Notice of HIPPA Privacy Practices
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.
Uses and Disclosures:
Each time you visit a hospital, physician, or other health care provider, a record of your visit is made. Typically,
this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future
care or treatment. This information, often referred to as your health or medical record, serves several
purposes. At Clinic of Pediatrics and GI Medicine, Inc., these include:
Treatment
- Basis for planning your care and treatment
- Communication among the many health professionals who contribute to your care
- Legal document describing the care you received
- Means of documenting laboratory test results and radiological examinations
- A record of your medical history from which you can obtain a copy to transfer to another health professional
Payment
- Means by which you or a third-party payer can verify that services billed were actually provided
- Business office can use your health information to bill you or your insurance company for services provided
- Business office can use your health information to verify you have insurance coverage and what your insurance will cover
- Third-party payers can use your health information to coordinate benefits, so they pay correctly
- Business office can use your health information to appeal non-payment of your claim to a third-party payer
- Assignment of benefits will be to the health care provider, as appropriate
- A collections agency can use your health information in their efforts to obtain payment of unpaid medical bills from our office
Health Care Operations
- Means to educate allied health professionals
- A source of information for public health officials charged with improving the health of the nation
- A tool with which we can assess and continually work to improve the care we render and the outcomes we achieve
- Business office can use your health information to audit the billing process to detect and prevent fraud and abuse
Uses and Disclosures Unique to Clinic of Pediatrics and GI Medicine, Inc.:
- We may contact you to provide appointment reminders.
- We may contact you to provide information about treatment alternatives or other health-related benefits and services that may be of interest to you.
- If the practice if sold, all patient records will be transferred to the new owner(s).
- Product vendors who visit the facility may recommend their products for certain classes of individuals (for example, pharmaceutical representatives).
- We will not see patients under the age of 18 unless accompanied by a parent, guardian, or personal representative.
Clinic of Pediatrics and GI Medicine, Inc., may also use and/or give out your health information for the following reasons:
- As required by the United States Department of Health and Human Services. This could be as part of an investigation or to determine if we are obeying the law.
- Protected information may be disclosed, in the course, of certain judicial or administrative proceedings.
- Medical information may be disclosed for law enforcement purposes or other specialized governmental functions.
- Your protected information may be disclosed as authorized by laws relating to workers’ compensation or similar programs.
Clinic of Pediatrics and GI Medicine, Inc., will not use or disclose your protected information for any other
purpose without your written authorization. Once given, you may reverse your authorization in writing at any time.
Individual Rights
You have the following rights regarding your protected health information:
- You may request restrictions in writing on certain uses and disclosures of your protected information. Clinic of Pediatrics and GI Medicine, Inc., is not required to agree to your requested restriction.
- You have the right to receive communications from Clinic of Pediatrics and GI Medicine, Inc., in a confidential manner.
- You have the right to inspect and copy your medical information. This right is subject to certain specific exceptions and you may be charged a reasonable fee for any copies, mailing, and/or summarizing of your records.
- You have the right to request an amendment of your medical information. The request must be in writing and must include a reason that the amendment be included. Clinic of Pediatrics and GI Medicine, Inc., may deny your request for certain specific reasons. If denied, the organization will provide you with a written explanation for the denial and information regarding further rights you would have at that point.
- You have the right to receive a record of the disclosures of your medical information made by Clinic of Pediatrics and GI Medicine, Inc., in the six years prior to your request, except for disclosures for treatment and/or payment, and for certain other specific disclosure types.
- You have the right to request a paper copy of this Notice of Privacy Practices for Protected Health Information.
Our Duties
Clinic of Pediatrics and GI Medicine, Inc., is dedicated to protecting your medical information. We are required
by law to maintain the privacy of protected health information and to provide you with this Notice of our legal
duties and privacy practices regarding protected health information. Clinic of Pediatrics and GI Medicine, Inc.,
is required by law to abide by the terms of this Notice, and we reserve the right to change the terms of this
Notice and any revision will apply to all the protected health information we maintain. If Clinic of Pediatrics
and GI Medicine, Inc., revises the terms of this Notice, we will post a revised notice and will make paper copies
of this Notice of Privacy Practices for Protected Health Information available upon request.
Complaints
If you believe your privacy rights have been violated, you have the right to complain to Clinic of Pediatrics and
GI Medicine, Inc., and/or to the United States Department of Health and Human Services. To complain to
Clinic of Pediatrics and GI Medicine, Inc., by writing to Clinic of Pediatrics and GI Medicine, Inc. at 102 Medical
Center Drive, Panama City, FL, 32405-4907. If you choose to file a complaint, you will not be retaliated against
in any way.
Contact Information
If you would like further information regarding your rights or regarding the uses and disclosures of your
protected health information, you may contact Clinic of Pediatrics and GI Medicine, Inc.’s Privacy Officer or
Effective Date
This Notice is effective as of March 1, 2003.