HEALTH 1ST CENTER NOTICE OF PRIVACY PRACTICE
In the course of receiving care from Health 1st Center, you provide us with “protected health information,” which is individually identifiable health information deserving special treatment under the Health Insurance Portability and Accountability Act (“HIPAA”), as amended. We may obtain your protected health information from conversations with you, questionnaires, examinations, tests, and from others who have provided or will provide care to you. This office is required to notify you in writing, that by law, we must maintain the privacy and confidentiality of your Personal Health Information. In addition we must provide you with written notice concerning your rights to gain access to your health information, and the potential *circumstances under which, by law, or as dictated by our office policy, we are permitted to disclose information about you to a third party without your authorization.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS CAREFULLY.
Below is a brief summary of these *circumstances. If you would like a more detailed explanation, one will be provided to you. In addition, you will find we have placed several copies in report folders labeled ‘HIPAA’ on tables in the reception in our clinic at 12750 s. Harlem ave.
PERMITTED DISCLOSURES for the following purposes allowed by HIPAA:
- Treatment purposes- to provide medical care and services. Our doctors, employees, and others who work under our direct control, may read protected health information to learn about your medical history and, in turn, use it to make decisions about your care. Discussion with other health care providers involved in your care.
- Inadvertent disclosures- open treating area mean open discussion. If you need to speak privately to the doctor, please let our staff know so we can place you in a private consultation room.
- For payment purposes – to obtain payment from your insurance company or any other collateral source.
- For workers compensation purposes- to process a claim or aid in investigation
- Emergency- in the event of a medical emergency we may notify a family member
- For Public health and safety – in order to prevent or lessen a serious or eminent threat to the health or safety of a person or general public.
- To Government agencies or Law enforcement – to identify or locate a suspect, fugitive, material witness or missing person.
- Health Care Operations- We may use protected health information for activities that are necessary to operate our organization. This includes reading protected health information to review the performance of our staff or to plan services we need to provide, expand, or reduce. We may disclose protected health information to others with whom we contract to provide administrative services, including our attorneys, auditors, accreditation services, and consultants. We may use protected health information to ensure quality control of office procedures and protocols, including audio and visual recording our offices to enhance our operations.
- For military, national security, prisoner and government benefits purposes.
- Deceased persons –discussion with coroners and medical examiners in the event of a patient’s death.
- Telephone calls or emails and appointment reminders –we may call your home and leave messages regarding a missed appointment or apprize you of changes in practice hours or upcoming events.
- Information to Patients- We may use protected health information to provide you with additional information. This may include sending you appointment reminders or information regarding treatment options or other health-related services that we provide.
- Change of ownership- in the event this practice is sold, the new owners would have access to your PHI.
- To receive an accounting of disclosures
- To receive a paper copy of the comprehensive “Detail” Privacy Notice
- To request mailings to an address different than residence
- To request Restrictions on certain uses and disclosures and with whom we release information to, although we are not required to comply. If, however, we agree, the restriction will be in place until written notice of your intent to remove the restriction.
- To inspect your records and receive one copy of your records at no charge, with notice in advance
- To request amendments to information. However, like restrictions, we are not required to agree to them.
- To obtain one copy of your records at no charge, when timely notice is provided (72 hours). X-rays are original records and you are therefore not entitled to them. If you would like us to outsource them to an imaging center, to have copies made, we will be happy to accommodate you. However, you will be responsible for this cost.
If you wish to make a formal complaint about how we handle your health information, please call our office at (708) 598-2000. If no one is available, you may make an appointment with our receptionist to see her within 72 hours or 3 working days. If you are still not satisfied with the manner in which this office handles your complaint, you can submit a formal complaint to:
DHHS, Office of Civil Rights
200 Independence Ave. SW
Room 509F HHH Building
Washington DC 20201
Note: This office reserves the right to amen this notice of privacy practice at any time in the future and will make the new provisions effective for all information that maintains past and present. Before we make any change in the privacy practices described in this Notice, we will adopt a new Notice that includes the change and its effective date. The new Notice will be available in our office and on our website at Health 1st Center / 12750 S Harlem Ave / Palos Heights IL 60463 / 708-598-2000 / www.health1stcenter.com