Manatee Surgical Specialist, P.A.

Notice of Privacy Practices

As Required by the Privacy Regulations Created as a Result of the

Health Insurance Portability and Accountability Act of 1996 (HIPPA)

Please Review this Notice Carefully

OUR COMMITMENT TO YOUR PRIVACY

Our practice is dedicated to maintaining the privacy of your individually identifiable health information (IIHI).  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 IIHI.  By federal and state law, we must follow the terms of the notice of privacy practices that we have in effect at this time.

The terms of this notice apply to all records containing your IIHI 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 of your records that we may create or maintain in the future.  Our practice will post a copy of our current Notice in our offices in a visible location at all times, and you may request a copy of our most current Notice at any time.

WE MAY USE AND DISCLOSE YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION (IIHI) IN THE FOLLOWING WAYS

1.  Treatment.  Our practice may use your IIHI to treat you.  For example, we might disclose your IIHI to a pharmacy when we order a prescription for you.  Your IIHI may be shared between the individuals that make up our practice to determine your appropriate treatment plan.  Finally, we may also disclose your IIHI to other health care providers for purposes related to your  treatment.

2.  Payment.  Our practice may use and disclose your IIHI in order to bill and collect payment for services 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 pay for, your treatment.  Also, we may use your IIHI to bill you directly for services and treatment.  We may disclose your IIHI to other health care providers and entities to assist in their billing and collection efforts.

3.  Health Care Operations.  Our practice may use and disclose your IIHI to operate our business.  As examples of the ways in which we may use and disclose your information for our operations, our practice may use your IIHI to evaluate the quality of care you received from us, or to conduct cost-management and business planning activities for our practice.

4.  Appointment Reminders.  Our practice may use and disclose your IIHI to contact you and remind you of an appointment via phone, letter or postcard.  When time permits, we do try to make a courtesy call to remind patients of their upcoming appointments.  Please notify us immediately should you not desire us to do so.

5.  Treatment Options.  Our practice may use and disclose your IIHI to inform you of potential treatment options or alternatives.

6.  Health-Related Benefits and Services.  Our practice may use and disclose your IIHI to inform you of health-related benefits or services that may be of interest to you.

7.  Disclosures Required by Law.  Our practice will use and disclose your IIHI when we are required to do so by federal, state, or local law. 

USE AND DISCLOSURE OF YOUR IIHI IN CERTAIN SPECIAL CIRCUMSTANCES

The following categories describe unique scenarios in which we may use or disclose your identifiable health information:

1.  Public Health Risks.  Our practice may disclose your IIHI to public health authorities that are authorized by law to collect information for the purposes of:

  • maintaining vital records, such as births and deaths
  • reporting child abuse or neglect
  • preventing or controlling disease, injury or disability
  • reporting reactions to drugs
  • notifying individuals if a product they may be using has been recalled
  • notifying appropriate government agency(ies) and authority(ies) regarding the potential abuse or neglect of an adult patient (including domestic violence); however, we will only disclose this information if the patient agrees or we are required or authorized by law to disclose this information

2.  Health Oversight Activities.  Our practice may disclose your IIHI to a health oversight agency for activities authorized by law.  Oversight activities can include, for example, investigations, inspections, audits, licensure and disciplinary actions; civial, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws and the health care system in general.

3.  Lawsuits and Similar Proceedings.  Our practice may use and disclose your IIHI in response to a court or administrative order, if you are involved in a lawsuit or similar proceeding.  We may disclose your IIHI in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.

4.  Law Enforcement.  We may release IIHI if asked to do so by a law enforcement official:

  •      regarding a crime victim in certain situations, if we are unable to obtain the person's agreement
  •      concerning a death we believe has resulted from criminal conduct
  •      regarding criminal conduct at our offices
  •      in response to a warrant, summons, court order, subpoena or similar legal process
  •      to identify/locate a suspect, material witness, fugitive or missing person

    5.  Deceased Patients.  Our practice may release IIHI to a medical examiner or coroner to identify a cause of death.  If necessary, we also may release information in order for funeral directors to perform their jobs.

6.  Organ and Tissue Donation.  Our practice may release your IIHI to organizations that handle organ, eye or tissue procurement or transplantation, including organ donation banks, as necessary to facilitate organ or tissue donation and transplantation if you are an organ donor.

7.  Research.  Our practice may use and disclose your IIHI for research purposes when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.  No IIHI will be used without your prior authorization.

8.  Military.  Our practice may disclose your IIHI if you are a member of the US or foreign military forces (including veterans) and if required by the appropriate authorities.

9.  National Security.  Our practice may disclose your IIHI to federal officials for intelligence and national security activities authorized by law. 

10.  Workers' Compensation.  Our practice may release your IIHI for workers' compensation and similar programs.

YOUR RIGHTS REGARDING YOUR IIHI

You have the following rights regarding the IIHI that we maintain about you:

1.  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 work, rather than home.  Our practice will accommodate reasonable requests.  You do not need to give a reason for your request.

2.  Requesting Restrictions.  You have the right to request a restriction in the use or disclose of your IIHI for treatment, payment or health care operations.  Additionally, you have the right to request that we restrict our disclosure of your IIHI to only certain individuals involved in your care or the payment of your care.  We are not required to agree to your request; however, 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.

3.  Inspection and Copies.  Psychiatric and mental health providers are exempt from this portion of the regulation and you do not have the right to inspect or request copies of your patient medical records, notes and treatment plans.  You do have the right to inspect and obtain copies of billing records.

4.  Amendment.  You may ask us to amend your health information if you believe it is incorrect or incomplete.  This request must be in writing and must provide us with a reason that supports your request for amendment.  Our practice may deny your request if you ask us to amend information that is in our opinion:  (a) accurate and complete; (b) not part of the IIHI kept by or for the practice; or (c) not created by our practice, unless the individual or entity that created the information is not available to amend the information.

5.  Right to a Paper Copy of This Notice.  You are entitled to receive a paper copy of our notice of privacy practices.  You may ask us to give you a copy of this notice at any time.

6.  Right to File a Complaint.  If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services.  All complaints must be submitted in writing and you will not be penalized for filing a complaint.

7.  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 us regarding the use and disclosure of your IIHI may be revoked at any time in writing.  After you revoke your authorization, we will no longer use or disclose your IIHI for the reasons described in the authorization.  Please note, we are required to retain records of your care.

Again, if you have questions regarding this notice or our health information privacy policies, please contact our office.