Privacy Policy / HIPAA
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HIPAA NOTICE OF PRIVACY PRACTICES
This notice outlines your protected health information, how it may be used, and
what your rights are. Please review carefully and ask any questions prior to
signing. Questions about this notice can be directed to Mindful
Medical Care PC. Please note that Mindful Medical Functional Clinic is part of Mindful Medical Care PC.
OUR PLEDGE REGARDING PROTECTED HEALTH INFORMATION:
We, Mindful Medical Care PC, understand that protected
health information about you and your health is personal. We are committed to
protecting health information about you. This Notice applies to all of the
records of your care generated by Mindful Medical Care PC,,
whether made by Mindful Medical Care PC, personnel or your
personal doctor or other health care provider. This Notice will tell you about
the ways in which we may use and disclose protected health information about
you. We also describe your rights and certain obligations we have regarding the
use and disclosure of protected health information. The law requires us to:
· make sure that protected health information that
identifies you is kept private
· notify you about how we protect protected health
information about you
· explain how, when and why we use and disclose
protected health information
· follow the terms of the Notice that is currently
in effect.
We are required to follow the procedures in this Notice. We reserve the right
to change the terms of this Notice and to make new notice provisions effective
for all protected health information that we maintain by:
· posting the revised Notice in our office
· making copies of the revised Notice available
upon request
· posting the revised Notice on our website.
HOW WE MAY USE AND DISCLOSE PROTECTED HEALTH INFORMATION ABOUT YOU
The following categories describe different ways that we use and disclose
protected health information without your written authorization.
For Treatment: We may use protected health information about you to
provide you with, coordinate or manage your medical treatment or services. We
may disclose protected health information about you to doctors, nurses,
technicians, medical students, or other personnel who are involved in taking
care of you. Mindful Medical Care PC, staff may also share
protected health information about you in order to coordinate the different
things you need, such as prescriptions, lab work and x-rays. We also may
disclose protected health information about you to people outside of Mindful Medical Care PC,’s office who may be involved in your medical care.
We may use and disclose protected health information to contact you as a
reminder that you have an appointment for treatment or medical care
at Mindful Medical Care PC,. We may use and disclose protected
health information to tell you about or recommend possible treatment options or
alternatives or health-related benefits or services.
For Payment for Services: We may use and disclose protected health
information about you so that the treatment and services you receive
at Mindful Medical Care PC, may be billed to and payment
may be collected from you, an insurance company or a third party. For example,
we may need to give your health plan information about services you received
at Mindful Medical Care PC, so your health plan will pay us
or reimburse you for the service. We may also tell your health plan about the
services you are going to receive to obtain prior approval or to determine
whether your plan will cover the treatment.
For Health Care Operations: We may use and disclose protected health
information about you for Mindful Medical Care PC, health
care operations, such as our quality assessment and improvement activities,
case management, coordination of care, business planning, customer services and
other activities. These uses and disclosures are necessary to run the facility,
reduce health care costs, and make sure that all of our patients receive
quality care. We may also combine protected health information about many Mindful Medical Care PC, patients to decide what additional
services Mindful Medical Care PC, should offer, what
services are not needed, and whether certain new treatments are effective. We
may also disclose information to doctors, nurses, technicians, medical
students, and other Mindful Medical Care PC, personnel for
review and learning purposes. We may also combine the protected health
information we have with protected health information from other health care facilities
to compare how we are doing and see where we can make improvements in the care
and services we offer. We may remove information that identifies you from this
set of protected health information so others may use it to study healthcare
and health care delivery without learning who the specific patients are. We may
also contact you as part of a fundraising effort. Subject to applicable state
law, in some limited situations the law allows or requires us to use or
disclose your health information for purposes beyond treatment, payment, and
operations. However, some of the disclosures set forth below may never occur at
our facilities.
As Required By Law: We will disclose protected health information about
you when required to do so by federal, state or local law.
Research: We may disclose your PHI to researchers when their research
has been approved by an institutional review board or privacy board that has
reviewed the research proposal and established protocols to ensure the privacy
of your information.
Health Risks: We may disclose protected health information about you to
a government authority if we reasonably believe you are a victim of abuse,
neglect, or domestic violence. We will only disclose this type of information
to the extent required by law, if you agree to the disclosure, or if the
disclosure is allowed by law and we believe it is necessary to prevent or
lessen a serious and imminent threat to you or another person.
Judicial and Administrative Proceedings: If you are involved in a
lawsuit or dispute, we may disclose your information in response to a court or
administrative order. We may also disclose health information about you in
response to a subpoena, discovery request, or other lawful process by someone
else involved in the dispute, but only if efforts have been made, either by us
or the requesting party, to tell you about the request or to obtain an order
protecting the information requested.
Business Associates: We may disclose information to business associates
who perform services on our behalf (such as billing companies); however, we
require them to appropriately safeguard your information. Public Health. As
required by law, we may disclose your protected health information to public
health or legal authorities charged with preventing or controlling disease,
injury, or disability.
To Avert a Serious Threat to Health or Safety: We may use and disclose
protected health information about you when necessary to prevent a serious
threat to your health and safety or the health and safety of the public or
another person.
Health Oversight Activities: We may disclose health information to a
health oversight agency for activities authorized by law. These activities
include audits, investigations, and inspections, which may be necessary for
licensure and for the government to monitor the health care system, government
programs, and compliance with civil rights laws.
Law Enforcement: We may release protected health information as required
by law, or in response to an order or warrant of a court, a subpoena, or an
administrative request. We may also disclose protected health information in
response to a request related to identification or location of an individual,
victims of crime, decedents, or a crime on the premises.
