HIPPA Notice of Privacy Practices for Maumee Integrated Health
This Notice Describes How Medical Information About You May Be Used and Disclosed and How You Can Access This Information. Please Review it Carefully.
This Notice of Privacy Practices is how we may use and disclose your Protected Health Information (PHI) to carry out treatment, payment, or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your right to access and control your PHI. PHI is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services.
Uses and Disclosures of PHI
Your PHI may be used and disclosed by your physician, our office staff, and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you to pay your health care bills, to support the operation of the physicians practice and any other use required by law.
Treatment
We will use and disclose your PHI to provide, coordinate or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, we would disclose your PHI, as necessary, to a home health agency that provides care to you. For example, your PHI may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.
Payment
Your PHI will be used, as needed, to obtain payment for your health care services. This may include certain activities that your health insurance plan may undertake before it approves or pay for the health care services we recommend for you, such as: making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities.
Healthcare Options
We may use or disclose, as needed, your PHI in order to support the business activities of your physician’s practices. These activities include but are not limited to quality assessment activities, employee review activities, training or medical students, licensing, and conducting or arranging for other business activities. For example, we may disclose your PHI to medical school students that see patients at our office. In addition, we may use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your physician. We may also call you by name in the waiting room when your physician is ready to see you. We may use or disclose your PHI, as necessary, to contact you to remind you of your appointment.
We may use or disclose your PHI in the following situation without your authorization. These situations include: as required by law, public health issues as required by law, Communicable Diseases; Health Oversight: Abuse or Neglect: Food and Drug Administration requirements; Legal Proceedings: Law Enforcement, Coroners, Funeral Directors, and Organ Donation; research Criminal Activity; Military Activity and National Activity; Workers’ Compensation; Inmates: Required Uses and Disclosures: Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliances with the requirement of Session 164.500. We will share your PHI with third party “business associates” that perform various activities (e.g. billing) for the clinic. Whenever an arrangement between our office and a business associate involves the use of disclosure of your PHI, we will have a written contract that contains terms that wilt protect the privacy of your PHI.
We may use or disclose your PHI as necessary to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may also use and disclose your PHI for other marketing activities. For example, your name, email, mobile phone number, and address may be used to send you information about products or services that we believe may be beneficial to you. Other permitted and required uses and disclosures will be made only with your consent, authorization, or opportunity to object unless required by law.
You may revoke this authorization, at any time, in writing, except to the extent that your physician or the physician’s practice has taken an action in reliance on the use or disclosure indicated in this authorization.
Your Rights
The following is a statement of your rights with respect to your PHI.
You Have the Right to Inspect and Copy Your PHI
This means you may Inspect and obtain a copy of PHI about you that is contained in a designated record set for you as long as we maintain the PHI. A “designated record set” contains medical and billing records and any other records that your physician and the practice use for making decisions about you. Under federal law, however, you may not inspect or copy the following records: psychotherapy notes; Information compiled In reasonable anticipation of, or use In, a civil, criminal, or administrative action or proceeding and PHI that Is subject to law that prohibits access to PHI.
You have the Right to Request a Restriction of Your PHI
This means you may ask us not to use or disclose any part of your PHI for the purposes of treatment, payment, or healthcare operations. You may also request that any part of your PHI for the purpose of treatment, payment, or healthcare operations. You may also request that any part of your PHI not be disclosed to family members or friends who may be involved in your care or for notification purposes as described In the Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply. Your physician is not required to agree to a restriction that you may request. If the physician believes it is in your best interest to permit the use and disclosure of your PHI, your PHI will not be restricted. You then have the right to use another Healthcare Professional.
You have the Right to Receive Confidential Communications from us by Alternative Means or at an Alternative Location.
We will accommodate reasonable requests. We may also condition this accommodation by asking you for Information as to how payment will be handled or specification of an alternative address or other method of contact. We will not request an explanation for you as to the basis for the request.
You have the Right to Receive an Accounting of Certain Disclosures we have made, if any, of Your PHI.
This right applies to disclosures for purposes other than treatment, payment, or healthcare operations as described in this Notice of Privacy Practices. We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice at any time. This notice will be effective for all PHI that we maintain at this time. Upon your request, we will provide you with any revised Notice of Privacy Practices by calling our office and requesting that a revised copy be sent to you In the mall or asking for one at the time of your next visit.
Medical Consent
I request and authorize Maumee Integrated Health, a subsidiary of Health and Pain Care, LLC, its physicians, employees, and any health CARE PROVIDER OR CONTRACTOR RETAINED BY Health and Pain Care, LLC to provide and perform such medical care, tests, procedures, medications, and other services and supplies as ls considered advisable for my health and well being. I acknowledge that no representations, warranties, or guarantees as to results have been made or implied.
Complaints
You may complain to us if you believe your privacy rights have been violated. We will not retaliate against you for filing a complaint.
This notice was published and becomes effective on or before July 1, 2020. We are required by law to maintain the privacy of and provide individuals with this notice of our legal duties and privacy practices with respect to PHI.