NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES OUR PRIVACY PRACTICES, HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
PLEASE READ THE FOLLOWING CAREFULLY
Effective June 1, 2014
DOC-AID is required to:
- Maintain the privacy of your protected health information (PHI) to the extent required by state and federal law. PHI is information about you that may be used to identify you (such as your name, social security number, or address) and that relates to (a) your past, present, or future physical or mental health or condition, (b) the provision of health care to you, or (c) your past, present, or future payment for the provision of health care. In conducting its business, DOC-AID will receive and create records containing your PHI.
- We give you this Notice explaining our legal duties and privacy practices with respect to medical information about you.
- DOC-AID is required to notify affected individuals following a breach of unsecured medical information under federal law.
- DOC-AID is required by law to maintain the privacy of your PHI and to provide you with notice of its legal duties and privacy practices with respect to your PHI. Additionally, DOC-AID must abide by the terms of this Notice while it is in effect. This current Notice takes effect on June 1, 2014, and will remain in effect until DOC-AID replaces it.
- DOC-AID reserves the right to change the terms of this Notice at any time as long as the changes are in compliance with applicable law. If DOC-AID changes the terms of this Notice, the new terms will apply to all PHI that it maintains, including PHI that was created or received before such changes were made.
- If DOC-AID changes this Notice, it will post the new Notice on its Web site and will make the new Notice available upon request.
Uses and Disclosures of PHI
The following categories describe the different reasons that we typically use and disclose medical information. These categories are intended to be general descriptions only and not a list of every instance in which we may use or disclose your medical information. Please understand that for these categories, the law generally does not require us to get your authorization in order for us to use or disclose your medical information.
DOC-AID may use and disclose your PHI in the following ways:
- Treatment, Payment, and Health Care Operations. DOC-AID is permitted to use and disclose your PHI for purposes of (a) treatment, (b) payment, and (c) healthcare operations. For example:
- DOC-AID may disclose your PHI to another physician or health care provider for purposes of a consult or in connection with the provision of follow-up treatment.
- DOC-AID may use and disclose your PHI to your health insurer or health plan in connection with the processing and payment of claims and other charges.
- Health Care Operations. DOC-AID may use and disclose your PHI in connection with its healthcare operations, such as providing customer services and conducting quality review assessments. DOC-AID may engage third parties to provide various services for DOC-AID. If any such third party must have access to your PHI in order to perform its services, DOC-AID will require that third party to enter a business associate agreement that binds the third party to the use and disclosure restrictions outlined in this Notice.
- We may use and disclose medical information in order to contact you (including, for example, contacting you by phone and leaving a message on an answering machine) to provide appointment reminders and other information. We may use and disclose medical information to tell you about health-related benefits or services that we believe may be of interest to you.
- DOC-AID is permitted to use and disclose your PHI upon your written authorization, to the extent such use or disclosure is consistent with your authorization. You may revoke any such authorization at any time.
- As Required by Law. DOC-AID may use and disclose your PHI to the extent required by federal, state, or local laws or regulations.
Special Circumstances
The following categories describe unique circumstances in which DOC-AID may use or disclose your PHI:
- Public Health Activities. DOC-AID may disclose your PHI to public health authorities or other governmental authorities for purposes including preventing and controlling disease, reporting child abuse or neglect, reporting domestic violence, and reporting to the Food and Drug Administration regarding the quality, safety, and effectiveness of a regulated product or activity. DOC-AID may, in certain circumstances, disclose PHI to persons who have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition.
- Workers Compensation Workers™ Compensation. DOC-AID may disclose your PHI as authorized by, and to the extent necessary to comply with, worker's compensation programs and other similar programs relating to work-related illnesses or injuries.
- Health Oversight Activities. DOC-AID may disclose your PHI to a health oversight agency for authorized activities such as audits, investigations, inspections, licensing, and disciplinary actions relating to the health care system or government benefit programs.
- Judicial and Administrative Proceedings. DOC-AID may disclose your PHI, in certain circumstances, as permitted by applicable law, in response to an order from a court or administrative agency, or in response to a subpoena or discovery request.
- Law Enforcement. DOC-AID may, under certain circumstances, disclose your PHI to a law enforcement official, such as for purposes of identifying or locating a suspect, fugitive, material witness, or missing person.
- DOC-AID may, under certain circumstances, disclose PHI to coroners, medical examiners, and funeral directors for purposes such as identification, determining the cause of death, and fulfilling duties relating to decedents.
- Organ Procurement. DOC-AID may, under certain circumstances, use or disclose PHI for the purposes of organ donation and transplantation.
