This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
University Physical Medicine is committed to the confidentiality of your medical information. We use your medical records to provide you with quality care, to obtain payment, and to meet our professional and legal obligations. We are required by law to protect the privacy of your health information and to notify you of our privacy practices and of any breach of unsecured protected health information.
A. How this medical practice may use or disclose your health information
Your medical record is the property of the practice, but the information in it belongs to you. The law permits us to use or disclose your health information for the following purposes:
1. Treatment
We use your medical information to provide care and may disclose it to our employees and other providers involved in your care — including physicians, pharmacists, laboratories, and family members assisting in your care.
2. Payment
We use and disclose your medical information to obtain payment for the services we provide. This may include sharing information with your health plan or other providers involved in billing.
3. Health Care Operations
We may use your information to operate the practice — including quality improvement, staff competence review, referral authorization, medical reviews, legal services, audits, fraud and abuse detection, compliance, and business planning. We share information with business associates performing services on our behalf under written contracts requiring confidentiality protection.
4. Appointment reminders
We may use your medical information to contact you and remind you about appointments. Messages may be left on answering machines or with the person answering the phone.
5. Sign-in sheet
You may sign in upon arrival, and we may call your name when we are ready to see you.
6. Notification and communication with family
We may disclose your health information to notify family members, personal representatives, or others involved in your care about your location, general condition, or death. In disasters, we may disclose information to relief organizations to help coordinate notification. When possible we will give you the opportunity to object before disclosure.
7. Marketing
We may contact you about products or services related to your treatment, case management, or care coordination. We will not otherwise use or disclose your medical information for marketing purposes, or accept any payment for other marketing communications, without your prior written authorization.
8. Sale of health information
We will not sell your health information without your prior written authorization. Any authorization will disclose any compensation we receive for the sale and may be revoked by you.
9. Required by law
We will use and disclose health information as required by law, limited to the relevant requirements. Special rules apply to reports of abuse, neglect, and domestic violence, and to responses from law enforcement.
10. Public health
We may disclose information to public health authorities for disease control and prevention, injury reporting, FDA-related reporting, and to notify persons who may have been exposed to a disease.
11. Health oversight activities
We may disclose health information to oversight agencies conducting audits, investigations, or licensure proceedings.
12. Judicial and administrative proceedings
We may disclose health information in administrative or judicial proceedings as authorized by law, and in response to subpoenas, discovery requests, or other lawful process where reasonable efforts have been made to notify you.
13. Law enforcement
We may disclose information to law enforcement for suspect identification, fugitive location, witness involvement, missing person location, warrant service, and grand jury response.
14. Coroners
Health information may be disclosed to coroners investigating deaths.
15. Organ or tissue donation
Information may be disclosed to organizations involved in procurement, banking, or transplantation.
16. Public safety
Information may be disclosed to appropriate persons to prevent or lessen a serious and imminent threat to health or safety.
17. Proof of immunization
Immunization proof will be disclosed to schools that require it if you agree to disclosure.
18. Specialized government functions
Information may be disclosed for military or national security purposes, or to correctional institutions or law enforcement with lawful custody.
19. Workers' compensation
We may disclose information as needed to comply with workers' compensation laws, including periodic condition reports to employers when care is covered by workers' compensation.
20. Change of ownership
If the practice is sold or merged, your health information will become the property of the new owner, but you will retain the right to request transfer of your records to another physician.
21. Breach notification
Following any breach of unsecured protected health information, we will notify you as required by law.
B. When this medical practice may not use or disclose your health information
Except as described above, we will not use or disclose health information that identifies you without your written authorization. You may revoke any written authorization in writing at any time.
C. Your health information rights
1. Right to request special privacy protections
You have the right to request restrictions on how we use and disclose your information by sending us a written request specifying the desired limitations. If you request that we not disclose information to your health plan for a service you paid for in full out of pocket, we will honor the request unless disclosure is required for treatment or by law.
2. Right to request confidential communications
You have the right to request that we communicate with you in a specific way or at a specific location. Written requests for reasonable alternatives will be honored.
3. Right to inspect and copy
You have the right to inspect and copy your health information, with limited exceptions. Please submit a written request detailing the information you wish to inspect or copy, the preferred format, and whether copies should be sent to a designated person. Reasonable fees for labor, supplies, and postage may apply.
4. Right to amend or supplement
You have the right to request that we amend your health information if you believe it is inaccurate or incomplete. Written requests must include your reasons. We are not required to make the change, and if we deny the request we will provide the reason and our disagreement procedures.
5. Right to an accounting of disclosures
You have the right to receive an accounting of certain disclosures of your health information, with the exceptions described above.
6. Right to a paper or electronic copy of this notice
You have the right to a paper copy of this Notice even if you previously agreed to receive it electronically. Contact the Privacy Officer at the phone number above to request a copy.
D. Changes to this Notice of Privacy Practices
We reserve the right to amend this Notice at any time. The amended notice will apply to all protected health information we maintain. Current copies are posted in the reception area and on our website.
E. Complaints
Complaints about this Notice or how we handle your health information should be directed to our Privacy Officer. You may also file a formal complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at hhs.gov/hipaa/filing-a-complaint. You will not be penalized in any way for filing a complaint.