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Notice of Privacy Practices for Protected Health Information HIPAA Revision 10.350 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAYBE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. Understanding Your Health RecordJInformation Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:
Although your health record is the physical property of The Kaufmann Clinic, Inc., the information belongs to you. You have the:
The Kaufmann Clinic is required to:
The Kaufmann Clinic will not use or disclose your health information without your authorization, except as described in this notice. Examples of Disclosures for Treatment, Payment and Health Operations The Kaufmann Clinic will use your health information for treatment. For example: Information obtained by a nurse, physician, or othe_ member of your healthcare team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record the actions taken and observations in how you respond to your treatment. If your treatment requires you seeing another physician or health care provider, we will provide copies of your record that should assist them in providing you treatment. The Kaufmann Clinic will use your health information for payment. For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, or supplies used. The Kaufmann Clinic will use your health information for regular health operations. For example: Information in your health record may be provided to Business Associates such as physicians in the emergency department, radiology, outside reference laboratories, and a copy service we use when making copies of your health record. When these services are contracted, we may disclose your health information so that they can perform the job we have asked them to do and bill you or your third-party payer for the services rendered. To protect your health information, however, we require the Business Associate to appropriately safeguard your information. Notification and Communication with family: We may use or disclose information to notify or assist a family member, personal representative, or another person responsible for your care, your location, and general condition. We may, using our best judgment, disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person's involvement in your care or payment related to your care. Funeral Directors: We may disclose health information to funeral directors consistent with applicable law to carry out their duties. Workers Compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law. Public Health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability. Correctional Institutions: Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals. Law Enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. 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 protocols to ensure the privacy of your health information. Other Uses and Disclosures of Health Information We will not use or disclose your health information for any purpose other than those identified in the previous sections without your specific, written Authorization. We must obtain your Authorization separate from any Consent we may have obtained from you. If you give us this Authorization to use or disclose health information about you, you may revoke that Authorization, in writing, at any time. If you revoke your Authorization, we will no longer use or disclose information about you for the reasons covered by your written Authorization, but we cannot take back any uses or disclosures already made with your permission. If we have HIV or substance abuse information about you, we cannot release that information without a special signed, written authorization ( different than the Authorization and Consent mentioned above) from you. In order to disclose these types of records for purposes of treatment, payment or healthcare operations, we will have to have both your Consent and a special written Authorization that complies with the law governing HIV or substance abuse records. Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public. Effective Date: April 14,2003  | Main Page | Medical Care | Our Doctors | Patient Library | Forms | | Locations/Hours | Office Information | Alzheimer`s Link | Privacy Practices |  The Kaufmann Clinic, Inc. * Internal Medicine Patient Account Inquirie`s (for both offices): 770-874-2765 or 770-874-2766 E-mail: info@thekaufmannclinic.com
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