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Privacy Policy

PLEASE REVIEW THIS NOTICE CAREFULLY

This Practice is committed to maintaining the privacy of your protected health information (“PHI”), which includes information about your health condition and the care and treatment you receive from the Practice. The creation of a record detailing the care and services you receive helps this office to provide you with quality health care. This Notice details how your PHI may be used and disclosed to third parties. This Notice also details your rights regarding your PHI. The privacy of PHI in patient files will be protected when the files are taken to and from the Practice by placing the files in a box or brief case and kept within the custody of a doctor or employee of the Practice authorized to remove the files from the Practice’s office. It may be necessary to take patient files to a facility where a patient is confined or to a patient’s home where the patient is to be examined or treated.

NO CONSENT REQUIRED

The Practice may use and/or disclose your PHI for the purposes of:

The Practice may use and/or disclose your PHI, without a written Consent from you, in the following additional instances:

Communication Barriers – If due to substantial communication barriers or inability to communicate, the Practice has been unable to obtain your Consent and the Practice determines, in the exercise of its professional judgment, that your Consent to receive treatment is clearly inferred from the circumstances.


APPOINTMENT REMINDER

The Practice may, from time to time, contact you to provide appointment reminders of information about treatment alternatives or other health-related benefits and services that may be of interest to you. The following appointment reminders are used by the Practice: a) a postcard mailed to you at the address provided by you; and b) telephoning your home and leaving a message on your answering machine or with the individual answering the phone.

SIGN-IN LOG

The Practice maintains a sign-in log for individuals seeking care and treatment in the office. The sign-in log is located in a position where staff can readily see who is seeking care in the office, as well as the individual’s location within the Practice’s office suite. This information may be seen by, and is accessible to, others who are seeking care or services in the Practice’s offices.

FAMILY/FRIENDS

The Practice may disclose to your family member, other relative, a close personal friend, or any other person identified by you, your PHI directly relevant to such person’s involvement with your care or the payment for your care. The Practice may also use or disclose your PHI to notify or assist in the notification (including identifying or locating) a family member, a personal representative, or another person responsible for your care, of your location, general condition or death. However, in both cases, the following conditions will apply:

AUTHORIZATION
Uses and/or disclosures, other than those described above, will be made only with your written authorization.

YOUR RIGHTS
You have the right to:

PRACTICE REQUIREMENTS
The practice:

Section 381.004 relating to HIV testing, Chapter 384 relating to sexually transmitted diseases and
Section 456.057 relating to patient records ownership, control and disclosure.

QUESTIONS AND COMPLAINTS
You may obtain additional information about our privacy practices or express concerns or complaints to the person identified below whom COMPLIANCE OFFICER and Contact person is appointed for this practice. The COMPLIANCE OFFICER is Dr. Keith Engler.
You may file a complaint with the COMPLIANCE OFFICER if you believe that your privacy rights have been violated relating to release of your protected health information. You may, also, submit a complaint to the Department of Health and Human Services the address of which will be provided to you by the COMPLIANCE OFFICER. We will not retaliate against you in any way if you file a complaint.

EFFECTIVE DATE
This Notice is in effect as of 1/28/2012.


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