Organ and Tissue Donation: If you are an organ donor, we may release
protected health information to organizations that handle organ procurement or
organ, eye or tissue transplantation or to an organ donation bank to facilitate
organ or tissue donation and transplantation.
Special Government Functions: If you are a member of the armed forces,
we may release protected health information about you if it relates to military
and veterans’ activities. We may also release your protected health information
for national security and intelligence purposes, protective services for the
President, and medical suitability or determinations of the Department of
State.
Coroners, Medical Examiners, and Funeral Directors: We may release
protected health information to a coroner or medical examiner. This may be
necessary, for example, to identify a deceased person or determine the cause of
death. We may also disclose protected health information to funeral directors
consistent with applicable law to enable them to carry out their duties.
Correctional Institutions and Other Law Enforcement Custodial Situations:
If you are an inmate of a correctional institution or under the custody of a
law enforcement official, we may release protected health information about you
to the correctional institution or law enforcement official as necessary for
your or another person’s health and safety.
Worker’s Compensation: We may disclose information as necessary to
comply with laws relating to worker’s compensation or other similar programs
established by law.
Food and Drug Administration: We may disclose to the FDA, or persons
under the jurisdiction of the FDA, protected health information relative to
adverse events with respect to drugs, foods, supplements, products and product
defects, or post marketing surveillance information to enable product recalls,
repairs, or replacement.
YOU CAN OBJECT TO CERTAIN USES AND DISCLOSURES. Unless you object, or request
that only a limited amount or type of information be shared, we may use or
disclose protected health information about you in the following circumstances:
· We may share with a family member, relative,
friend, or other person identified by you protected health information directly
relevant to that person’s involvement in your care or payment for your care. We
may also share information to notify these individuals of your location,
general condition or death.
· We may share information with a public or
private agency (such as the American Red Cross) for disaster relief purposes.
Even if you object, we may still share this information if necessary for the
emergency circumstances.
If you would like to object to use and disclosure of protected health
information in these circumstances, please call or write to our contact person
listed on page 1 of this Notice.
YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION ABOUT YOU.
You have the following rights regarding protected health information we
maintain about you:
Right to Inspect and Copy: You have the right to inspect and copy
protected health information that may be used to make decisions about your
care. Usually, this includes medical and billing records. To inspect and copy
protected health information that may be used to make decisions about you, you
must submit your request in writing to Mindful Medical Care PC,.
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, and we will
respond to your request no later than 30 days after receiving it. There are
certain situations in which we are not required to comply with your request. In
these circumstances, we will respond to you in writing, stating why we will not
grant your request and describe any rights you may have to request a review of
our denial.
Right to Amend: If you feel that protected health information we have
about you is incorrect or incomplete, you may ask us to amend or supplement the
information. To request an amendment, your request must be made in writing and
submitted to Mindful Medical Care PC,. In addition, you must
provide a reason that supports your request. We will act on the/ your request
for an amendment no later than 60 days after receiving the 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, and will provide a written denial to you. In
addition, we may deny your request if you ask us to amend information that:
· Was not created by us, unless the person or
entity that created the information is no longer available to make the
amendment
· Is not part of the protected health information
kept by Mindful Medical Care PC,
· Is not part of the information which you would
be permitted to inspect and copy, or
· We believe is accurate and complete.
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 protected health information about you. To request this list or
accounting of disclosures, you must submit your request in writing to Mindful Medical Care PC,. You may ask for disclosures made up to six years
before your request (not including disclosures made before June 25, 2014). The
first list you request within a 12-month period will be free. For additional
lists, we may charge you for the costs of providing the list. We are required
to provide a listing of all disclosures except the following:
· For your treatment
· For billing and collection of payment for your
treatment
· For health care operations
· Made to or request by you, or that you
authorized
· Occurring as a byproduct of permitted use and
disclosures
· For national security or intelligence purposes
or to correctional institutions or law enforcement regarding inmates
· As part of a limited data set of information
that does not contain information identifying you
Right to Request Restrictions: You have the right to request a
restriction or limitation on the protected health information we use or
disclose about you for treatment, payment or health care operations or to
persons involved in your care. 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 you emergency treatment, the disclosure is to the Secretary of the
Department of Health and Human Services, or the disclosure is for one of the
purposes described on pages 4-5. To request restrictions, you must make your
request in writing to Mindful Medical Care PC,.
Right to Request Confidential Communications: You have the right to
request that we communicate with you about medical 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 Mindful Medical Care PC,. We will
accommodate all reasonable requests.
Right to a Paper Copy of This Notice: You have the right to a paper copy
of this Notice at any time by contacting Mindful Medical Care
PC,.
OTHER USES AND DISCLOSURES
We will obtain your written authorization before using or disclosing your
protected health information for purposes other than those provide for above
(or as otherwise permitted or required by law). You may revoke this
authorization in writing at any time. Upon receipt of the written revocation,
we will stop using or disclosing your information, except to the extent that we
have already taken action in reliance on the authorization.
YOU MAY FILE A COMPLAINT ABOUT OUR PRIVACY PRACTICES
If you believe your privacy rights have been violated, you may file a complaint
with Mindful Medical Care PC,, or file a written complaint with
the Secretary of the Department of Health and Human Services. A complaint to
the Secretary should be filed within 180 days of the occurrence of the
complaint or violation. If you file a complaint, we will not take any action
against you or change our treatment of you in any way.