Patient 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.
WE ARE REQUIRED BY FEDERAL LAW UNDER THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) TO PROVIDE YOU WITH THIS PRIVACY NOTICE.
"Protected Health Information" is defined as any written or oral health information about you, which includes demographic data, by which you can be identified. This is the health information created or received by your health care provider which can relate to your past, present or future physical or mental health or condition.
YOUR RIGHTS:
The right to request a restriction or limitation on the use or disclosure of the medical information for your treatment, payment or health care operations. You must make written request specifying restrictions requested and to whom the restrictions apply. We are not required to grant all restriction requests.
The right to obtain a paper copy of this notice.
The right to inspect and obtain a copy of your health care record upon written request to the Administrator or Privacy Officer. We may, in certain instances, deny your request. You then have the right to make the request in writing. Certain denials are not reviewable.
The right to request an amendment to your health care record upon written request to the Administrator or Privacy Officer. The request must include the reason for the request. We may, in certain instances, deny your request. You then have the right to file a statement of disagreement with us and we may prepare a rebuttal. We will provide you with a copy of the rebuttal.
The right to request, in writing, a disclosure history, specifying the time period involved, listing entities that obtained information unrelated to treatment or payment or health care operations. We must provide this within 60 days of the request. We are not required to account for disclosures requested by you, disclosures you agreed to by signing an authorization form, disclosures to friends or family members involved in your care, or certain other disclosures we are permitted to make without your authorization.
The right to request in writing that we communicate with you about your medical information by alternative means. We will attempt to accommodate reasonable requests. We may ask you for the information about payment methods, alternative address, or other method of contact.
The right to revoke your authorization to Central Point Surgery Center to use and disclose medical information. Any written revocation request will have no effect on information already released under your prior authorization.
The right to request release of your health information to another entity, for example a doctor or other agency. This release will be honored by Central Point Surgery Center upon you signing a release. The released information may no longer be protected by federal privacy regulations.
YOUR RESPONSIBLITIES:
We are required by law to:
- Maintain the privacy of your health information.
- Provide you with a copy of our "Notice of Privacy Practices".
- Abide by the terms of the "Notice of Privacy Practices".
- Notify you if we are unable to agree to a restriction you request.
- Accommodate reasonable requests you make to communicate your health information to you by alternative means.
- Inform you of the effective date of this notice.
We reserve the right to change this notice and to make the revised notice effective for medical information we already have about you, as well as future information. We must post a copy of the current notice, which will contain an effective date. Each time you register at Central Point Surgery Center, we will offer you a copy of the current notice in effect.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU
Each time you are a patient at Central Point Surgery Center, we make a record of your visit and may use your protected health information for purposes of providing treatment, obtaining payment for treatment and conducting health care operations as described below:
Treatment: Doctors, nurses and other Central Point Surgery Center personnel involved in your care will use and disclose health information to determine your course of treatment. This includes coordinating and managing your health care with third parties, such as your medical doctor, a laboratory, or other facilities.
Payment: Use and disclosure for purposes of billing and payment collection from you, your insurance companies or a third party. We may also disclose patient information to another provider involved in your care, for example an anesthesia care provider.
Healthcare Operations: We may use your health information as a tool to assess the function of the ASC and improve our delivery of patient care services. This can include quality review and improvement, staff, training, accreditation, certification, licensing and credentialing, audit process, medical reviews, legal services, compliance programs, and business management and general administrative activities.
Other Uses: To remind you, or a contact person designated by you, by telephone or U.S. Postal Service, of an appointment or surgery date, potential treatment alternatives or health related services.
Federal privacy rules allow us to use or disclose your protected health information without your permission or authorization as described below:
As Required By Law: We will disclose your protected health information when required to comply with federal and state laws.
Public Health Risks: Public health reporting must be done as required by law to prevent, control or report disease, injury or disability, to report vital events, such as death, to conduct public health investigations, and to track adverse events, product defects and recalls, FDA regulated products and surveillance.
To Report Suspected Abuse, Neglect or Domestic Violence: As required by law, or when the patient agrees to the disclosure.
Health Oversight Activities: For government monitoring of the health care system, government programs and civil rights laws.
In Connection With Judicial and Administrative Proceedings: In response to an order of the court or authorized tribunal, we may disclose medical information about you. Efforts will be made by us to contact you prior to release of information in response to a subpoena.
Law Enforcement: Health information may be disclosed in such instances as reporting certain types of wounds or other injuries, court orders or other process, identification or location of suspect, fugitive, material witness or missing person, crime victim, in emergency crime reporting or to a law enforcement official if your condition is suspect of criminal conduct.
Coroners, Medical Examiners and Funeral Directors: As directed by law, for identification purposes, to determine or funeral duties. Health information may be used or disclosed for cadaver ic donation purposes.
Emergency: To prevent or lessen a serious threat to your health and safety, or the health and safety of the public, we will, consistent with applicable law and ethics, only use and disclose information to prevent or lessen the threat.
Workers' Compensation: We must comply with laws relating to release of health information.
For Specified Government Functions: Relative to military and veterans activities, national security and intelligence activities, protective services, correctional institutions or law enforcement custody.
USES AND DISCLOSURES PREMITTED WITHOUT AUTHORIZATION, BUT WITH OPPORTUNITY FOR YOU TO OBJECT:
Individuals Involved in Your Care or Care Payment: We may disclose your protected health information to a family member or close personal friend if it is directly relevant to the person's involvement in your surgery or payment related to your surgery. You may object to these disclosures, but if you do not object, or we infer from circumstances that you do no object or we determine, in exercising our professional judgment, that 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.
OTHER USES:
Use or disclosure not covered by this Patient Notice of Privacy Practices, or other laws, will be made only after specific written authorization by you. A form is available upon request. You may revoke your authorization, but this will have no effect on any action already taken by us.
In certain cases, your refusal of information release may negate our ability to treat. If this occurs, we will make alternative suggestions for care.