NOTICE OF PRIVACY POLICIES FOR BURLINGTON ENT CLINIC, P.C.
This notice describes how information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
AUTHORIZATION AND RELEASE INFORMATION
At BURLINGTON ENT CLINIC, P.C., we are committed to treating and using Protected Health Information (PHI) about you responsibly. This Notice of Private Health Information Practices describes the personal information we collect and how and when we use or disclose that information. This Notice is effective September 4, 2013, and applies to all (PHI) as defined by federal regulations. We reserve the right to revise this notice at any time.
UNDERSTANDING YOUR PHI
Each time you visit BURLINGTON ENT CLINIC, P.C., 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 and treatment. Understanding what is in your record and how your PHI is used helps to ensure its accuracy, better understand who, what, when, and why others may access your PHI and make more informed decisions when authorizing disclosure to others.
YOUR PHI RIGHTS
Federal law grants you certain rights with respect to your PHI. Specifically, you have the right to:
• Receive notice of our policies and procedures used to protect your PHI.• Request that certain uses and disclosures of your PHI be restricted, provided however, if we may release the information without your consent or authorization, we have the right to refuse your request.
• Access to your PHI, provided however, the request must be in writing and may be denied in certain limited situations. • Request that your PHI be amended.
• Obtain an accounting of certain disclosures by us of your PHI for the past six years.
• Revoke in writing any prior authorization for use of disclosure of PHI, except to the extent that action has already been taken.
• Notification of any breach of unsecured PHI relating to you and actions you may take in relationship to such a breach.
Federal law also imposes certain obligations and duties upon us with respect to your PHI. Specifically, BURLINGTON ENT CLINIC P.C., is required to:
• Provide you with notice of our legal duties and our facility’s policies regarding the use and disclosure of your PHI.
• Maintain the confidentiality of your PHI in accordance with state and federal law.
• Review your requested restrictions regarding the use and disclosure of your PHI and inform you if these restrictions will be used.
• Allow you to inspect and copy your PHI during our regular business hours with a scheduled appointment pursuant to any legal restrictions. Please contact our Privacy Officer for fees and/or an explanation of our fee structure for copies, staff time charges and postage.
• Act on your request to amend PHI within sixty (60) days and notify you of any delay that would require us to extend the deadline by the permitted thirty (30) day extension, although this does not guarantee that amendment is appropriate.
• Accommodate reasonable requests to communicate PHI by alternative means or methods.
• Abide by the terms of this notice.
• Notification of any breach of unsecured PHI relating to you and actions you may take in relation to such a breach.
We reserve the right to change our practices and to make the new provisions effective for all PHI we maintain. We will not use or disclose your PHI without your authorization, except as described in this notice. We will also discontinue to use or disclose your PHI after we have received written revocation of the authorization according to the procedures included in the authorization.
HOW YOUR PHI MAY BE USED OR DISCLOSED
Generally, your PHI may be used and disclosed for treatment, payment or operations as required by law. This includes a variety of areas.
WE WILL USE YOUR PHI FOR TREATMENT PURPOSES
We may use or disclose your PHI for treatment purposes, including continuing care and case or care management. During your care at our office, it may be necessary for various personnel, including, but not limited to, physicians, nurses or other members of your health care team involved in your care to access to your PHI in order to provide you quality care. We will also provide your physician and a subsequent health care provider outside of our office with copies of various reports that should assist him or her in treating you with your current or future care. We will also contact you to provide appointment reminders and information about treatment options.
WE WILL USE YOUR PHI FOR REGULAR HEALTH OPERATIONS
Your PHI may be used for facility operations that are necessary to ensure our office provided the highest quality of care. For example, your PHI may be used for learning, quality assurance purposes, risk management or disclosed to accounting personnel for auditing purposes. We may also remove information that could identify you from your record so as to prevent others from learning who the specific patients are. We may also release information to business associates who perform various treatment, payment or operation functions.
If an emergency situation exists and providing you with this notice is not practicable, we may use or disclose PHI to the extent necessary during the emergency.
Unless you have informed us otherwise, your PHI may be used or disclosed by us to notify or assist in notifying you, a family member or other person responsible for your care. This may include, but not limited to, voicemail messages, emails or letters. In most cases, PHI disclosed for notification purposes will be limited to your name, location and general condition. In addition, unless you have notified us otherwise, PHI may be released to a family member, relative or close friend who is involved in your care to the extent necessary for them to participate in your care. If you wish for any of these uses and disclosures to be limited, please contact facility personnel.
In the event of a disaster, we may provide information to public or private entities as needed to facilitate treatment, locate family members and caregivers and to facilitate public health needs.
Your PHI may be used or disclosed for research purposes. All research projects that use PHI are subject to a special approval process that will, among other things, evaluate the precautions used to protect patient medical information. In some cases, information that identifies you as the patient will be removed.
Nondiscrimination and Accessibility:
Burlington Ear, Nose & Throat Clinic, P.C. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, and gender identity or expression.