The Lung & Sleep Clinic of Alaska, Inc.
HIPAA Notice of Privacy Information Practices
Effective Date: 10/02/2002
Date(s) of Revision: 02/07/2007
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW CAREFULLY.
Please contact the Office Manager if you have any questions regarding this notice.
This notice describes our information privacy practices and that of:
|1.||Any health care professional authorized to enter information into your medical record created and/or maintained at our clinic;|
|2.||Any member of a volunteer group which we allow to help you while receiving services at our clinic; and|
|3.||All clinic employees, staff, and other personnel.|
All of the individuals and/or entities identified above follow the terms of this Notice. In addition, these individuals and/or entities may share health information with each other for purposes of treatment, payment, or health care operations, as further described in this notice.
We understand that the health information created and/or maintained by us regarding your health is personal. We are committed to protecting your health information. We create a record of care and services, which you receive from our health care professionals. We need this record to provide you with appropriate and consistent quality care, and to comply with certain legal requirements. This Notice applies to all of the records of your care created and/or maintained by our health care providers. Other health care providers or facilities, such as hospitals, may have different policies or notices regarding their use and disclosure of you health information created and /or maintained at their offices or facilities.
This Notice tells you about the ways in which we may use, and disclose your health information. We also describe your rights and certain obligations we have regarding the use and disclosure of your health information.
We are required by law to:
|1.||Protect the privacy and confidentiality of your health information;|
|2.||Give you notice of our legal duties and privacy information practices with respect to your health information; and|
|3.||Follow the terms of the Notice that is currently in effect.|
|1.||Treatment. We may use your health information to provide you with health care treatment and services. We may disclose your health information to doctors, nurses, technicians, medical and nursing students, or other personnel who are involved in your health care. For example, a physician treating you for a broken leg may need to know if you have diabetes, because diabetes may slow the healing process. The physician may need to talk with a dietician so that appropriate dietary modifications can be made to facilitate your healing process. We also may disclose your health information to people outside of our clinic who may be involved in your health care, such as family members (with your authorization), social services, or home health agencies.|
|2.||Payment. We may use and disclose your health information so that the treatment and services you receive at our clinic may be billed and payment may be collected from you, an insurance company, or a third party. For example, we may need to give information to your health plan regarding the services you received from our health care providers so that your health plan will pay us, or reimburse you for the services. We also may tell your health plan about a treatment you are going to receive in order to obtain prior approval for the services or to determine if your health plan will cover the treatment.|
|3.||Health Care Operations. We may use and disclose your health information to perform certain clinic operations. These uses and disclosures are necessary to operate our clinic and to make sure that our patients receive quality care. For example, we may use your health information to review our treatment and services, and to evaluate the performance of our staff in caring for you. We also may combine health information about many of our patients to decide what additional services we should provide, what services are not needed, and whether certain new treatments are effective. We also may disclose your health information to physicians, nurses, technicians, medical and nursing students, and other clinic personnel for review and learning purposes. We also may combine health information with information from other health care providers and/or facilities to compare how we are doing and see where we can make improvements in the care and services offered to our patients. We may remove information that identifies you from this set of health information so that others may use the information to study health care and health care delivery without learning the specific identities of our patients.|
|4.||Appointment Reminders. We may use and disclose your health information to contact you as a reminder that you have an appointment for treatment or health care at our clinic.|
|5.||Treatment Alternatives. We may use and disclose health information to tell you about or to recommend possible treatment options or alternatives that may be of interest to you.|
|6.||Health-Related Benefits and Services. We may use and disclose health information to tell you about health-related benefits or services that may be of interest to you.|
|7.||Clinic Directory. We do not have a clinic directory.|
|8.||Individuals involved in your care or payment for your care. We may release health information to a friend or family member who is involved in your care. We also may give information to someone who helps pay for your care.|
|9.||Research. Under certain circumstances, we may use and disclose health information for research purposes. For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received a different medication for the same condition. All research subjects are subject to a special approval process. This process evaluates a proposed research project and its use of health information, trying to balance the research needs with patients’ needs for privacy of their health information. Before we use or disclose health for research, the project will have been approved through this research approval process. We may however disclose health information to people preparing to conduct a research project, in order to assist them in identifying patients with specific health care needs. Information reviewed for these purposes will not leave the clinic site. We will almost always ask for your specific permission if the researcher requests access to your name, address, or other information that reveals who you are, or will be involved in your care.|
|10.||As Required By Law. We will disclose health information when required to do so by federal, state, or local law.|
|11.||To Avert a Serious Threat to Health and Safety. We may use and disclose health information when necessary to prevent a serious threat to your health and safety or to the health and safety of the public or another person. Any disclosure however would be made only to an individual or entity that is able to help prevent and/or minimize the threat.|
