Notice of Privacy Practices

Effective 03/10/2010

 

This notice describes how your medical information may be used and disclosed and how you can access your information. PLEASE REVIEW IT CAREFULLY.

 

This notice of Privacy Practices applies only to employees of Ohara & Associates.

 

I. OUR COMMITMENT TO GUARDING YOUR INFORMATION

 

We are committed to protecting the privacy of your medical information. We are required by law to keep your medical information private and we must provide you with this Notice about our privacy practices that explains how, when, and why we use and disclose your medical information. With some exceptions, we may not use or disclose any more information than is needed. We are legally required to follow the privacy practices in this Notice.

 

This Notice will tell you about the ways we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.

 

II. HOW WE MAY USE & DISCLOSE YOUR MEDICAL INFORMATION

 

A. Uses & Disclosures WITHOUT Your 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, or other health care personnel who provide you with health care services or are involved in your care. For example, a doctor treating you for a broken leg may need to know you have diabetes because diabetes may slow down the healing process. We may disclose medical information about you to other health care providers who request such information to provide medical care to you.

 

For Payment. We may use and disclose your medical information to bill and collect payment for treatment and services given to you. For example, we may need to give your insurance company information about surgery you received so it will pay for the surgery. We may also contact your insurance company to get prior authorization for a treatment you are going to receive or to determine if it will cover the treatment.

 

We may also provide medical information about you to our business associates, such as billing companies, claims processing companies, and others that process our health care claims. We require those business associates to also safeguard the privacy of your information.

 

We may also provide information about you to other health care providers that have treated you or provided services to you to assist them in obtaining payment.

 

For Health Care Operations. We may use and disclose medical information about you for health care operations. These uses and disclosures are necessary to operate Ohara MD & Associates and make sure all of our patients get quality care. For example, we may use your medical information in order to evaluate the quality of health care services that you received or to check the performance of health care professionals who provided services to you. We may also combine medical information about many patients to decide what additional services we should offer, what services are not needed, and whether certain treatments are effective.

 

We may disclose medical information about you to another health care provider or health plan with which you also have a relationship for such things as quality assurance and case management.

 

We may also provide medical information about you to our business associates, such as accountants, lawyers, consultants, and others to make sure we are following the laws that affect us. We require those business associates to guard the privacy of your information.

 

Appointment Services and Reminders. We may use and disclose medical information to provide appointment reminders for follow-up visits. We may also use and disclose medical information to make appointments for you with other health care providers.

 

Individuals involved in your care or payment for your care. We may provide medical information about you to a family member, friend, or other person who is involved in your care or the payment for your care. We may also tell your family or friends about your general health condition. In addition, we may disclose medical information about you to an organization assisting in a disaster relief effort so that your family can be notified about your condition, status, and location. You have the right to restrict what information is provided and/or to whom.

 

As required by law. We will disclose medical information about you when required to do so by federal, state, or local law. For example, we make disclosures when a law requires that we report information to government agencies and law enforcement about victims of abuse, neglect, or domestic violence; when dealing with gunshot and other wounds; to report reactions to medications or problems with products; or to notify patients of product recalls they may be using.

 

To avert a serious threat to health or safety. We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure will only be to someone able to help prevent the threat or lessen the harm.

 

Lawsuits and disputes. If you are involved in a lawsuit or dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a court or administrative ordered subpoena or discovery request.

 

Public health activities. We may disclose medical information about you for public health activities. For example, we report information about births, deaths, and various diseases, to government officials in charge of collecting that information, and we provide coroners, medical examiners, and funeral directors necessary information relating to an individual’s death.

 

Minors. We may release medical information about minors to their parents or legal guardians. However, in instances where California law allows minors to consent to their own treatment without parental consent (i.e., HIV testing), information will not be released to a minor’s parents without the minor’s authorization unless otherwise specifically allowed under California law.

 

Worker’s compensation. We may release medical information about you for worker’s compensation or similar agencies as necessary to determine if you are eligible for benefits for work-related injuries or illnesses.

 

B. Uses & Disclosures REQUIRING Authorization

 

Other Uses & Disclosures of Medical Information. Other uses and disclosures of medical information not covered by this Notice or laws that apply to us will be made only with written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission in writing at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization; however, we cannot take back any disclosures we have already made based upon your prior permission.

 

Alcohol & Drug Abuse Patient Records. Use and disclosure of any medical information about you relative to alcohol or drug abuse programs is protected by federal law and regulations. Generally we may not say to a person outside the program that you are or have attended the program, or disclose any information identifying you as an alcohol or drug abuser unless:

(i) you have consented in writing;

(ii) we receive a court order requiring the disclosure; or

(iii) the disclosure is made to medical personnel in a medical emergency or to qualified personnel for audit or program evaluation.

 

HIV/AIDS Information. Use and disclosure of any medical information about you relative to HIV testing, HIV status, or AIDS, is protected by state and federal law. Generally, an authorization must be obtained for the disclosure of such information; however, state law may allow for or require disclosure of information for public health purposes.

 

Psychotherapy Notes. We must obtain an authorization for use or disclosure of psychotherapy notes, except under limited circumstances, such as:

(i) for treatment purposes by originator of psychotherapy notes; or

(ii) for use or disclosure in defend ourselves in a legal action or other proceedings.

