operations. A Business Associate is an entity or person engaged by this organization to perform a business activity on behalf of the organization. Our Business Associates are obligated by contract to protect health information they receive or generate about you.

For example:

  • We may provide information to our transcription service so that they can produce a written copy of your encounter in our office.
  • We may provide information to our accountant in order to prepare our organization’s financial reports.
  • We may share information with qualified consultants in order for them to provide business management advice.
D. Other Contact Situations
  • We may use your information to call and remind you of an appointment in our office.
  • We may tell you about or recommend possible treatment options or alternatives that may be of interest to you.
  • We may tell you about health-related products or services that may be of interest to you.
  • We may use your information for marketing, and fund raising you do have the right to opt out of the marketing and fund raising information.
E. Special Situations

Emergencies: We may use or disclose protected health information in the case of a medical emergency.

Required by Law: We may use or disclose your protected health information if the disclosure is required by law.

Public Health: We may disclose protected health information about you for public health activities. These activities generally include the following:

  • To prevent or control disease, injury or disability.
  • To report births or deaths.
  • To report child abuse or neglect.
  • To report reactions to medications or problems with products.
  • To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
  • To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized bylaw.

Health Oversight: We may disclose protected health information to health oversight agencies that oversee our activities. These activities may include audits, investigations and inspections and are necessary for the government to monitor the health care system, government programs and compliance with civil rights laws.

Lawsuits or Disputes: If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. Subject to legal requirements, we may also disclose medical information about you in response to a subpoena.

Law Enforcement: We may disclose protected health information, so long as all applicable legal requirements are met, for law enforcement purposes.

Coroners, Medical Directors and Funeral Directors: We may disclose protected health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release information about patients to funeral directors as necessary to carry out their duties.

Workers Compensation: We may disclose medical information about you for programs that provide benefits for work-related injuries or illness.

Military Activities, National Security and Intelligence Activities: If you are a member of the armed forces, or part of the national security or intelligence communities, we may be required by military command or other government authorities to disclose protected health information about you. We may also disclose information about foreign military personnel to the appropriate foreign military authority.

Organ and Tissue Donation: If you are an organ or tissue donor, we may disclose protected health information to organizations that handle organ or tissue procurement when necessary to facilitate organ or tissue donation or transplantation.

Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. The release would be necessary 1) for the institution to provide you with health care; 2) to protect your health and safety or the health and safety of others; or 3) for the safety and security of the correctional institution.

Serious Threats: As permitted by applicable law and standards of ethical conduct, we may use or disclose protected health information if we, in good faith, believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.

Information that is not personally identifiable: We may use or disclose information about you in a way that does not personally identify you.