NOTICE OF PRIVACY PRACTICES
The notice below will explain how we may use and disclose your medical information, our obligations related to the use and disclosure of your medical information, and your rights related to any medical information that we have about you. This notice applies to the medical records that are generated in or by our office.
With a few exceptions, we are required to obtain your authorization for the use or disclosure of the information. We have listed some of the reasons why we might use or disclose your medical information and some examples of the types of uses and disclosures below. Not every use or disclosure is covered.
In addition to the office, the following persons will also follow the practices described in this Notice of Privacy Practices: Any health care professional who is authorized to enter information in your medical records. In addition, they may share medical information for treatment, payment or healthcare operations as they are described in this Notice of Privacy Practices.
USE AND DISCLOSURE OF MEDICAL
FOR TREATMENT: To provide you with medical treatment and services, we may need to use or disclose information about you to doctors, nurses, technicians, or other healthcare personnel who are involved in your treatment. For example, a doctor may need to know what drugs you are allergic to before prescribing medications. We may also disclose medical information about you to people who may be involved in your medical care after you leave the office such as home health agencies, your family, a friend, Hospice employees, long term care facilities, and, if you request, your clergy member.
FOR PAYMENT: We may use and disclose your medical information to bill and receive payment for the treatment that you receive here. We may also ask your insurance company for prior approval for a service to determine whether the insurance company will pay for the service.
USES AND DISCLOSURES OF MEDICAL
INFORMATION THAT DO NOT REQUIRE YOUR AUTHORIZATION: We can use
or disclose health information about you without your authorization
when there is a potential emergency, when we are required by
law or statue, or when there are substantial communication barriers
to obtaining authorization from you. Further, we may disclose
your health information without your authorization in any of
the following circumstances:
Disclosure or to which you may
Other uses and Disclosures:
Your Health Information Rights:
Receive information in certain form and location: You have the right to receive information about your health in a certain form and location. For instance, you can request that we contact you at work. To request confidential communications, you must make your request in writing to the privacy Site Coordinator. The request must tell us how and/or where you want to receive information. We will attempt to accommodate reasonable requests.
Inspect and copy your protected health information: You have the right to inspect and request a copy of your protected health information that may be used to make decisions about your care, with the exception of psychotherapy notes. If you want to see or copy your medical information, you must submit your request in writing to the office Privacy Officer. If you request copies of information, we may charge the standard fee for any costs associated with your request, including the cost of copies, mailing, or other supplies as set by Missouri statues and regs.
*** NOTE: We can deny your request if it is not in writing and if it does not include why the information should be changed. We can also deny your request for the following reasons: (1) the information was not created by our office or unless the person or entity that did create the information is no longer available; (2) the information is not part of the medical record kept by or for our office, or (3) the information is not part of the medical record that you would be permitted to inspect and copy; or (4) we believe the information is accurate and complete.
Complaints: If you believe that we have violated any of your privacy rights or to have not adhered to the information contained in this Notice of Privacy Practices, you can file a complaint by putting it in writing and sending it to the Office or Privacy Site Coordinator. You may also file a complaint with Secretary of the US Department of Health and Human Services, 200 Independence Avenue, S.W., Washington, DC 20201. To acquire a copy of the complaint form from the Office of Civil Rights please call 1-800-368-1019.
Changes to this Notice of privacy Practices: We reserve the right to change or modify the information contained in this Notice of Privacy Practices. Any changes that we can make can be effective for any health information that we can have about you and any information that we might obtain. The most recent version of our Notice of practices will be with the office receptionist or can be obtained from our office.
If you have any questions about
the content of this Notice of privacy Practices, or if you need
to contact someone at this site about any of the information
contained in this Notice of Privacy Practices, please contact: