PRIVACY POLICY

THE SALUTARY FAMILY MEDICINE

 

NOTICE OF PRIVACY PRACTICES

 

I hereby acknowledge that I have received or have been given the opportunity to receive a copy of THE SALUTARY FAMILY MEDICINE Notice of Privacy Practices. I further acknowledge that a copy of the current notice will be made available to me upon request.  

 

As Required by the Privacy Regulations Created as a Result of the Health Insurance Portability and Accountability Act of 1996-(HIPAA) Health Information Technology for Economic and Clinical Health Act (HITECH Act), and associated regulations and amendments. This notice describes how health information about you may be used and disclosed, and how you can get access to this information. 

 

PLEASE REVIEW THIS NOTICE CAREFULLY

 

If you have any questions about this notice or if you need more information, please contact THE SALUTARY FAMILY MEDICINE (ADDRESS).

 

 ABOUT THIS NOTICE 

 

We understand that health information about you is personal and we are committed to protecting your information. We create a record of the care and services you receive at all divisions of THE SALUTARY FAMILY MEDICINE. We need this record to provide care (treatment), for payment of care provided, for health care operations, and to comply with certain legal requirements. This Notice will tell you about the ways in which we may use and disclose health information about you. It also describes your rights and certain obligations we have regarding the use and disclosure of health information. We are required by law to follow the terms of this Notice that is currently in effect. 

 

WHAT IS PROTECTED HEALTH INFORMATION (“PHI”) 

 

PHI is information that individually identifies you. We create a record or get from you or from another health care provider, health plan, your employer, or a health care clearinghouse that relates to: 

• Your past, present, or future physical or mental health or conditions, 

• The provision of health care to you, or 

• The past, present, or future payment for your health care. 

 

HOW WE MAY USE AND DISCLOSE YOUR PHI 

 

We may use and disclose your PHI in the following circumstances: 

• Treatment. We may use or disclose your PHI to give you medical treatment or services and to manage and coordinate your medical care. For example, your PHI may be provided to a physician or other health care provider (e.g., a specialist or laboratory) to whom you have been referred to ensure that the physician or other health care provider has the necessary information to diagnose or treat you or provide you with a service. 

• Payment. We may use and disclose your PHI so that we can bill for the treatment and services you receive from us and can collect payment from you, a health plan, or a third party. This use and disclosure may include certain activities that your health insurance plan may undertake before it approves or pays 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. For example, we may need to give your health plan information about your treatment in order for your health plan to agree to pay for that treatment.

 • Health Care Operations. We may use and disclose PHI for our health care operations. For example, we may use your PHI to internally review the quality of the treatment and services you receive and to evaluate the performance of our team members in caring for you. We also may disclose information to physicians, nurses, medical technicians, medical students, and other authorized personnel for educational and learning purposes. 

• Appointment Reminders/Treatment Alternatives/Health-Related Benefits and Services. We may use and disclose PHI to contact you to remind you that you have an appointment for medical care, or to contact you to tell you about possible treatment options or alternatives or health related benefits and services that may be of interest to you.

 • Minors. We may disclose the PHI of minor children to their parents or guardians unless such disclosure is otherwise prohibited by law.

 • Research. We may use and disclose your PHI for research purposes, but we will only do that if the research has been specially approved by an authorized institutional review board or a privacy board that has reviewed the research proposal and has set up protocols to ensure the privacy of your PHI. Even without that special approval, we may permit researchers to look at PHI to help them prepare for research, for example, to allow them to identify patients who may be included in their research project, as long as they do not remove, or take a copy of, any PHI. We may disclose PHI to be used in collaborative research initiatives amongst Hoover Family Medicine providers. We may use and disclose a limited data set that does not contain specific readily identifiable information about you for research. However, we will only disclose the limited data set if we enter into a data use agreement with the recipient who must agree to (1) use the data set only for the