- DOC-AID may, under certain circumstances, use or disclose PHI that is necessary for research purposes.
- Threat to Health or Safety. DOC-AID may, under certain circumstances, use or disclose PHI if necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
- Specialized Government Functions. DOC-AID may, in certain situations, use and disclose PHI of persons who are or were in the Armed Forces for purposes such as ensuring proper execution of a military mission or determining entitlement to benefits. DOC-AID may also disclose PHI to federal officials for intelligence and national security purposes.
Your Rights Regarding Your PHI
Federal and state laws provide you with certain rights regarding the medical information we have about you. You have the following rights regarding the PHI maintained by DOC-AID:
- Inspection and Copies. You have the right to inspect and copy your PHI. You must submit your request in writing to DOC-AID. DOC-AID may impose a fee for the costs of copying, mailing, labor, and supplies associated with your request. DOC-AID may deny your request to inspect and/or copy your PHI in certain limited circumstances. If that occurs, DOC-AID will inform you of the reason for the denial, and you may request a review of the denial.
- You have a right to request that DOC-AID amend your PHI if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is maintained by DOC-AID. You must submit your request in writing to DOC-AID and provide a reason to support the requested amendment. DOC-AID may, under certain circumstances, deny your request by sending you a written notice of denial. If DOC-AID denies your request, you will be permitted to submit a statement of disagreement for inclusion in your records.
- Accounting of Disclosures. You have a right to receive an accounting of all disclosures DOC-AID has made of your PHI. However, that right does not include disclosures made for treatment, payment, or health care operations, disclosures made to you about your treatment, disclosures made pursuant to an authorization, and certain other disclosures. You must submit your request in writing to DOC-AID, and you must specify the time period involved (which must be for a period of time less than six years from the date of the disclosure). Your first accounting will be free of charge. However, DOC-AID may charge you for the costs involved in fulfilling any additional request made within a period of 12 months. DOC-AID will inform you of such costs in advance so that you may withdraw or modify your request to save costs.
- You have the right to request restrictions on certain uses and disclosures of PHI for treatment, payment, or healthcare operations. You also have the right to request that DOC-AID restrict its disclosures of PHI to only certain individuals involved in your care or the payment of your care. You must submit your request in writing to DOC-AID. DOC-AID is not required to comply with your request. However, if DOC-AID agrees to comply with your request, it will be bound by such agreement, except when otherwise required by law or in the event of an emergency.
- Confidential Communication. You have the right to receive confidential communications of your PHI. You may request that DOC-AID communicate with you through alternate means or at an alternate location, and DOC-AID will accommodate your reasonable requests. You must submit your request in writing to DOC-AID.
- Inspection and Paper Copy. You have the right to inspect and copy your PHI. You must submit your request in writing to DOC-AID. DOC-AID may impose a fee for the costs of copying, mailing, labor, and supplies associated with your request. DOC-AID may deny your request to inspect and/or copy your PHI in certain limited circumstances. If that occurs, DOC-AID will inform you of the reason for the denial, and you may request a review of the denial. To obtain a paper copy of this notice, please contact stop by any DOC-AID Location.
- Breach Notification. You have the right to be notified in the event that DOC-AID (or a DOC-AID Business Associate) discovers a breach of unsecured PHI.
- Changes To This Notice. We reserve the right to change this Notice at any time, along with our privacy policies and practices. We reserve the right to make the revised or changed Notice effective for medical information we already have about you, as well as any information we receive in the future. We will post a copy of the current notice, along with an announcement that changes have been made, as applicable, on our website. When changes have been made to the Notice, you may obtain a revised copy by sending a letter to the Practice’s HIPAA Officer at the address listed in Section VI below or by asking the receptionist for a current copy of the Notice.
- If you believe that your privacy rights, as described in this Notice, have been violated, you may file a complaint with DOC-AID at the following address or phone number. To file a complaint with DOC-AID, you may either call or send a written letter. DOC-AID will not retaliate against any individual who files a complaint. You may also file a complaint with the Secretary of the Department of Health and Human Services. In addition, if you have any questions about this Notice, please contact DOC-AID HIPAA Security Officer at the address or phone number listed below.
DOC-AID Urgent Care
Attn: HIPAA Security Officer
PO box 243 Katy, TX 77492
Further Information
If you would like more information about your privacy rights, please contact DOC-AID by calling 281-712-4722 and ask to speak to the Privacy and Security Officer. To the extent you are required to send a written request to DOC-AID to exercise any right described in this Notice, you must submit your request to DOC-AID at: Attn: Security Officer, PO box 243 Katy, TX 77492
