Grogan & Howard, PSC must
maintain the privacy of your personal health information and give you this
notice that describes our legal duties and privacy practices concerning your
personal health information. In general,
when we release your health information, we must release only the information
we need to achieve the purpose of the use or disclosure. However, all of your personal health
information that you designate will be available for release if you sign an authorization
form, if you request the information for yourself, to a provider regarding your
treatment, or due to a legal requirement.
We must follow the privacy practices described in this notice.
However, we reserve the right
to change the privacy practices described in this notice, in accordance with
the law. Changes to our privacy
practices would apply to all health information we maintain. If we change our privacy practices, you will
receive a revised copy.
Without your written authorization, we can use your
health information for the following purposes:
1. Treatment. (For example, a doctor
may use the information in your medical record to determine which treatment
option, such as a drug or surgery, best addresses your health needs. The treatment selected will be documented in
your medical record, so that other health care professionals can make informed
decisions about your care.)
2. Payment.
In order for an insurance company to pay for your treatment, we
must submit a bill that identifies you, your diagnosis, and the treatment provided
to you. As a result, we will pass such
health information onto an insurer in order to help receive payment for your
medical bills. (This does include
Medicare, Medicaid, Workers Comp, and all other insurance entities).
3. Health Care Operations. We may need
to use your diagnosis, treatment, and outcome information in order to improve
the quality or cost of care we deliver.
These quality and cost improvement activities may include evaluating the
performance of your doctors, nurses, and other health care professionals, or
examining the effectiveness of the treatment provided to you when compared to
patients in similar situations.
In addition, we may want to
use your health information for appointment reminders. For example, we may look at your medical
record to determine the date and time of your next appointment with us, and
then send you a reminder letter to help you remember the appointment. Or, we may look at your medical information
and decide that another treatment or a new service we offer may interest
you. For example, we may contact a
cancer patient to notify them that we have a new cancer research facility that
offers new life-saving treatments.
4. As required by law. Sometimes we must report some of your
health information to legal authorities, such as law enforcement officials,
court officials, or government agencies.
For example, we may have to report abuse, neglect, domestic violence, or
certain physical injuries, or to respond to a court order.
5. For public health activities. We may be required to report your health
information to authorities to help prevent or control disease, injury, or
disability. This may include using your
medical record to report certain diseases, injuries, birth or death
information, information of concern to the Food and Drug Administration, or
information related to child abuse or neglect.
We may also have to report to your employer certain work-related
illnesses and injuries so that your workplace can be monitored for safety. In the case of a minor, we may also have to
report health information to your school.
6. For health oversight activities. We may disclose your health
information to authorities so they can monitor, investigate, inspect,
discipline or license those who work in the health care system or for
government benefit programs.
7. For activities related to death. We may disclose your health
information to coroners, medical examiners, and funeral directors so they can
carry out their duties related to your death, such as identifying the body,
determining cause of death, or in the case of funeral directors, to carry out
funeral preparation activities.
8. For organ, eye or tissue donation. We may disclose your health
information to people involved with obtaining, storing, or transplanting
organs, eyes, or tissue of cadavers for donation purposes.
9. For research. Under certain circumstances, and only
after a special approval process, we may use and disclose your health
information to help conduct research.
Such research might try to find out whether a certain treatment is
effective in curing an illness.
10. To avoid a serious threat to health or
safety. As required by law and
standards of ethical conduct, we may release your health information to the
proper authorities if we believe, in good faith, that such release is necessary
to prevent or minimize a serious and approaching threat to your or the public’s
health or safety.
11. For military, national security, or
incarceration/law enforcement
custody. If you are
involved with the military, national security or intelligence activities, or
you are in the custody of law enforcement officials or an inmate in a
correctional institution, we may release your health information to the proper
authorities so they may carry out their duties under the law.
12. For
workers’ compensation. We
may disclose your health information to the appropriate persons in order to
comply with the laws related to workers’ compensation or other similar
programs. These programs may provide
benefits for work-related injuries or illnesses.
13. To those involved with your care or payment
of your care. If people such as
family members, relatives, or close personal friends are helping care for you
or helping you pay your medical bills, we may release important health
information about you to those people.
The information released to these people may include your location
within our facility, your general condition, or death. You have the right to object to such
disclosure, unless you are unable to function or there is an emergency. In addition, we may release your health
information to organizations authorized to handle disaster relief efforts so
those who care for you can receive information about your location or health
status. It is our duty to give you
enough information so you can decide whether or not to object to release of
your health information to others involved with your care.
NOTE: Except for the situations listed above, we must obtain
your specific written authorization for any other release of your health
information.
If you sign an authorization
form, you may withdraw your authorization at any time, as long as your
withdrawal is in writing. If you wish to
withdraw your authorization, please submit your written withdrawal to Linda
Pegram at Grogan & Howard, PSC.
Your Health Information Rights
You have several rights with
regard to your health information. If
you wish to exercise any of the following rights, please contact Linda Pegram
at Grogan & Howard, PSC.
Specifically, you have the right to:
1. Inspect
and copy your health information. With
a few exceptions, you have the right to inspect and obtain a copy of your
health information. However, this right
does not apply to psychotherapy notes or information gathered for judicial
proceedings, for example. In addition,
we will provide you or your designee one free copy of your medical records as
required by
2. Request
to correct your health information. If
you believe your health information is incorrect, you may ask us to correct the
information. You may be asked to make
such requests in writing and to give a reason as to why your health information
should be changed. However, if we did
not create the health information that you believe is incorrect, or if we
disagree with you and believe your health information is correct, we may deny
your request.
3. Request
restrictions on certain uses and disclosures.
You have the right to ask for restrictions on how your health
information is used or to whom your information is disclosed, even if the
restriction affects your treatment or our payment or health care operation
activities. Or, you may want to limit
the health information provided to family or friends involved in your care or
payment of medical bills. You may also
want to limit the health information provided to authorities involved with
disaster relief efforts. However, we are
not required to agree in all circumstances to your requested restriction.
If you receive certain medical
devices (for example, life-supporting devices used outside our facility), you
may refuse to release your name, address, telephone number, social security
number or other identifying information for purpose of tracking the medical
device.
4. As
applicable, receive confidential communication of health information. You have the right to ask that we
communicate your health information to you in different ways or places. For example, you may wish to receive
information about your health status in a special, private room or through a
written letter sent to a private address.
We must accommodate reasonable requests.
5. Receive
a record of disclosures of your health information. In some limited instances, you have the
right to ask for a list of the disclosures of your health information we have
made during the last six years, but the request cannot include dates before
6. Obtain
a paper copy of this notice. Upon
request, you may at any time receive a paper copy of this notice even if you
have already received a copy.
7. Complain. If you believe your privacy rights have
been violated, you may file a complaint with us with the federal Department of
Health and Human Services. We will not
retaliate against you for filing such a complaint.
Again, if you have any
questions or concerns regarding your privacy rights or the information in this
notice, please contact Linda Pegram
Office Manager, at Grogan & Howard, PSC
(270)442-9463.
This Notice of Medical Information Privacy is Effective
HIPAA PRIVACY NOTIFICATION
Grogan & Howard, PSC
Effective
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.