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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. |
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| INTRODUCTION |
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| We
maintain protocols to ensure the security
and confidentiality of your personal
information. We have physical security
in our building, passwords to protect
databases, compliance audits, and virus/intrusion
detection software. Within our practice
access to your information is limited
to those who need it to perform their
jobs. |
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| At
our practice, we are committed to treating
and using protected health information
about you responsibly. This Notice of
Privacy Policies 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 protected health information.
This Notice is effective April 14, 2003,
and applies to all protected health
information as defined by federal regulations. |
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| UNDERSTANDING
YOUR HEALTH RECORD |
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| Each
time you visit our 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: |
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Basis
for planning your care and treatment. |
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Means
of communication among the many
health professionals who contribute
to your care. |
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Legal
document describing the care you
received. |
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Means
by which you or a third-party
payer can verify that services
billed were actually provided. |
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Tools
in educating health professionals. |
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Source
of data for medical research. |
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Source
of information for public health
officials charged to improve the
health of the state and nation. |
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Tool
by which we can assess and continually
work to improve the care we render
and outcomes we achieve. |
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| Understanding
what is 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. |
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| YOUR
HEALTH INFORMATION RIGHTS |
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| Although
your health record is the physical property
of our practice, the information belongs
to you. You have the right to: |
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Obtain
a paper copy of this notice of
privacy policies upon request. |
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Inspect
and copy your health record. |
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Request
to amend your health record. |
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Obtain
an accounting of disclosures of
your health information. |
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Request
confidential communications of
your health information. |
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Request
restriction on certain uses and
disclosures of your information.
Our practice, however, is not
required by law to agree to a
requested restriction. |
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| OUR
RESPONSIBILITIES |
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| Our
practice is required to: |
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Maintain
the privacy of your health information. |
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Provide
you with this notice as to our
legal duties and privacy practices
with respect to information we
collect and maintain about you. |
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Abide
by the terms of this notice. |
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Notify
you if we are unable to agree
to a requested restriction. |
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Accommodate
reasonable requests you may have
to communicate your health information. |
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| We
reserve the right to change our practices
and to make the new provisions effective
for all protected health information
we maintain. We will keep a posted copy
of the most current notice in our facility
containing the effective date in the
top, right-hand corner. In addition,
each time you visit our facility for
treatment, you may obtain a copy of
the current notice in effect upon request. |
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| We
will not use or disclose your health
information in a manner other than described
in the section regarding Examples Of
Disclosures For Treatment, Payment,
and Health Operations, without your
written authorization, which you may
revoke, except to the extent that action
has already been taken. |
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| EXAMPLES
OF DISCLOSURES FOR TREATMENT, PAYMENT AND HEALTH OPERATIONS |
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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 expectations of the members of your health care team. Members
of your health care team will then record the actions they took
and their observations. In that way, the physician will know
how you are responding to treatment.
We will also provide your other physician(s) or subsequent health
care provider(s) (when applicable) with copies of various reports
that should assist them 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.
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| FOR
MORE INFORMATION, OR TO REPORT A PROBLEM |
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| For more
information about our privacy practices, please contact: |
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Peggy
Dobish, Administrator
211 W. 33rd Street
Kearney, NE 68845
308-865-2141 |
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| EFFECTIVE
DATE |
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