Notice of Privacy Practices

Page 4

 

 

There are some jobs we hire other people to do for us. They are called our business associates in the law. Examples include hiring a typist to prepare reports and correspondence regarding your PHI, photocopying services, collection agencies and billing services. These business associates need to receive some of your PHI to do their jobs properly. To protect your privacy, they have agreed in their contract with us to safeguard your information.

 

 

 

 

 

 

 

 

 

2. Uses and disclosures requiring your Authorization

 

 

 

 

If we wish to use your information for any purpose besides the TPO or those we described above, we need your permission on an Authorization Form. If you do authorize us to use or disclose your PHI,  you can revoke or cancel that permission, in writing at any time. After that time we will not use or disclose your information for the purposes that we agree to. Of course, we cannot take back any information we have already disclosed with your permission or that had been used in our office.

 

 

 

 

 

 

 

 

3. Uses and disclosures not requiring Consent or Authorization

 

 

 

 

There are some federal, state and local laws that require us to disclose PHI. We have to report suspected child and adult abuse, neglect or exploitation as well as adult incapacity or vulnerability. If you are involved in a law suit or legal proceeding and we receive a subpoena, discovery request, or other lawful process we may have to release some of your PHI. We will do so only after trying to tell you about the request, consulting your or our own attorney, or trying to get a court order to protect the information they requested. Please be advised that any and all costs incurred by NANpc by engaging legal counsel to respond to any such requests in any manner are your responsibility and must be paid by you to NANpc. These costs include time spent by the healthcare provider assisting counsel, preparing documents or appearing at any hearing, deposition or trial.

 

 

 

 

 

We have to disclose some information to the government agencies that check on us to see that we are obeying the privacy laws. We may disclose PHI to a law enforcement officer, if asked to do so, to investigate a crime or criminal. We might disclose PHI to agencies that investigate diseases or injuries. We may disclose PHI to coroners, medical examiners or funeral directors and to organizations relating to organ, eye, or tissue donations or transplants. We may disclose PHI of military personnel and veterans to government benefit programs relating to eligibility and enrollment, to Workers Compensation programs, to correctional facilities if you are an inmate, and for national security purposes. If we come to believe that there is serious threat to your health or that of another person or the public we can disclose some of your PHI. We will only do this to persons who can prevent the danger.

 

 

 

 

 

 

 

 

 

4. Uses and disclosures requiring you to have the opportunity to
    object

 

 

 

 

We can share some information about you with your family or close others. We will only share information with those involved in your care and anyone else you choose such as friends or clergy. We will ask you about who you want us to share information about your condition or situation. You can tell us what you want and we will honor your wishes as long as it is not against the law.

 

 

 

 

 

 

 

5. An accounting of disclosure

 

 

 

 

When we disclose your PHI we keep some records of whom we sent it to, when we sent it, and what we sent. You can get an accounting (a list) of many of these disclosures.

 

 

 

 

 

 

 

 

E. If you have questions or problems

 

 

 

 

 

 

If you need more information or have questions about the privacy practices described above please speak to the Privacy Officer listed below. If you have a problem with how your PHI has been handled or if you believe your privacy rights have been violated, contact the Privacy Officer. You have the right to file a complaint with us and with the Secretary of the Federal Department of Health and Human Services. We promise that we will not limit your services here or take any actions against you. 

 

 

 

 

 

 

 

NANpc's Privacy Officer is Dr. John Zarske who can be reached by phone at 928-779-3478 or by email at jaz@nazneuropsychology.com