This Notice Describes How Medical Information About You May Be Used and Disclosed
And How You Can Get Access To This Information.
Please Review It Carefully.
As a medical practice, we have always considered it an honor and privilege to care for our patients. Our staff approaches your healthcare very seriously and knows that to be able to treat you fully — you must trust us. Keeping our patients’ confidences and privacy is an integral part of your healthcare and we want you to be assured that this has always been the way we have run our practice. Recently governmental regulations have been enacted requiring certain postings relating to patients’ privacy and communication. This posting, although required, will serve to verify the lengths we have gone to – and will continue to go to — in order to protect your healthcare information.
With your consent, we may use health information about you for treatment (such as sending your medical record information to a specialist physician as part of a referral); to obtain payment for treatment (such as sending billing information to a health insurance plan); for administrative purposes (such as providing information on healthcare services); and to evaluate the quality of care that you receive (such as comparing patient data to improve treatment methods or medications). If you provide us with a written request to release health information to other healthcare providers, we will comply with your request.
Subject to certain requirements, we may be required to give out health information without your authorization for public health purposes, abuse or neglect reporting, auditing purposes, advance directives or wishes (for example a “Living Will” request), worker’s compensation purposes, and emergencies. We are required to provide information when required by law, such as for law enforcement in specific circumstances. We may contact you about appointment reminders, test results, or treatment alternatives. In other situations, we will ask for your written authorization before using or disclosing any identifiable health information about you. If you choose to sign an authorization to disclose information, you can later revoke that authorization to stop any future uses and disclosures.
We may change our policies at any time. Before we make a significant change in our policies, we will amend our Privacy Notice and post the new Notice in the waiting area with a revision date (and on our Web site – if we have one). You can request a copy of our notice at any time and any subsequent amendments. For more information about our privacy practices, please contact the person listed below.
In most cases, you have the right to look at or get a copy of health information about you that we use to make decisions about your healthcare. If you request copies, we are allowed by Indiana law to charge you in accordance with statutory rates.
You also have the right to receive a list of instances where we have disclosed health information about you for reasons other than treatment, payment or related administrative purposes. If you believe that information in your record is incorrect or if important information is missing, you have the right to request that we correct the existing information or add the missing information.
You have the right to request that you health information be communicated to you in a confidential manner such as sending mail to an address other than your home.
You may request in writing that we not use or disclose your information for treatment, payment, or administrative purposes or to persons involved in your care except when specifically authorized by you, when required by law, or in emergency circumstances. We will consider your request but are not legally required to accept it.
If you are concerned that we have violated your privacy rights, or you disagree with a decision we made about access to your records, you may contact the person listed below. You may also send a written complaint to the U.S. Department of Health and Human Services. The person listed below can provide you with the appropriate address upon request. Under no circumstances will you be retaliated against for filing a complaint.
We are required by law to maintain and protect the privacy of your information, provide this notice about our information practices, and follow the information practices that are described in this notice.
If you have any questions or complaints, please contact:
Heather Myers, RN BSN
HIPAA Privacy Officer
117 N Main St., Winchester, IN 47394
Telephone: 765-584-3267
Fax: 800-339-3139
heather@homehealthangels.biz
This Privacy Notice is effective April 1, 2003.