 

III. WHAT RIGHTS YOU HAVE ABOUT YOUR MEDICAL INFORMATION

 

You have the following rights with respect to your medical information:

 

A.        The Right to Inspect and Copy. You have the right to inspect and receive a copy of medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes. Normally we will provide access to your medical information within five (5) working days of a written request to inspect the information. We will notify you in writing if more time is necessary. We will provide copies of your medical information within fifteen (15) days of a written request.

 

            To inspect and receive a copy of medical information that may be used to make a medical decision about you, submit your request in writing. If you request a copy of the medical information, we will charge you a fee for the costs of copying, mailing, and other supplies and services associated with your request.

 

            In certain limited situations, we may deny your request. If we do, we will advise you in writing in a timely manner of our reasons for the denial and information on how you may have the denial reviewed.

 

B.         The Right to Request Restrictions. You have a right to submit a written request to restrict or limit the medical information we use or disclose. You may not limit the uses and disclosures that we are legally required or allowed to make. You also have a right to request a limit on medical information we disclose about you to someone who is involved in your care or payment of your care, like family member or friend.

 

            We may deny certain requests. Your request for restriction will be reviewed and granted or denied based on administrative practicality, technical ability to comply with the request, and the best medical interest for you, the patient. If we do agree to your request, we will comply with it unless the information is needed to provide you with emergency treatment.

 

            To request restrictions on the use or disclosure of your medical information, you may submit your request in writing. Your request must include:

            (1) what information you want to limit;

            (2) whether you want to limit our use, disclosure, or both; and

            (3) to whom you want the limits to apply (for example, disclosures to your spouse).

 

            A previously agreed to restriction may be terminated by you or Ohara & Associates, either orally or in writing. If we terminate the restriction, we can only use or disclose medical information we create or obtain after such restriction is terminated.

 

C.        The Right to Request an Amendment. If you believe that medical information we have about you is incorrect or incomplete, you have the right to request that we amend the existing information or add the missing information. You have the right to request an amendment for as long as the information is kept by or for us. To request an amendment, you must provide the request in writing with the reason for your request. We will respond within 60 days of receiving your request.

 

            We may deny your request for an amendment if it is not in writing or does not include a reason to support the request In addition, we may deny your request if the medical information is

            (i) complete and correct;

            (ii) not created by us;

            (iii) not allowed to be disclosed; or

            (iv) not part of our records.

            Our written denial will state the reasons for the denial and explain your right to file a written statement of disagreement with the denial. If you don’t file a written statement of disagreement you have the right to request that your request and our denial be attached to all future disclosures of your medical information.

 

            If we approve your request, we will add the amendment to your medical information, tell you that we have done it, and tell others that need to know about the change to your medical information.

 

D.        The Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of instances in which we have disclosed medical information about you, with certain exceptions specifically defined by the law. The list will not include certain uses or disclosures, such as ones specifically authorized by you, and uses or disclosures that are otherwise permitted, such as ones made for treatment or payment, or directly to you or your family.

 

            To request this list of accounting disclosures, you must submit your request in writing. Your request must state a time period and may not include dates before April 14, 2003. The first list you request within a 12-month period will be free. For additional lists during the same time period we will charge you a fee for the costs of providing that list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

 

            We will respond within 60 days of receiving your written request. The list we will give you will include the date of each applicable disclosure, to whom medical information was disclosed, a description of the information disclosed, and the reason for the disclosure.

 

E.         The Right to Request an Exception to Standard Confidential Communications. You have the right to ask that we send information to you at an alternate address (for example, if you doesn’t want messages left on an answering machine or if you want information sent to your work address instead of home address). We will agree to all reasonable requests so long as we can easily provide it in the format you requested. Any such requests must be submitted in writing.

 

F.         The Right to a Paper Copy of this Notice. You have the right to a paper copy of this Notice at any time.

 

IV. COMPLAINTS

 

If you believe we may have violated your rights with respect to your medical information, you may file a written complaint. You may also send a written complaint to the Office of Civil Rights, U.S. Dept of Health and Human Services within 180 days of an alleged violation of your rights. You will not be penalized for filing a complaint about our privacy practices. You will not be required to waive this right as a condition of treatment.

 

V. PERSON TO CONTACT FOR INFORMATION ABOUT THIS NOTICE OR TO COMPLAIN ABOUT OUR PRIVACY PRACTICES

 

If you have any questions about this Notice or wish to make a complaint about our privacy practices, please mail all written requests or complaints to any of the above office locations, attention to Privacy Officer.

 

VI. CHANGES TO THIS NOTICE

 

We reserve the right to change the terms of this Notice and our privacy policies at any time. We reserve the right to make the revised or changed Notice effective for medical information we already have about you as well as any information we receive in the future. Before we make an important change to our policies, we will promptly change this Notice and post a new Notice in the waiting room. The Notice will contain the effective date on the first page at the top right hand corner.

 

VII. ACKNOWLEDGEMENT

 

You will be asked to sign an acknowledgement of your receipt of this Notice of Privacy Practices. We are required by law to make a good faith effort to provide you with our Notice of Privacy Practices and obtain such acknowledgement from you. However, your receipt of care and treatment from Ohara & Associates is not conditioned upon your providing the written acknowledgement.