privacy notice
Lippy Group for
Ear, Nose and Throat & Lippy Group Hearing Aid Center
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.
Our Promise To You, Our Patients Your Information Is Confidential
Your information is important and confidential. Our ethics and policies
require that your information be held in the strict confidence.
Effective April 14, 2003
Introduction
We maintain protocols to ensure the security and confidentiality of your
personal information. We have physical security in our building,
passwords to protect databases, compliance audits, and virus/intrusion
detection software. Within our practice, access to your information is
limited to those who need it to perform their jobs.
At Lippy Group for ENT, we are committed to treating and using protected
health information about you responsibly. This Notice of Privacy
Policies 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
Each time you visit Lippy Group for ENT, 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:
Basis for
planning your care and treatment,
Means of communication among the many health professionals who
contribute to your care,
Legal document describing the care you received,
Means by which you or a third-party payer can verify that services
billed were actually provided,
Tool in educating health professionals,
Source of data for medical research,
Source of information for public health officials charged to improve the
health of the state and nation,
Source of data for our planning and marketing, and
Tool by which we can assess and continually work to improve the care we
render and outcomes we achieve.
Understanding what is in your record and how your health information is
used helps you to: ensure its accuracy, better understand whom, 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 Lippy Group for
ENT, the information belongs to you have the right to:
Obtain a paper copy of this notice of privacy policies upon request,
Inspect and copy your health record as provided by 45 CFR 164.524, and
Amend your health record as provided by 45 CFR 164.526,
Obtain an acconting of disclosures of your health information as
provided by 45 CFR 164.528,
Request confidential communications of your health information as
provided by 45 CFR 164.522, and
Request a restriction on certain uses and disclosures of your
information as provided by 45 CFR 164.522 (Lippy Group for ENT, however,
is not required by law to agree to a requested restriction).
Our Responsibilities
Lippy Group for ENT is required to:
Maintain the privacy of your health information,
Provide you with this notice as to our legal duties and privacy
practices with respect to information we collect and maintain about you.
Abide by the terms of this notice,
Notify you if we are unable to agree to a requested restriction, and
Accommodate reasonable requests you may have to communicate your health
information.
We reserve the right to change our practices and to make the new
provisions effective for all protected health information we maintain.
We will keep a posted copy of the most current notice in our facility
containing the effective date in the top, right-handed corner. In
addition, each time you visit our facility for treatment, you may obtain
a copy of the current notice in effect upon request.
We will not use or disclose your health information in a manner other
than described in the section regarding Examples Of Disclosures For
Treatment, Payment, And Health Operations, without your written
authorization, which you may revoke as provided by 45 CFR 164.508(b)(5),
except to the extent that action has already been taken.
For More Information Or To Report A Problem
If you have questions and would like additional information, you may
contact our practice's Privacy Officer, Carolyn Croft, B.A., R.N., at
(330) 856-5995.
If you believe your privacy rights have been violated, you can either
file a complaint with Carolyn Croft, B.A., R.N., or with the Office for
Civil Rights, U.S. Department of Health and Human Services (OCR). There
will be no retaliation for filing a complaint with either our Privacy
Officer or the OCR. The address for the OCR is as follows:
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 Disclosures For Treatment, Payment, And Health Operations
We will use your health information for treatment.
For example:
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 other physician(s) or subsequent health care
provider(s) (when applicable) with copies of various reports that should
assist them in treating you.
We will use your health information for payment.
For example:
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.
We will use your health information for regular health operations.
For Example:
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 others
like it. This information will then be used in an effort to continually
improve the quality and effectiveness of the healthcare and service we
provide.
Business Associates
There are some services provided in our organization through contacts
with business associates. Examples include physician services in the
emergency department and radiology, certain laboratory tests, and a
transcription service we use to transfer dictated patient care into the
medical record. Due to the nature of business associates services, they
must receive your health information in order to perform the jobs we've
asked them to do. To protect your health information, however, when
these services are contracted we require the business associate to
appropriately safeguard your information.
Research
We may disclose information to researchers when their research has been
approved by an institutional review board that has reviewed the research
proposal and established protocols to ensure the privacy of your health
information.
Funeral directors
We may disclose health information to funeral directors to carry out
their duties consistent with applicable law.
Organ Procurement Organizations
Consistent with applicable law, we may disclose health information to
organ procurement organizations or other entities engaged in the
procurement, banking, or transplantation of organs for the purpose of
tissue donation and transplant.
Fundraising
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 product defects, or post
marketing surveillance information to enable product recalls, repairs,
or replacement.
Workers Compensation
We may disclose health information to the extent authorized by and
necessary to comply with laws relating to workers compensation or other
similar 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.
Appointment Reminders
We may contact you or a family member at the phone number you have
provided to us as a reminder that you have an appointment.
Marketing
We may contact you to provide information about treatment alternatives
or other health-related benefits and services that may be of interest to
you.
Directory
Unless you notify us that you object, we will use your name, location in
the facility, and general condition for our directory purposes. This
information may be provided to members of your family and to other
people who ask for you by name.
Notification
We may use or disclose information to notify or assist in notifying a
family member or personal representative (or other person responsible
for your care) of your location and general condition.
Communication With Family
Health professionals, using their best judgement, may disclose to a
family member, other relative, or close personal friend (or any other
person you identify) health information relevant to that person's
involvement in your care or payment related to your care.
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.
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