Your privacy is extremely important to us!
NOTICE OF PRIVACY PRACTICES
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.
Buckhead Primary Care and Affiliated Healthcare Providers deemed as covered entitles under the federal Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) will be referred to in this Notice of Privacy Practices (“Notice”) as “BPC.” This Notice is given to you by BPC to describe the ways in which BPC may use and disclose your medical information (called “protected health information” or “PHI”) and to notify you of your rights with respect to PHI in the possession of BPC. BPC protects the privacy of PHI which also is protected from disclosure by state and federal law. In certain circumstances, pursuant to this Notice, patient authorization or applicable laws and regulations, PHI can be used by BPC or disclosed to other parties. Below are categories describing these uses and disclosures, along with some examples to help you better understand each category.
SECTION I: Uses and Disclosures for Treatment, Payment and Health Care Operations. BPC may use or disclose your PHI for the purposes of treatment, payment and health care operations, described in more detail below, without obtaining written authorization from you.
- For Treatment. BPC may use and disclose PHI in the course of providing, coordinating, or managing your medical treatment, including the disclosure of PHI for treatment activities of another health care provider. These types of uses and disclosures may take place between physicians, nurses, technicians, students, and other health care professionals who provide you health care services or are otherwise involved in your care. For example, if you are being treated by a primary care physician, that physician may need to use/disclose PHI to a specialist physician whom he or she consults regarding your condition, or to a nurse who is assisting in your care.
- For Payment. BPC may use and disclose PHI in order to bill and collect payment for the health care services provided to you. For example, ACS may need to give PHI to your health plan in order to be reimbursed for the services provided to you. ACS may also disclose PHI to their business associates, such as billing companies, claims processing companies, and others that assist in processing health claims. BPC may also disclose PHI to other health care providers and health plans for the payment activities of such providers or health plans.
- For Health Care Operations. BPC may use and disclose PHI as part of its operations, including for quality assessment and improvement, such as evaluating the treatment and services you receive and the performance of our staff in caring for you. Other activities include provider training, underwriting activities, compliance and risk management activities, planning and development, and management and administration. BPC may disclose PHI to doctors, nurses, technicians, students, attorneys, consultants, accountants and others for review and learning purposes. These disclosures help make sure that BPC is complying with all applicable laws, and are continuing to provide health care to patients at a high level of quality. BPC may also disclose PHI to other health care providers and health plans for certain of their operations, including their quality assessment and improvement activities, credentialing and peer review activities, and health care fraud and abuse detection or compliance, provided that those other providers and plans have, or have had in the past, a relationship with the patient who is the subject of the information.
- Release of Information to Family/Friends. We may release your PHI to a friend or family member who is involved in your care, or who assists in taking care of you. We may also give information to someone who pays or helps pay for your medical care. As stated below, you have the right to request restrictions on who receives your medical information. Therefore, if there are specific family members or other persons to whom you do not want your PHI disclosed, please let us know in Unless you object, BPC may disclose your PHI to a family member, other relative, friend or other personyou identify as involved in your health care or payment for your health care.
SECTION II: Other Uses and Disclosures for Which Authorization is Not Required. In addition to using or disclosing PHI for treatment, payment and health care operations, BPC may use and disclose PHI without your written authorization under the following circumstances
- Required by Law and Law Enforcement. BPC may use or disclose PHI when required by law. BPC also may disclose PHI when ordered to in a judicial or administrative proceeding. In response to subpoenas or discovery requests, to identify or locate a suspect, fugitive, material witness, or missing person, when dealing with gunshot or other wounds, about criminal conduct, to report a crime, its location or victims, or the identity, description or location of a person who committed a crime, or for other law enforcement purposes. Further BPC may disclose your PHI to correctional institutions or law enforcement officials if you are an inmate or under the custody or a law enforcement official. Disclosure for these purposes would be necessary: (a) for the institution to provide healthcare services to you; (b) for the safety and security of the institution; and/or (c) to protect your health and safety or the health and safety of other individuals.
- Public Health Activities and Public Health Risks. BPC may disclose PHI to government officials in charge of collecting information about births and deaths, preventing and controlling disease, reports of child abuse or neglect and of other victims or abuse, neglect, or domestic violence, reactions to medications or product defects or problems, or to notify a person who may have been exposed to a communicable disease or may be at risk of contracting or spreading a disease or condition.
- Health Oversight Activities. BPC may disclose PHI to the government for oversight activities authorized by law, such as audits, investigations, inspections, licensure or disciplinary actions and other proceedings, actions or activities necessary for monitoring the health care system, government programs, and compliance with civil rights laws.
- Coroners, Medical Examiners, and Funeral Directors. BPC may disclose PHI to coroners, medical examiners, and funeral directors for the purpose of identifying a decedent, determining a cause of death, or otherwise as necessary to enable these parties to carry out their duties consistent with applicable law.
- Organ, Eye and Tissue Donation. BPC may release PHI to organ procurement organizations to facilitate organ, eye and tissue donation and transplantation.
- Under certain circumstances, ACS may use the disclose PHI for medical research purposes.
- To Avoid a Serious Threat to Health or Safety. BPC may use and disclose PHI to law enforcement personnel or other appropriate persons, to prevent or lessen a serious threat to the health or safety of a person or the public.
- Specialized Government Functions. BPC may use and disclose PHI of military personnel and veterans under certain circumstances, and may also disclose PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities, and for the provision of protective services to the President or other authorized persons or foreign heads of state or to conduct special investigations.
- Workers’ Compensation. BPC may disclose PHI to comply with workers’ compensation or other similar laws that provide benefits for work-related injuries or illnesses.
