Privacy and Legal Statements for Accent on You Medical
Day Spa by Aesthetic and Plastic Surgery PA
Privacy Notice
Health Insurance Portability and Accountability Act (HIPPA)
Privacy Rule
Purpose
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. This notice took
effect on April 14 2003 and remains in effect until it is
replaced. We are required by the HIPPA privacy rule under
federal and state law to protect the privacy of our patient
medical information.
Our
pledge regarding medical information
The
privacy of your medical information is important to us. We
understand that your medical information is personal and we
are committed to protecting it. We create a record of the
care and services you receive at our practice. We need this
record to provide you with quality care and to comply with
certain medical and legal requirements. The health and
billing records we maintain are the physical property of the
office and James A. Rieger, M.D. However, you may inspect
and obtain a copy for your information. This notice will
tell you about the ways we may use and share medical
information about you. We also describe your rights and
certain duties we have regarding the use and disclosure of
medical information.
Our
legal duty
The office
is required to:
Maintain the privacy of your health information as required
by law
Provide you with a notice as to our duties and privacy
practices as to the information we collect and maintain
about you;
Abide by the terms of this Notice;
Notify you if we cannot accommodate a requested restriction
or request; and, accommodate your reasonable requests
regarding methods to communicate health information with
you.
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 and requesting a copy of our "Notice"
or by visiting our office and picking up a copy.
If you use
another language besides English please notify our office
staff.
How
we may use and disclose medical information about you
The
following section describes different way that we use and
disclose medical information. For each kind of use or
disclosure, we will explain what we mean and give examples.
Not every use or disclosure will be listed. However, we have
listed all of the different ways we are permitted to use and
disclose medical information. We will not use or disclose
your medical information for any purpose not listed below,
without your specific written authorization. Any specific
written authorization you provide may be revoked at any time
by writing to us. However, you may not revoke this
authorization for any actions taken before receipt of my
written notice to revoke this authorization.
For treatment:
We may use
medical information about you to provide you with medical
treatment or services. We may disclose medical information
about you to doctors, nurses, technicians or other people
who are taking care of you.
Example:
You are in the hospital or surgical center having breast
reconstruction for breast cancer. A number of health care
and support staff need to know about your medical history.
The anesthesia doctor for example will need to know about
your medical information in order to give your anesthesia.
During the course of your treatment, your physician may need
to consult with another specialist. He will share the
information with such specialist and obtain his/her input.
Example:
Medical photography is taken before, during and after a
surgical procedure or treatment. Medical photography is
required for purposes of documentation. The photography
records and images are an important part of the medical
record and are the sole property of James A. Rieger, M.D.
However, you may inspect and obtain a copy for your
information.
For payment :
We may use
and disclose your medical information for payment purposes.
Example:
We submit requests 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. We usually
use a business associate to help us file insurance and
provide this information to them.
Example:
Medical photography is taken before, during and after a
surgical procedure or treatment. Medical photography is
required for purposes of documentation and insurance
authorization /payment.
For health care operations:
We may use
and disclose your medical information for our health care
operations. This might include measuring and improving
quality, evaluating the performance of employees, conducting
training programs, and getting the accreditation,
certificates, licenses and credentials we need to serve you.
In some instances we obtain the above services from our
insurers or other business associates and will share
information about you with such insurers or other business
associates as necessary to obtain these services.
Example:
Medical information may be required for credentialing
purposes at a surgical center or hospital.
We may use
and disclose medical information about you without your
prior authorization for several other reasons noted below:
We may also contact you for appointment reminders, or to
tell you about or recommend possible treatment options,
alternatives, health-related benefits or services that may
be of interest to you.
We may disclose medical information about you to a friend
or family member who is involved in your medical care or to
disaster relief authorities so that your family can be
notified of your location and condition.
Subject to certain requirements, we may give out medical
information about you without prior authorization for public
health purposes, abuse or neglect reporting, health
oversight audits or inspections, funeral arrangements, organ
donation, workers’ compensation purposes, and emergencies.
We may also disclose medical information when required by
law, such as in response to valid judicial or administrative
orders.
Other uses of medical information:
In any
other situation not involving routine care, treatment,
payment, health care operations or matters as noted above in
the section entitled How we may use and disclose medical
information about you we will ask for your
written authorization before using or disclosing medical
information about you. If you choose to authorize use or
disclosure, you can later revoke that authorization by
notifying us in writing of your decision, except to the
extent information has been disclosed or action has already
been taken.
Example:
Authorization for and release of medical photography for
purposes of patient education or use during lectures to
medical or lay groups would require a written authorization.
Your
rights regarding medical information about you
You have a
right to:
Look at or get a copy of medical information that we use to
make decisions about your care after you submit a written
request to our office. Reasonable costs will apply to
copying, revival, and supplies. Records are keep at least as
long as required by law.
Request that your health care record be amended to correct
incomplete or incorrect information by delivering a request
to our office. We may deny your request if you ask us to
amend information that was not created by us; is not part of
the health information kept by or for the office; is not
part of the information that you would be permitted to
inspect and copy; or is accurate and complete. If your
request is denied, you will be informed of the reason for
the denial and will have an opportunity to submit a
statement of disagreement to be maintained with your
records. If we accept your request to change the
information, we will make reasonable efforts to tell others,
including people you name, of the change and to include the
changes.
Request that communication of your health information be
made by reasonable alternative means or at an alternative
location by delivering the request in writing to our office.
Receive a list of those instances where we have disclosed
medical information about you. This accounting will not
include uses and disclosures of information for treatment,
payment, or health care operations; disclosures or uses made
to you or made at your request; uses or disclosures made
pursuant to an authorization signed by you; uses or
disclosures made to family members or friends relevant to
that person's involvement in your care or in payment for
such care; or, uses or disclosures to notify family or
others responsible for your care of your location and
condition. The request must state the time period desired
for the accounting, which must be less than a 6 year period
and starting after April 14 2003. You may receive the list
in paper or electronic form. The first disclosure list
request in a 12 month period is free; other requests will be
charged according to our cost of producing the list. We will
inform you of the cost before you incur any costs.
Appeal a denial of access to your protected health
information.
Revoke authorizations that you made previously to use or
disclose information by delivering a written revocation to
our office, except to the extent information has been
disclosed or action has already been taken.
Request a restriction on certain uses and disclosures of
your health information by delivering the request to our
office -- we are not required to grant the request, but we
will consider the request.
Receive a paper copy of this notice if this notice was sent
electronically.
If you
want to exercise any of the above rights, please contact
Linda , Danae or Doctor Rieger at the office in person, in
writing, or by phone (316-652-9333) during regular, business
hours.
Questions and Complaints
If you
have questions, would like additional information, or want
to report a problem regarding the handling of your
information, you may contact Linda or Danae or Doctor Rieger
at the office at 316-652-9333. Additionally, if you believe
your privacy rights have been violated, you may file a
written complaint at our office by delivering the written
complaint to Linda or Danae or Doctor Rieger.
You may
also file a complaint to the Department of Health and Human
Services (Department of Health and Human Services, Office of
Civil Rights, 200 Independence Ave. S.W., Washington, DC
20201). Under no circumstances will you be penalized or
retaliated against for filing a compliant.
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