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HIPAA Disclosure

HIPAA (Health Insurance Portability and Accountability Act)

Introduction

At Borland-Groover Clinic, we are committed to treating and using protected health information about you responsibly. This notice of Health Information Practices describes the personal information we collect, and how and when we use or disclose that information. It also describes your rights as they relate to your protected health information. This Notice is effective April 14, 2003, and applies to all protected health information as defined by federal regulations.

Understanding your Health Record/Information

Each time you visit Borland-Groover Clinic or any of our other facilities, 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:

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 Borland-Groover Clinic, the information belongs to you. You have the right to:

Our Responsibilities

Borland-Groover Clinic is required to:

We reserve the right to change our practices and to make new provisions effective for all protected health information we maintain. Should our information practice change, we will mail a revised notice to the address you’ve supplied us, or if you agree, we will mail the revised notice to you.

We will not use or disclose your health information without our authorization, except as described in this notice. We will also discontinue to use or disclose your health information after we have received a written revocation of the authorization according to the procedures included in the authorization.

For more information, or to report a problem

If you have questions and would like additional information, you may contact the Practice’s Privacy Office, Vicki King at 904.398.3262.

If you believe your privacy rights have been violated, you can file a complaint with the practice’s Privacy Officer, or with the Office for Civil Rights, U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint with either the Privacy office or the Office for Civil Rights. The address for the OCR is listed below:

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201

Examples of Disclosure for Treatment, Payment and Health Operations

For Treatment:

Information obtained by a nurse, physician, or other member of your health care team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his or her expectations of the members of your health care team. Members of your health care team will then record the actions they took and their observations. In that way, the physician will know how you are responding to treatment.

We will also provide your physician or a subsequent health care provider with copies of various reports that should assist him or her in treating you once you’re discharged from the hospital.

For Payment:

A bill may be sent to you or a third party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

For Health Operations:

Members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and other like it. This information will then be used in an effort to continually improve the quality and effectiveness of the health care and service we provide.

Other Examples:

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

Communication from Offices:
We may call your home or other designated location and leave a message on voice mail or in person in reference to any items that assist the practice in carrying out TPO, such as appointment reminders, insurance items and any call pertaining to your medical care. We may mail to your home or other designated location any items that assist the practice in carrying out TPO, such as appointment reminder cards and patient statements. We may e-mail to your home or other designated location any items that assist the practice in carrying out TPO, such as appointment reminder cards and patient statements.

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

Open Treatment Areas:
Sometimes patient care is provided in an open treatment area. While special care is taken to maintain patient privacy, some patient information may be overheard by others while receiving treatment. Should you be uncomfortable with this, please bring this to the attention of our Privacy Officer.

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

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

Fund Raising:
We may contact you as part of a fund-raising effort.

Food and Drug Administration (FDA):
We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and produce defects, or post marketing surveillance information to enable product recalls, repair, or replacement.

Workers Compensation:
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 programs established by law.

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.

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

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