- Appointment Reminders; Health-related Benefits and Services; Limited Marketing Activities. BPC may use and disclose PHI to remind you of an appointment, or to inform you of treatment alternatives or other health-related benefits and services that may be of interest to you, such as disease management programs. BPC may use and disclose your PHI to encourage you to purchase or use a product or service through a face-to-face communication or by giving you a promotional gift of nominal value.
- Disclosures to You or for HIPAA Compliance Investigations. BPC may disclose your PHI to you or to your personal representative, and are required to do so in certain circumstances described below in connection with your rights of access to your PHI and to an accounting of certain disclosures of your PHI. BPC must disclose your PHI to the Secretary of the U.S. Department of health and Human Services (the “Secretary”) when requested by the Secretary in order to investigate compliance with privacy regulations issued under HIPAA.
- Lawsuits and Similar Proceedings. BPC may use and disclose your PHI in response to a Court or Administrative Order, if you are involved in a lawsuit or similar proceeding. We also may disclose your PHI in response to a Discovery Request, Subpoena, or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the other party has requested.
SECTION III: Other Uses and Disclosures of PHI for Which Authorization is Required. We will obtain your written authorization for uses and disclosures that are not identified by this Notice or permitted or required by applicable law. Any authorization you provide to us regarding the use and disclosure of your PHI may be revoked at any time in writing. After you revoke your authorization, we will no longer use or disclose your PHI for the reasons described in the authorization.
SECTION IV: Regulatory Requirements. BPCis required by law to maintain the privacy of your PHI, to provide individuals with notice of their legal duties and privacy practices with respect to PHI, and to abide by the terms described in this Notice. BPC reserves the right to change the terms of this Notice and of its privacy policies, and to make the new terms applicable to all PHI it maintains. Before ACS makes an important change to its privacy policies, BPC will promptly revise this Notice and post a new Notice in the registration areas.
SECTION V: Your Rights. You have the following rights regarding our PHI:
- Requesting Restrictions. You may request that BPC restrict the use and disclosure of your PHI.BPC is not required to agree to any restrictions you request, but if BPC does so it will be bound by the restrictions to which it agrees except in emergency situations.
- Confidential Communications. You have the right to request that communications of PHI to you from BPC be made by particular means or at particular locations. For instance, you might request that communications be made at your work address, or by e-mail rather than regular mail. Your requests must be in writing and sent to this office. BPC will accommodate your reasonable requests without requiring you to provide a reason.
- Access and Copies. Generally, you have the right to inspect and copy your PHI in the possession of BPC, if you make a request in writing to the Patient Administrator at this Buckhead Primary Care Within thirty (30) days of receiving your request (unless extended by an additional thirty (30) days), BPC will inform you of the extent to which your request has or has not been granted. In some cases, BPC may provide you a summary of the PHI you requested if you agree in advance to such a summary and any associated fees. If you request copies of your PHI or agree to a summary of your PHI, BPC may impose a reasonable fee to cover copying, postage, and related costs. If BPC denies access to your PHI, it will explain the basis for denial and your opportunity to have the denial reviewed by a licensed health care professional (not involved in the initial denial decision) designated as a reviewing official. If BPC does not maintain the PHI you request but BPC knows where that PHI is located, BPC will tell you how to redirect your request.
- Right to Amend. If you believe that your PHI maintained by BPC contains an error or needs to be updated, you have the right to request that BPC correct or supplement your PHI. Your request must be made in writing to the Patient Administrator, and it must explain why you are requesting an amendment to your PHI. Within sixty (60) days of receiving your request (unless extended by an additional thirty (30) days), BPC will inform you of the extent to which your request has or has not been granted. BPC generally can deny your request if your request relates to PHI: (i) not created by the entity; (ii) that is not part of the records the entity maintains; (iii) that is not subject to being inspected by you; or (iv) that is accurate and complete. If your request is denied, BPC will give you a written denial that explains the reason for the denial and your rights to: (i) file a statement disagreeing with the denial; (ii) if you do not file a statement of disagreement, submit a request that any future disclosures of the relevant PHI be made with a copy of your request and the entity’s denial attached; and (iii) complain about the denial.
- Accounting of Disclosures. You generally have the right to request and receive a list of disclosures of your PHI BPC has made during the six (6) years prior to your request (but not before July 30, 2010). The list will not include disclosures (i) for which you have provided a written authorization; (ii) for treatment, payment and health care operations; (iii) made to you; (iv) for BPC’S patient director or to persons involved in your health care; (v) for national security or intelligence purposes; (vi) to correctional institutions or law enforcement officials; or (vii) of a limited data set. You should submit any such in writing to the Patient Administrator at 404.465.1000 and within sixty (60) days of receiving y our request (unless extended by an additional thirty (30) days), ACS will respond to you regarding the status of your request. The entity will provide the list to you at no charge, but if you make more than one request in a year you will be charged a fee of $25 for each additional request.
- Right to a Paper Copy of this Notice. You have the right to receive a paper copy of this notice upon request, even if you have agreed to receive this notice electronically. You may request a paper copy of this notice by contacting the Patient Administrator.
- Right to Complain. You may complain to BPC if you believe your privacy rights with respect to your PHI have been violated by contacting Buckhead Primary Care, 1891 Howell Mill Road Nw, Atlanta, Georgia 30318 and submitting a written complaint. BPC will not penalize you or retaliate against you for filing a complaint regarding their privacy practices. You also have the right to file a complaint with the Secretary of the Department of Health and Human Services.
If you have any questions about this notice, please contact the Patient Administrator of Buckhead Primary Care at 678-515-0688.
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