NOTICE OF HIPAA PRIVACY RIGHTS   Algos Consultants    Algos Addiction Treatment

 

Get an electronic or paper copy of your medical records.   You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee

Ask us to correct your medical record   You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.  We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications  You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.  We will say “yes” to all reasonable requests.

Ask us to limit what we use or share  You can ask us not to use or share certain health information for treatment, payment, or our operations.  We are not required to agree to your request, and we may say “no” if it would affect your care.  If you pay for a service or health care item out=of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.  We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared information   You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.  We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make).  We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice  You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly

Choose someone to act for you  If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated  You can complain if you feel we have violated your rights by contacting us using the information on the back page. • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696- 6775, or visiting www.hhs.gov/ocr/privacy/hipaa/ complaints/.   We will not retaliate against you for filing a complaint.

We reserve the right to select who will be our patients independent of any complaint.

You have both the right and choice to tell us to:  Share information with your family, close friends, or others involved in your care • Share information in a disaster relief situation • Include your information in a hospital directory.   If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:  Marketing purposes  • Sale of your information  • Most sharing of psychotherapy notes (see 42CFR Consent)

We use or share your health information: To treat you, and share this information with your current pharmacy or other treating doctors.  To run our organization- sharing with others in the organization or authorized vendors on a need to know basis.  To bill for services.

We also share your health information to: prevent disease, help with product recalls, reporting adverse reactions to medications, reporting suspected abuse/neglect/domestic violence, preventing or reducting a serious threat to anyone’s health or safety.  We may share your information for health research.  We share information about you in compliance with state and federal laws or on subpoena and upon organ transplantation.  We share your health information with medical examiners, coroners, or funeral directors upon the death of a patient.  We share your information for workers compensation claims, law enforcement purposes, with health oversight agencies for activities authorized by law, for special governmental functions such as military or national guard or presidential protection, and in response to a court or administrative order.

NOTE: 42CFR Part 2 laws (mental health) are more restrictive than HIPAA laws on disclosure of health information

We are required by law to: maintain the privacy and security of your protected health information and let you know promptly if a breech occurs that may have compromised your information security.  We follow the privacy practices in this notice and give you a copy of the notice.  We will not use the information or share it in an otherwise manner than described here without your permission, and you can change your mind at any time.

Terms of the notice:  May change at anytime but the new notice will be available on request in our office or on our website.

ALGOS CONSULTING, www.algosdoc.wix.com/algos  Privacy officer Michael Whitworth, MD

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from http://www.hhs.gov/sites/default/files/ocr/privacy/hipaa/npp_booklet_hc_provider.pdf