NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU
MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS
TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Effective Date: April 14, 2003
We are required by law to maintain the privacy of
your health information and to give you notice of
our legal duties and privacy practices with respect
to your protected health information. This Notice
summarizes our duties and your rights concerning
your protected health information. Our duties and
your rights are set forth more fully in 45 C.F.R.
part 164. We are required to abide by the terms
of our Notice that is currently in effect.
USES AND DISCLOSURES OF INFORMATION THAT WE MAY
MAKE WITHOUT WRITTEN AUTHORIZATION
Treatment
We may use or disclose protected health information
so that we, or other persons involved in your health
care, may provide treatment to you. For example,
information obtained by a nurse, physician, or other
members of your healthcare team will be recorded
in your record and used to determine the course
of treatment that should work best for you.
Payment
We may use or disclose protected health information
so that we, and other health care providers, may
obtain payment for treatment provided to you. For
example, a bill will be sent to you or a third-party
payer such as an insurance company for your treatment.
The information on or accompanying the bill may
include information that identifies you, as well
as your diagnosis and procedures.
Healthcare Operations
We may use or disclose protected health information
for certain healthcare operations that are necessary
to run our practice and ensure that our patients
receive quality care. For example, members of the
medical staff or our practice managers may use information
in your 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
services we provide.
Required by Law
We may use or disclose protected health information
to the extent that such use or disclosure is required
by law.
Threat to Health and Safety
We may use or disclose protected health information
to avert a serious threat to your health or safety
or the health and safety of others.
Appointments and Services
We may use or disclose protected health information
to contact you to provide appointment reminders,
or to provide information about treatment alternatives
or other health-related benefits and services that
may be of interest to you.
Public Health Activities
We may use or disclose protected health information
to public health or other government authorities
charged with preventing or controlling disease,
injury or disability. We may also disclose to the
FDA health information relative to adverse events
with respect to products or product recalls.
Abuse or Neglect
We are required to disclose protected health information
to the appropriate government agency if we believe
it is related to child abuse or neglect, or if we
believe that you have been a victim of abuse, neglect
or domestic violence.
Communicable Disease
We are required to disclose protected health information
concerning certain communicable diseases to the
appropriate government agency. To the extent authorized
by law, we may also disclose protected health information
to a person who may have been exposed to a communicable
disease or may otherwise be at risk of contracting
or spreading the disease or condition.
Health Oversight
Activities
We may use or disclose protected health information
to governmental health oversight agencies to help
them perform certain activities authorized by law,
such as audits, investigations, and inspections.
Workers’ Compensation
We may use or disclose protected health information
to the extent authorized by law and as necessary
to comply with laws relating to workers’ compensation
or similar benefit programs established by law.
Coroner and Mortuary
We may use or disclose protected health information
such as final diagnosis to coroners so they can
carry out their duties and as consistent with applicable
state laws.
Organ Donation
We may use or disclose protected health information
to organ procurement organizations or other entities
engaged in the procurement, banking, or transplantation
of cadaveric organs or tissue.
Business Associates
We may use or disclose protected health information
to our third party business associates who perform
activities involving protected health information
for us. To protect your health information; however,
we require the business associate to appropriately
safeguard your information.
Marketing
We may use or disclose protected health information
for limited marketing activities, including face-to-face
communications with you about our services.
Research
We may use or disclose protected health information
to researchers when we are involved in drug studies
or other medical related studies only after the
study proposal has been approved by an appropriate
review board.
Correctional Institution
Should you be an inmate of a correctional facility,
we may use or disclose protected health information
to the institution or agents necessary for your
health care.
Law Enforcement
We may use or disclose protected health information
to law enforcement as required by law, in response
to a valid subpoena or search warrant, or under
certain other limited circumstances.
Judicial and Administrative Proceedings
We may disclose protected health information in
response to an order of a court or administrative
tribunal. We may also disclose protected health
information in response to a subpoena, discovery
request or other lawful process if we receive satisfactory
assurances from the person requesting the information
that they have made efforts to inform you of the
request or to obtain a protective order.
Military
Should you be a member of the military, we may use
or disclose protected health information as required
by military command authorities.
National Security
We may use or disclose protected health information
to authorized federal officials for national security
activities.