|1.||Organ and Tissue Donation. If you are an organ donor, we may release health information to organizations that handle organ procurement or organ, eye, or tissue transplantation, or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.|
|2.||Military and Veterans. If you are a member of the armed forces, we may release health information about you as required by military command authorities. We also may release health information about foreign military personnel to the appropriate foreign military authorities.|
|3.||Workers’ Compensation. We may release health information about you for workers’ compensation or similar programs providing benefits for work-related injuries or illnesses.|
|4.||Public Health Risks. We may disclose health information about you for public health activities. These activates generally include the following:|
|5.||Health Oversight Activities. We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights law.|
|6.||Lawsuits and Disputes. If you are involved in a lawsuit or dispute, we may disclose health information about you in response to a court or administrative order. We also may disclose health information about you in response to a subpoena, discovery request, or other lawful processes by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.|
|7.||Law Enforcement. We may release health information if asked to do so by a law enforcement official:|
|8.||Coroners, Medical Examiners, and Funeral Directors. We may release health information to a coroner or medical examiner. This may be necessary to identify a deceased person or to determine the cause of death. We also may release health information about patients to funeral directors as necessary to carry out their duties.|
|9.||National Security and Intelligence Activities. We may release health information to authorized federal officials for intelligence, counterintelligence, and other national security activities as authorized by law.|
|10.||Protective Services for the President and Others. We may disclose health information to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state, or to conduct special investigations.|
|11.||Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release health information to the correctional institution or law enforcement official. This release would be necessary (a) for the institution to provide you with health care; (b) to protect your health and safety or the health and safety of others; or (c) for the safety and security of the correctional institution and/or its personnel.|
You have the following rights regarding you health information, which we create and/or maintain about you:
Right to Inspect and Copy. You have the right to inspect and copy health information that may be used to make decisions about your care. You must submit a written request to Dr. William Lucht, or the Office Manager to do so. Some one must be present at this time. Usually, this includes going over medical and billing records, but not including psychotherapy notes.
To inspect a copy of health information that may be used to make decisions about you, you must submit your request in writing to Dr. William Lucht, or the Office Manager. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, or other supplies associated with your request.
We may deny your request to inspect and copy your health information in certain limited circumstances. If you are denied access to your health information, you may request that the denial be reviewed. Another licensed health care professional selected by the clinic will review your request and the denial. The person conducting the review will not be the person who initially denied your request. We will comply with the outcome of this review.
Right to Amend. If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our clinic.
To request an amendment, your request must be made in writing and submitted to Dr. William Lucht. In addition, you must provide a reason that supports your request.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of your health information. This accounting will not include disclosures of health information that we made for purposes of treatment, payment or health care operations.
To request this list or accounting of disclosures, you must submit your request in writing to the Office Manager. Your request must state a time period which may not be longer than six (6) years and may not included dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper or via electronic means). The first list you request within a twelve (12) month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved, and you may choose to withdraw or modify your request at that time before any costs are incurred.
|4.||Right to Request Restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care, such as a family member or friend. For example, you could ask that we not use or disclose information regarding a particular treatment that you received.
We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide emergency treatment to you.
|5.||Right to Request Confidential Communications. You have the right to request that we communicate with you about health care matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
To request confidential communications, you must make your request in writing to the Office Manager. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
|6.||Right to a Paper Copy of this Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this Notice at anytime. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy of this Notice.
You may obtain a copy of this Notice at our Website Lungandsleep.com.
To obtain a paper copy of this Notice, contact the Office Manger.
We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current Notice in our clinic offices. The first page of the Notice will contain the effective date and any dates of revision.
If you believe your privacy rights have been violated, you may file a complaint with our clinic or with the secretary of the Department of Health and Human Services (“DHHS”). To file a complaint with our clinic, contact the Office Manager. All complaints must be submitted in writing. If you like a complaint letter is kept on file for you to fill out in the office. If you would like a copy please ask the Office Manager.
You will NOT be penalized for filing a complaint.
Other uses and disclosures of health information not covered by this Notice or the laws that apply to us will be made only with your written permission. If you provide us with permission to use or disclose your health information, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we already made with your permission, and that we are required to retain our records of the care that we provided to you.