NOTICE OF PRIVACY PRACTICES
OUR PLEDGE TO PROTECT YOUR PRIVACY
So that we may best meet your medical needs, we share your medical records with the health care providers involved in your care. We share your information only to the extent necessary to collect payment for the services we provide, to conduct our business operations, and to comply with the laws that govern health care. We will not use or disclose your information for any other purpose without your permission.
WHO WILL COMPLY WITH THIS NOTICE
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU
You have the right to inspect and obtain a copy of the medical records that CEI, Cal Sleep, CEI Sinus, CFI, and CCI use to make decisions about you and your treatment, subject to certain limited exceptions. This information includes your medical and billing records, but may not include some mental health information. We reserve the right to charge a fee to cover the cost of providing your records to you.
Correction: If you believe that the medical information the California Ear Institute (CEI), California Sleep Institute (Cal Sleep), the Sinus Institute at CEI (CEI Sinus), the California Face and Laser Institute (CFI), and the California Craniofacial Institute (CCI) has on file for you is inaccurate or incomplete, you may request that we correct the medical information in your records. This request must be done in written form. Your written request must explain why the information should be corrected. If, however, after reviewing your medical records, your physician determines that they are correct or complete, we may deny your request. We will provide you with a written explanation for our denial.
Addendum: Adult CEI/Cal Sleep/CEI Sinus/CFI/CCI patients who believe that an item or statement in his/her medical record is inaccurate or incomplete has the right to provide CEI/Cal Sleep/CEI Sinus/CFI/CCI with a written addendum to his/her record.
You have the right to request an “accounting of disclosure” which is a list describing how we have shared your medical information with outside parties. We will begin maintaining disclosures starting April 14, 2003 for purposes other than treatment, payment and health care operations. Those functions are described below in the section entitled “How We May Use and Disclose Medical Information About You”. If you request this accounting more than once in a 12-month period, we may charge you a cost-based fee.
You have the right to request restrictions on certain uses or disclosures of your personal and medical information. You can request, in writing, that we place additional restrictions on the use or disclosure of your personal and health information. We are not required to agree to these restrictions, but if we elect to do so, we will abide by our agreement unless the information is needed to provide you with emergency treatment or comply with the law. If we deny your request, we will inform you in writing why we cannot honor your request.
You have the right to receive certain communications confidentially. You can request that we communicate with you in confidence about your personal and medical information by alternative means or to an alternative location. We will not ask the reasons for your request and will use our best efforts to accommodate all reasonable requests.
You have the right to a copy of this Notice. It is available at the Front Desk and on our internet site (http://www.calear.com) in the “About Us” section under HIPAA.
USES AND DISCLOSURES OF YOUR PERSONAL AND HEALTH
We may disclose your personal and health information to a provider who requests this information to treat you.
We may use and disclose your personal and health information to bill and receive payment for the services you receive.
We may use and disclose your personal and health information for business functions necessary to operate CEI/Cal Sleep/CEI Sinus/CFI/CCI and assure that our patients receives quality care. We may also share your personal and medical information with affiliated healthcare providers to coordinate your care.
We may use or disclose your personal and health information with outside companies that perform business services for us, such as, but not limited to, collection companies, accountants, electronic medical records software companies, and attorneys. We may need to share your medical information so that these outside companies can perform a service on our behalf. CEI/Cal Sleep/CEI Sinus/CFI/CCI will limit the disclosure of your information to the “minimum necessary” for the business associate to perform services for CEI/Cal Sleep/CEI Sinus/CFI/CCI. In addition, we will have a written contract in place requiring the business associate to safeguard the privacy of your personal and medical records.
We may use your personal and health information to contact you with information about health-related services, appointment reminders or treatment alternatives. We may use your personal health information to inform you about up coming conferences or patient-oriented events. If you do not wish to receive this type of information, you may request to opt-out of receiving this information from GHI by sending an e-mail to email@example.com or by calling (650) 494-1000. If you are a patient of both the California Ear Institute and GHI, we will provide access to your California Ear Institute medical records to GHI personnel in order to maximize your care.
We may disclose your personal and health information to a family member, friend, or other person if you are unavailable to agree such as in a medical emergency. We will disclose this information only to the extent necessary to help with your health care or with payment for your health care.
We may use and disclose your personal and health information to the extent necessary to avert a serious and imminent threat to your health or safety or the health or safety of others. We may disclose your personal and health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, domestic violence or other crimes.
We will use or disclose your personal and health information when we are required to do so by law.
We may disclose your personal and health information in response to a court or administrative order, subpoena, discovery request or other lawful process.
We may disclose limited information to a law enforcement official concerning the personal or health information of a suspect, fugitive, material witness, crime victim or missing person. We may disclose the personal and health information of an inmate or other person in lawful custody to a law enforcement official or correctional institution under certain circumstances.
We may disclose to military authorities the personal and medical information of Armed Forces personnel. We may disclose to authorize federal officials personal and health information required for lawful intelligence, counterintelligence, and other national security activities.
We may disclose medical information to a health oversight agency, such as the California Department of Health Services, for activities authorized by law. These oversight activities include audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the healthcare system, government programs, and compliance with civil rights laws.
CHANGES TO THIS NOTICE
COMMENTS OR COMPLAINTS
To register a comment or complaint with the California Ear Institute, please contact:
HIPAA Privacy Officer
To register a complaint with the Department of Health and Human Services:
Secretary of the Department of Health and Human Services
PLEASE BE ASSURED THAT NO ONE WILL RETALIATE OR TAKE ACTION AGAINST YOU FOR FILLING A COMPLAINT.
OTHER USES OF MEDICAL INFORMATION