Notice of Privacy Practices
As required by the privacy regulations created as a result of Health Insurance Portability and Accountability Act of 1996 (HIPAA) as revised in the 2013 HIPAA Omnibus Rule.
This notice describes how health information about you (as a patient of this practice) may be used and disclosed, and how you can get access to your protected health information.
A. OUR COMMITMENT TO YOUR PRIVACY.
Our practice is dedicated to maintaining the privacy of your protected health information (PHI). In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We also are required by law to provide you with this notice of our legal duties and the privacy practices that we maintain in our practice concerning your PHI. By federal and state law, we must follow the terms of the notice of privacy practices that we have in effect at the time. We realize that these laws are complicated, but we must provide you with the following important information:
- How we may use and disclose your PHI.
- Your privacy rights regarding your PHI.
- Our obligations concerning the use and disclosure of your PHI.
The terms of this notice apply to all records containing your PHI that are created or retained by our practice. We reserve the right to revise or amend this Notice of Privacy Practices. Any revision or amendment to this notice will be effective for all your records that our practice has created or maintained in the past, and for any of your records that we may create or maintain in the future.
B. If you have questions about this notice or would like a copy of the current notice, please contact: Hearing Solutions, 300 Green Avenue, Gillette, WY 82716, (307)689-3611.
C. WE MAY USE AND DISCLOSE YOUR PHI IN THE FOLLOWING WAYS.
1. Treatment. Our practice may use your PHI to treat you. For example, we may request a copy of a previous test done to find out the best form of treatment for you.
2. Payment. Our practice may use and disclose your PHI to bill and collect payment for the services and items you may receive from us. For example, we may contact your health insurer to certify that you are eligible for benefits, and we may provide your insurer with details regarding your treatment to determine if your insurer will cover or help pay for your treatment.
3. Marketing. Our practice may not sell your PHI or provide any of your health information to any outside marketing company. The use of your PHI by Hearing Solutions for marketing purposes does require a written authorization.
4. Release of information to family/friends. Our practice may release your PHI to a friend or family member who is involved in your care. For example, a parent, guardian or caretaker who comes with you to an appointment may have access to your medical information if it would assist in your treatment through our office.
5. Disclosure required by law. Our practice will use and disclose your PHI when we are required to do so by federal, state or local law. You will be notified, as required by law, of any such uses or disclosures.
6. Business Associates. Our practice may disclose your PHI to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. To protect your PHI, however, we require the business associate to appropriately safeguard your information.
7. Public Health. Our practice may disclose your PHI for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose of controlling disease, injury or disability.
8. Communicable Diseases. Our practice may disclose your PHI, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.
9. Abuse and Neglect. Our practice may disclose your PHI to a public health authority that is authorized by law to receive reports of abuse or neglect. In addition, we may disclose your PHI if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.
10. Legal Proceedings. Our practice may disclose your PHI during any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), and in certain conditions in response to a subpoena, discovery request or other lawful process.
11. Law Enforcement. Our practice may disclose your PHI, so long as applicable legal requirements are met, for law enforcement purposes.
12. Serious Threat to Health or Safety. Consistent with applicable federal and state laws, our practice may disclose your PHI to prevent or lessen a serious threat to your health and safety or to the health and safety of another person or the public.
13. Military Activity and National Security. If you are involved with military, national security or intelligence activities or if you are in law enforcement custody, our practice may disclose your PHI to authorized officials so they may carry out their legal duties under the law.
14. Workers’ Compensation. Our practice may disclose your PHI as authorized for workers’ compensation or other similar programs that provide benefits for a work-related illness.
15. For Data Breach Notification Purposes. Our practice may use or disclose PHI to provide legally required notices of unauthorized access to or disclosure of your health information.
E. YOUR RIGHTS REGARDING YOUR PHI.
1. Breach Notification. You have the right to be notified upon a breach of any of your unsecured protected health information.
2. Confidential Communications. You have the right to request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home rather than work. To request a type of confidential communication, you must make a written request to our office specifying the requested method of contact or the location where you wish to be contacted. Our practice will accommodate reasonable requests.
3. Requesting Restrictions. You have the right to request a restriction in our use of disclosure of your PHI for treatment, payment or health care operations. Additionally, you have the right to request that we restrict our disclosure of your PHI to only certain individuals involved in your care or the payment for your care, such as family members and friends. We are not required to agree to your request. If we do agree, we are bound by our agreement except when otherwise required by law, in emergencies or when the information is necessary to treat you. To request a restriction in our use or disclosure of your PHI, you must make your request in writing to our office.
If you have paid services “out of pocket” in full and advance, and you request that we do not disclose PHI related to those services to a health plan, we will accommodate your request, expect where we are required by law.
4. Right to Inspect, Copy and Amend. You may inspect and obtain a copy of your protected health information that is contained in your medical and billing records and any other records used for making decisions about you. You have the right to request that we amend your health information for seven years from the date the record was created or so long as the information remains in our files. Under federal law, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and protected health information that is subject to law that prohibits access to protected health information. Depending on the circumstances, we may deny your request to inspect and/or copy your protected health information.
5. Right to provide an authorization for other uses and disclosures. Our practice will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. Any authorization you provide to use regarding the use and disclosure of your PHI may be revoked at any time in writing. After you revoke your authorization, we will no longer use or disclose your PHI for the reasons described in the authorization.
300 Green Avenue
Gillette, WY 82716