NOTICE
OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION
Cardiovascular
Surgery Associates, P.C.
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 office is permitted by federal privacy laws to make uses and
disclosures of your health information for purposes of treatment,
payment, and health care operations. Protected health information
is the information we create and obtain in providing our services
to you. Such information may include documenting your symptoms,
examination and test results, diagnoses, treatment, and applying
for future care or treatment. It also includes billing documents
for those services.
Example of uses of your health information for treatment
purposes are:
•
A surgeon performs a preoperative consultation including a history
and physical examination and records health information in our
medical record.
Example
of use of your health information for payment purposes:
• We submit claims for payment to your health insurance
company. The health insurance company requests information from
us regarding the care provided. We will provide that information
to them.
Example
of Use of Your Information for Health Care Operations:
We may obtain services from business associates such as quality
assessment, quality improvement, outcome evaluation, protocol
and clinical guidelines, development, training programs, credentialing,
medical review, legal services, and insurance. We will share information
about you with such business associates as necessary to obtain
these services.
Your Health Information Rights
The
health and billing records we maintain are the physical property
of Cardiovascular Surgery Associates, P.C. You have the following
rights with respect to your Protected Health Information
Following
is a List of Other Uses and Disclosures Allowed by the Privacy
Rule
Patient
Contact
We
may contact you to provide you with appointment reminders, with
information about treatment alternatives, or with information
about other health-related benefits and services that may be of
interest to you.
Notification
– Opportunity to Agree or Object
Unless
you object, we may use or disclose your protected health information
to notify, or assist in notifying, a family member, personal representative,
or other person responsible for your care, about your location,
and about your general condition, or your death.
Communication
with Family – Using our best judgement, we may disclose
to a family member, other relative, close personal friend, or
any other person you identify, health information relevant to
that person’s involvement in your care or in payment for
such care if you do not object.
We
may use and disclose your protected health information to assist
in disaster relief efforts.
Opportunity
to Agree or Object Not Required
PUBLIC
HEALTH ACTIVITIES
Controlling
Disease – As required by law, we may disclose your protected
health information to public health or legal authorities charged
with preventing or controlling disease, injury, or disability.
Child
Abuse & Neglect – We may disclose protected health
information to public authorities as allowed by law to report
child abuse or neglect.
Food
and Drug Administration (FDA) – We may disclose to the
FDA your protected health information relating to adverse events
with respect to food, supplements, product and product defects,
or post-marketing surveillance information to enable product recalls,
repairs, or replacements.
If
we are evaluating whether you have a work-related injury or illness,
we may disclose protected health information pertaining to the
work-related injury or illness to your employer if your employer
needs the findings in order to comply with OSHA regulations.
VICTIMS OF ABUSE, NEGLECT, OR DOMESTIC VIOLENCE
We can disclose protected health information to governmental authorities
to the extent the disclosure is authorized by statute or regulation
and in the exercise of professional judgement the doctor believes
the disclosure is necessary to prevent serious harm to the individual
or other potential victim.
OVERSIGHT
AGENCIES
Federal law allows us to release your protected health information
to appropriate health oversight agencies or for health oversight
activities to include audits, civil, administrative or criminal
investigations: inspections, licensures or disciplinary actions,
and for similar reasons related to the administration of healthcare.
JUDICIAL/ADMINISTRATIVE
PROCEEDINGS
We may disclose your protected health information in the course
of any judicial or administrative proceeding as allowed or required
by law, with your consent, or as directed by a proper court order
or administrative tribunal, provided that only the protected health
information released is expressly authorized by such order, or
in response to a subpoena, discovery request or other lawful process.
LAW
ENFORCEMENT
We may disclose your protected health information for law enforcement
purposes as required by law, such as when required by court order,
including laws that require reporting of certain types of wounds
or other physical injury.
CORONERS,
MEDICAL EXAMINERS, AND FUNERAL DIRECTORS
We may disclose your protected health information to funeral directors
or coroners consistent with applicable law to allow them to carry
out their duties.
ORGAN
PROCUREMENT ORGANIZATIONS
Consistent with applicable law, we may disclose your protected
health information to organ procurement organizations or other
entities engaged in the procurement, banking, or transplantation
of organs, eyes, or tissue for the purpose of donation and transplant.
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 protected health information.
THREAT
TO HEALTH AND SAFETY
To avoid a serious threat to health or safety, we may disclose
your protected health information consistent with applicable law
to prevent or lessen a serious, imminent, threat to the health
or safety of a person or the public.
FOR
SPECIALIZED GOVERNMENTAL FUNCTIONS
We may disclose your protected health information for specialized
government functions as authorized by law such as to Armed Forces
personnel, for national security purposes, or to public assistance
program personnel.
CORRECTIONAL
INSTITUTIONS
If you are an inmate of a correctional institution, we may disclose
to the institution or it’s agents the protected health information
necessary for your health and the health and safety of other individuals.
WORKERS
COMPENSATION
If you are seeking compensation through Workers Compensation,
we may disclose your protected health information to the extent
necessary to comply with laws relating to Workers Compensation.
Other Uses and Disclosures
•
Other uses and disclosures besides those identified in this Notice
will be made only as otherwise authorized by law or with your
written authorization which you may revoke except to the extent
information or action has already been taken
Effective Date: April 14, 2003
