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CENTRAL DELAWARE FAMILY MEDICINE
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.
1. We have a duty to safeguard your protected health information (called PHI). Individually identifiable information about your past, present, or future physical or mental health or condition, or payment for the health care is considered "Protected Health Information" (PHI). We are required by law to give you this Notice about our privacy practices and how, when, and why we may use or disclose your PHI. Except in special circumstances, we may use or disclose only the minimum necessary PHI to accomplish the purpose of the use or disclosure.
2. How we are allowed to use and disclose your PHI:
Some uses are routine and do not require your prior authorization:
A. Related to Treatment, Payment, or Health Care Operations - We are allowed to use and disclose your PHI for your medical treatment, for instance to doctors, nurses, hospitals, emergency medical technicians, pharmacists, and other health care professionals. We are also permitted to share your PHI for purposes of payment, such as with your medical insurance provider. We also may share your PHI in evaluating the quality of services you received, or to an accountant or attorney for audit purposes.
B. Other Uses and Disclosures Not Requiring Your Authorization
1) When the law requires that we report information about suspected abuse, neglect, or domestic violence, or relating to suspected criminal activity, or in response to a court order or administrative tribunal. We must also disclose PHI to authorities who monitor compliance with these privacy requirements.
2) We may be required to collect information about disease or injury, or to report vital statistics (for example, births or deaths) to the public health authority.
3) For health oversight activities, such as investigations of unusual incidents.
4) Information relating to an individual?s death may be disclosed to coroners, medical examiners or funeral directors, and organ procurement organizations relating to organ, eye, or tissue donation or transplantation.
5) For research purposes, and under strict supervision of a privacy board, we may disclose PHI to assist research to contribute to knowledge.
6) We may disclose PHI to avoid a serious threat to health or safety to law enforcement or other persons who can prevent or lessen the threat of harm.
7) Certain government functions may require disclosure of PHI for national security reasons or for eligibility or enrollment in certain government programs.
Uses and Disclosures Requiring Written Authorization:
A. Other than those reasons listed above, we need your written authorization to use or disclose your PHI. You can revoke your authorization in writing at any time.
B. We may share PHI with your family or other person involved in your care or its payment only if you are informed about it beforehand and do not object. This includes information about your location and general condition. If there is an emergency situation, disclosure may be made if it is determined by our professional judgment to be in your best interests and not contradicted by your prior requests. You must be given an opportunity to object as soon as you are able.
3. Your Rights Regarding Your Protected Health Information (PHI)
A. You may request restrictions on the use and disclosure of your PHI. We are not legally bound to agree to the restriction, but if we agree, the restriction will be in writing. We cannot limit uses required by law.
B. You may choose how we get in touch with you, such as a specific address or telephone.
C. Unless your access is restricted for clear and documented treatment purposes, you have a right to see and/or have copies of your PHI if you put your request in writing. A charge may be imposed for the copying. If the request is denied, the denial will be in writing setting forth clear reasons for the denial. We will respond to your request within thirty days.
D. If you think that there is a mistake or missing information in your PHI, you may request in writing that the record be corrected. If we agree, we will make the amendment to your PHI. If we disagree, we will let you know in writing, but you statement may still be appended to your PHI.
E. You have the right to find out what disclosures of your PHI have been made. You may request disclosures going back six years. This list is not required to include those for treatment, payment, or health care operations, or for national security purposes or law enforcement officials, or before the date these federal privacy rules applied.
4. Complaints - If you think we may have violated your privacy rights, you may file a complaint with our office. You may also file a written complaint with the Secretary of the U. S. Department of Health and Human Services. The law does not permit anyone to take retaliatory action against you if you make a complaint.
We reserve the right to make changes to this Notice and to make such changes effective for all PHI we may already have about you. If and when this Notice is changed, we will post a copy in our office in a prominent location. We will also provide you with a copy of the revised Notice upon your request made to our Privacy Official.
The effective date of this policy is April 14, 2003.
If you have a question or complaint, the person to inform is:
Central Delaware Family Medicine
Elaine Balcerak, Practice Manager
1001 S. Bradford Street, Suite 4
Dover, Delaware 19904
Phone: (302) 735-1616
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