Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review carefully.
The Health Insurance Portability & Accountability Act of 1996 (“HIPAA”) is a federal program that requires that all medical records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper, or orally, are kept properly confidential. This Act gives you, the patient, significant new rights to understand and control how your health information is used. “HIPAA” provides penalties for covered entities that misuse personal health information.
All further references to Optimum Health Family Practice will be OHFP and all references to Center for Nutrition and Preventive Medicine, P.A. will be CFN.
If you consent, OHFP or CFN are permitted by federal privacy laws to make uses and disclosures of your health information for purposes of treatment, payment, and health care operations. Protected health information is the information we create and obtain in providing our services to you. Such information may include documenting your symptoms, examination and test results, diagnoses, treatment, and applying for future care or treatment. It also includes billing documents for those services.
Treatment means providing, coordinating, or managing health care and related services by one or more health care providers.
Examples of uses of your health information for treatment purposes are:
- A nurse obtains treatment information about you and records it in a health record.
- During the course of your treatment, the physician determines he/she will need to consult with another specialist in the area. He/she will share the information with such specialist and obtain his/her input.
Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review.
An example of use of your health information for payment purposes:
- We submit a request for payment to your health insurance company. The health insurance company requests information from us regarding medical care given. We will provide information to them about you and the care given.
Health care operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost- management analysis and customer service.
An example of use of your health information for health care operations:
- The state licensing authority wants to review records to assure that we have acted consistent with state law regarding your care. In doing so, it wants to take a sampling, which includes review of your chart. At the licensing authority’s request, we will provide it with a copy of your record.
- We may also create and distribute de-identified health information by removing all references to individually identifiable information.
- We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
- Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request.
Your Health Information Rights
The health record we maintain and billing records are the physical property of OHFP or CFN. The information in it, however, belongs to you. You have a right to:
- Request a restriction on certain uses and disclosures of your health information, including those related to disclosures to family members, other relatives, close personal friends, or any other person identified by you. By delivering the request in writing to our office—we are not required to grant the request but we will comply with any request granted. We must abide by this request unless you agree in writing to remove it.
- Obtain a paper copy of the Notice of Privacy Practices for Protected Health Information (“Notice”) by making a request at our office.
- Request that you be allowed to inspect and copy your health record and billing record—you may exercise this right by delivering the request in writing to OHFP or CFN, using the form we provide to you upon request.
- Appeal a denial of access to your protected health information except in certain circumstances.
- Request that your health care record be amended to correct incomplete or incorrect information by delivering a written request to OHFP or CFN using the form we provide to you upon request.
- File a statement of disagreement if your amendment is denied, and require that the request for amendment and any denial be attached in all future disclosures of your protected health information.
- Obtain an accounting of disclosures of your health information as required to be maintained by law by delivering a written request to OHFP or CFN, using the form we provide to you upon request; an accounting will not include internal uses of information for treatment, payment, or operations, disclosures made to you or made at your request or disclosures made to family members in the course of providing care.
- Request that communication of your health information be made by alternative means or at an alternative location by delivering the request in writing to OHFP or CFN, using the form we give you upon request: and,
- Revoke authorizations that you made previously to use or disclose information except to the extent information or action has already been taken by delivering a written revocation to OHFP or CFN.
You have a right to review this Notice before signing the consent authorizing use and disclosure of your protected health information for treatment, payment, and health care operations purpose.
If you want to exercise any of the above rights, please contact Cathy at OHFP, or Stacy at CFN, in person or in writing during normal business hours. . She will provide you with assistance on the steps to take to exercise your rights.
Our Responsibilities
OHFP OR CFN are required by law to maintain the privacy of your protected health information and to provide you with notice of our legal duties and privacy practices with respect to protected health information.
Accommodate your reasonable requests regarding methods to communicate health information with you.
This notice is effective as of March 1, 2003, and we are required to abide by the terms of this Notice of Privacy Practices currently in effect. We reserve the right to amend, change, or eliminate provisions in our privacy practices and access practices and to enact new provisions regarding the protected health information we maintain. If our information practices change, we will amend our Notice. You are entitled to receive a revised copy of the Notice by calling or requesting a copy by visiting our office and picking up a copy.
For more information about HIPAA or to file a complaint, please contact the following:
The US Department of Health & Human Services
Office of Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
(202) 619-0257
Toll Free: 1-877-696-6775
