NOTICE
OF PATIENT
INFORMATION PRACTICES
THE
FAMILY HEALTH CENTERS
Asheville (828) 258-8681
Arden (828) 684-9229
Hominy Valley (828) 667-2526
This notice describes
how medical information about you may be used and disclosed
and how you can get access to this information. Please
read carefully.
THE FAMILY HEALTH
CENTER’S LEGAL DUTY
The Family Health Center is required by law to protect
the privacy of your personal health information, provide
this notice about our information practices and follow
the information practices that are described below.
UNDERSTANDING
HEALTH INFORMATION
Each time you visit our practice, a record of the visit
is made. Typically this record contains your history,
symptoms, examination and test results, diagnoses, treatment,
and a plan for your future care or treatment. This information,
often referred to as your health or medical record,
serves as a:
¦ basis for planning your care and treatment
¦ means of communication among the health professionals
who care for you or your child
¦ legal document describing the care you received
¦ means by which you or a third-party payer can
verify that services billed were actually provided
¦ tool in educating health professionals
¦ source of data for medical research
¦ source of information for public health officials
Understanding what is in your record and how your health
information is used helps
you to ensure it is correct and allows you to make informed
decisions when authorizing disclosure to others. We
will not use or disclose your health information without
your authorization except as described in this notice.
HOW WE WILL
USE OR DISCLOSE HEALTH INFORMATION
Treatment: We will use your health information for treatment.
For example, we will record information we obtain during
the visit in the medical record and share this information
with other members of your healthcare team. We may provide
a copy of your health information to other physicians
when a referral is made to assist them in treating you.
Payment: We will use your health information for payment
of claims. For example, a bill
may be sent to your insurance company or third-party
payer that includes information about the date you or
your child was seen, the diagnosis and the services
we provided.
Health Care Operations: We will use your health information
for regular health care operations. For example, we
may use the information in the record to assess the
care and treatments provided in our practice.
Business Associates: There are some services provided
in our practice through contacts with business associates.
Examples include our accountants, consultants and attorneys.
When these services are provided, we may disclose health
information to our business associates so they can perform
the job we have asked them to do. To protect your information,
we will require they appropriately protect this information.
Communication with Family: Health professionals, using
their best judgment, may disclose to a family member,
other relative or close personal friend or any other
person you identify, health information relevant to
that person’s involvement in your care or payment
of services provided.
Research: We may disclose information to researchers
when their research has been approved by an institutional
review board that has reviewed the research proposal
and established methods to ensure the privacy of the
information.
Funeral Directors: We may disclose health information
to funeral directors and coroners
to carry out the duties consistent with the law.
Organ Procurement Organizations:
Consistent with the law, we may disclose health information
to organ procurement organizations for their designated
services.
Marketing: We may contact you to provide appointment
reminders or information about treatment alternatives
or other health-related benefits and services that may
be of interest to you.
Food and Drug Administration (FDA):
We may disclose to the FDA health information relative
to adverse events with respect to food, supplements,
products and product defects, or post-marketing surveillance
information to enable products recalls, repairs or replacement.
Workers Compensation: We may disclose health information
to the extent authorized by state law governing workers
compensation health care services.
Public Health: As required by law, we may disclose health
information to public health officials charged with
preventing or controlling disease, injury or disability.
For example, we are required to report certain communicable
diseases we provide treatment for.
Correctional Institutions: We may disclose health information
for law enforcement purposes as required by law or in
response to a valid subpoena.
Reports: We may disclose health information when directed
by the appropriate federal oversight agency related
to any complaints, surveys or requests.
YOUR HEALTH
INFORMATION RIGHTS
Although your health record is the physical property
of the practice, the information in the health record
belongs to you. You have the following rights:
¦ You may request that we not use or disclose
information for a particular reason related to treatment,
payment or health care operations, and/or to a particular
family member, other relative or close personal friend.
We ask that such requests be made in writing on a form
we will provide. Although we will consider your request,
please be aware we are not obligated to accept or abide
by it. We will review each request individually to determine
if we can honor your request.
¦ If you would like to make a request to receive
information from our office in another manner, you may
request that we provide it by an alternative means.
Such a request may be made in writing on a form we will
provide.
We will attempt to accommodate all reasonable requests.
¦ You may request to inspect and/or obtain copies
of you or your child’s health information. We
may charge you a reasonable fee for copies. We will
attempt to provide you with the information within thirty(30)
days of your request.
¦ If you believe that any information in the
record is incorrect or if you believe important information
is missing, you may request that we correct the existing
information or
add the missing information. Such requests must be made
in writing on a form we will provide. You may request
this form at the front desk.
¦ You may request a written accounting of all
disclosures made of your protected health information.
This request may be made for all information we have
after April 14th, 2003.
We will keep an accounting of disclosures made OTHER
THAN those disclosures for treatment, payment or health
care operations as defined above for six years. We will
respond to your request within thirty (30) days if possible.
If you request an accounting more than once in a twelve-month
period, you may be charged a reasonable fee.
¦ You have a right to obtain a paper copy of
this notice.
¦ We must obtain a written authorization from
you to disclose information for purposes other than
treatment, payment or health care operations. You have
the right to revoke this authorization, except to the
extent we have already used or disclosed the information.
CONCERNS AND
COMPLAINTS
If you are concerned that The Family Health Centers
may have violated your privacy rights or if you disagree
with any decisions we have made regarding access or
disclosure of your personal health information, please
contact our practice manager at the address listed below.
You may also send a written complaint to the US Department
of Health and Human Services. For further information
on The Family Health Center’s health information
practices or if you have a complaint, please contact
the following person:
Randi Ledford, Privacy Officer
Asheville/Arden/Hominy Valley Family
Health Centers
CHANGES TO THIS
POLICY
The Family Health Centers may change or update this
policy at any time. When changes are made, a new Notice
of Information Practices will be posted in the waiting
room and patient exam areas and will be provided at
your next visit. You may also request an updated copy
of our notice at any time.
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