Notice of Privacy Practices
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. THE PRIVACY OF YOUR MEDICAL INFORMATION IS IMPORTANT TO US. THIS INFORMATION IS REQUIRED BY LAW TO BE ON OUR WEBSITE
We are required by law to maintain the privacy of your health information. We are also required to give you this Notice about our privacy practices, our legal obligations, and your rights concerning your health information. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect April 14, 2003, and will remain in effect until we replace it. We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law.
We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all health information we maintain, including health information we created or received before we made the changes. Before we make a significant change in our privacy practices, we will change this Notice and make the new Notice available to you when you first receive services from us after the date the revised Notice becomes effective or upon request. You may request a copy of our Notice at any time. For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice.
USES AND DISCLOSURES OF HEALTH INFORMATION
We use and disclose health information about you for our treatment, payment, and health care operations. For example:
TREATMENT: We may use or disclose your health information to a physician or other health care provider providing treatment to you.
PAYMENT: We may use or disclose your health information to your health insurer to obtain payment for services we provide to you.
HEALTH CARE OPERATIONS: We may use and disclose your health information in connection with our health care operations. Health care operations include quality assessment and improvement activities, reviewing the competence or qualifications of health care professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities. For example, we may use or disclose your health information in order to conduct an internal assessment of the quality of care we provide.
PERSONS INVOLVED IN CARE: We may use or disclose health information to notify, or assist in the notification of (including identifying or locating) a family member, your personal representative or another person responsible for your care, to the extent necessary to help with your health care or with payment of your health care, if you agree that we may do so. We may also advise these persons of your location, your general condition, or death. If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to such uses or disclosures. In the event of your incapacity or emergency circumstances, we will disclose health information that is directly relevant to the person’s involvement in your health care. We will also use our professional judgement and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up filled prescriptions, medical supplies, x-rays, or other similiar forms of health information.
DISCLOSURES PERMITTED OR REQUIRED BY LAW: We are permitted and in some cases required, by law to make certain other disclosures of health information without your consent. We may disclose your health information, if appropriate, to the following entities under the following circumstances:
1. To public health agencies to satisfy certain reporting requirements, such as births and deaths, certain
communicable diseases, child abuse and other public health issue;
2. To health oversight agencies such as governmental auditors, the Florida Agency for Health Care
Administration, the Florida Department of Health and other agencies when required;
3. To any individual when we are ordered by a court or other legal process to do so;
4. To law enforcement officials when necessary for law enforcement purposes and required by law;
5. To a coroner or medical examiner when necessary to enable them to perform their duties;
6. To organ procurement organizations, to enable them to make suitably determination;
7. In cases of emergency; or
8. To researchers if their research has been approved by an institutional review board and they take certain
steps to protect your privacy.
APPOINTMENT REMINDERS: We may use or disclose your health information to provide you with appointment reminders (such as a voicemail message, postcard, or letter) or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
MARKETING HEALTH-RELATED SERVICES: We will not use your health information for marketing communications without your written authorization.
YOUR AUTHORIZATION: Other uses and disclosures of your health information will be made if you give us written authorization to do so. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Unless you give us a written authorization, we cannot use or disclose your health information for any reason except those described in this Notice:
You have certain rights regarding your health information. These rights include:
1. The right to obtain a paper copy of this Notice;
2. The right to inspect and copy your health information (copies are available for a reasonable fee);
3. The right to request amendments to your health information you believe to be inaccurate;
4. The right to obtain an accounting of our uses and disclosures of your health information, subject to
5. The right to request restrictions on our permitted uses and disclosures of your information (although
we are not legally obligated to honor this request); and
6. The right to request that communications regarding your health information be sent by alternative
means or at alternative locations.
QUESTIONS AND COMPLAINTS
If you want more information about our privacy practices or have questions or concerns, please contact us. If you are concerned that we may have violated your privacy rights or wish to exercise any of your rights described herein, please contact using the contact information listed at the end of this Notice. You also may submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request. We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services. Our HIPPA contact is: Tel: (321)449-0033 Fax (321)449-0012