THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

INTRODUCTION:
At Chatuge Family Practice, we are committed to treating and using protected health information about you responsibly. This Notice of Health Information Practices describes the personal information we collect, and how and when we use or disclose that information. It also describes your rights as they relate to your health information. This Notice is effective immediately and applies to all protected health information as defined by federal regulations.

Understanding Your Health Record/Information
Each time you visit Chatuge Family Practice, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:

Basis for planning your care and treatment,

Means of communication among the many health professionals who contribute to your care,

Legal document describing the care you received,

Means by which you or a third-party payer can verify that services billed were actually provided,

A source of data for medical research,

A source of data for our planning and marketing,

A tool with which we can assess and continually work to improve the care we render and the outcomes we achieve,

Understanding what is in your record and how your health information is used helps you to: ensure its accuracy, better understand who, what, when, where, and why others may access your health information, and make more informed decisions when authorizing disclosure to others.

Your Health Information Rights

Although your health record is the physical property of Chatuge Family Practice, the information belongs to you. You have the right to:

Take a copy of this Notice of Information Practices that is available in the waiting area of the office.

Inspect a copy of your health record.

Request to amend your health record.

Obtain an accounting of disclosures of your health information.

Request communications of your health information to alternative means (i.e. different phone number, address, or to any person not involved in your healthcare, etc.)

Request a restriction on certain uses and disclosures of your information.

Revoke your authorization to use or disclose health information except to the extent that action has already been taken.

Our Responsibilities

Chatuge Family Practice is required to:

Maintain the privacy of your health information,

Provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you,

Abide by the terms of this notice,

Notify you if we are unable to agree to a requested restriction , and

Accommodate reasonable requests you may have to communicate health information by alternative means as explained above.

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will notify all patients with bulletins and/or handouts upon their visit to our office.

We will not use or disclose your health information without your authorization, except as described in this notice. We also discontinue using and/or disclosing your health information after we have received a written cancellation of a previous authorization according to the procedures allowed by law.

For More Information or to Report a Problem If you have questions and would like additional information, you may contact Pebbles Rogers at (828) 389-6383.

If you believe your privacy rights have been violated, you can file a complaint with Chatuge Family Practice or with the Office for Civil Rights, U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint with either Chatuge Family Practice or the Office for Civil Rights. The address for the OCR is listed below:

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201

Examples of Disclosures for Treatment, Payment and Health Operations

We will use your health information for treatment

For example: Information obtained by a nurse, physician, or other member of your health care team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his or her instructions/recommendations for follow up care.

We will also provide other healthcare providers with copies of various reports that should assist him or her in treating you.

We will use your health information for payment.

For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

Business Associates: There are some services provided in our organization through contracts with business associates. These services include using a collection agency to collect unpaid debts, cleaning services in the office, and computer software/hardware support, which allow access to our office/computer files. We have Business Associate Agreements with these entities, which contract them to confidentiality of any information seen in our office or on the computer system.

Communication with patient or family: Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend, or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care. We may also contact you or a person you have authorized to provide appointment reminders, test results, or to discuss your account. In your absence or the absence of your authorized representative, a message may be left on an answering machine at the number you have provided. The message that is left will identify the staff member calling and a phone number to return the call. This standard protocol will remain in place until you request an alternative phone number or means of reaching you regarding this information.

Research: We currently participate in the PPRNET program that is supplied by Practice Partner, the vendor for our medical records system. This program receives information form our computer system regarding diagnosis and treatment of patients that we have seen. PPRNET automatically takes out all identifying patient information up front before processing any information. We receive a quarterly report of our patient database that shows grafts and percentages of our patients with certain diagnoses. This helps to stay up to date regarding current protocols regarding follow up care for these patients.

Worker’s Compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law.

Public Health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Law Enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.