USES AND DISCLOSURES OF INFORMATION THAT WE MAY
MAKE UNLESS YOU OBJECT
We may use or disclose protected health information
in the following instances without your written
authorization unless you object. If you object,
please notify the Privacy Contact identified below.
Persons Involved in Your Healthcare
Unless you object, we may use or disclose information
to a family member, relative, close friend, personal
representative, or other person identified by you
who is involved in your care or the payment for
your health care. We will limit the disclosure to
the protected health information relevant to the
person responsible for your healthcare or payment.
Notification
Unless you object, we may use or disclose protected
health information to notify a family member or
other person responsible for your care of your location
and condition. Among other things, we may disclose
protected health information to a disaster relief
agency to help notify family members.
USES AND DISCLOSURES
OF INFORMATION THAT WE MAY MAKE WITH YOUR WRITTEN
AUTHORIZATION
We will obtain a written authorization from you
before using or disclosing your protected health
information for purposes other than those summarized
above. You may revoke your authorization by submitting
a written notice to the Privacy Contact at the address
identified below.
YOUR RIGHTS CONCERNING HEALTH INFORMATION
Although your health record is the physical property
of The Digestive Health Clinic, the information
belongs to you. You have the following rights concerning
your health information. To exercise any of these
rights, please submit a written request to the Privacy
Contact identified below.
Right to Request Additional Restrictions
You may
request additional restrictions on the use or disclosure
of your protected health information for treatment,
payment, or health care operations. We are not required
to agree to a requested restriction. If we agree
to a restriction, we will comply with the restriction
unless an emergency or the law prevents us from
complying with the restriction, or until the restriction
is terminated.
Right to Inspect and Receive a Copy of Your Record
You may inspect and obtain a copy of protected health
information that is used to make decisions about
your care or payment for your care upon request
within the limits of the law and within a reasonable
time. You will be responsible for any costs incurred
in obtaining a copy of your record. We may deny
your request under limited circumstances; e.g.,
information prepared for legal proceedings or if
disclosure may result in substantial harm to you
or others.
Right to Request Amendment to Your Record
You may
request that your protected health information be
amended. Your request does not permit you to alter
or change the original record. We may deny your
request if we did not create the record unless the
originator is no longer available; if you do not
have a right to access the record; or if we determine
that the record is accurate and complete. If we
deny your request, you have a right to submit a
statement disagreeing with our decision and to have
the statement attached to the record.
Right to an Accounting of Certain Disclosures
You
may obtain an accounting of certain disclosures
of your protected health information after April
14, 2003. We are not required to account for disclosures
for treatment, payment, or healthcare operations;
to family members or others involved in your health
care or payment; for notification purposes; or pursuant
to your written authorization. You are entitled
to obtain the first copy of an accounting within
any 12-month period free of charge. You will be
responsible for any costs incurred in obtaining
any additional copy of your disclosures.
Right to Receive Communications by Alternative Means
We normally contact you by telephone or mail at
your home address. You may request confidential
communications of your protected health information
by some other method or at some other location.
We will not ask you to explain the reason for your
request. We will accommodate reasonable requests.
We may require that you explain how payment will
be handled if an alternative means of communication
is used.
Right to a Copy of This Notice
You have the right
to obtain a paper copy of this Privacy Notice upon
request. You have this right even if you have agreed
to receive the Notice electronically.
CHANGES TO THIS NOTICE
We reserve the right to change the terms of our
Notice of Privacy Practices and to make the new
provisions effective for all protected health information
we maintain. If we materially change our privacy
practices, we will prepare a new Notice of Privacy
Practices and will post a copy of the new Notice
in our reception area. You may obtain a copy of
the new Notice from our receptionist or by contacting
the Privacy Contact identified below.
FOR MORE INFORMATION OR TO REPORT A PROBLEM
If you have questions or would like additional information,
you may contact the Privacy Contact identified below.
If you believe your privacy rights have been violated,
you can complain to the Secretary of Health and
Human Services. You may also complain to us by mailing
or faxing a complaint to our office at one of the
locations listed below, Attention: Privacy Officer. There will be no retaliation for filing a complaint.
We will not retaliate against you for filing a complaint.
PRIVACY CONTACT
Privacy Officer
6259 West Emerald Street
Boise ID 83704
Phone: 208.489.1900
Fax: 208.375.5286
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