Paul N. Uhlig,  MD, MPA, FACS

      Central plains cardiothoracic surgery LLC

                                                                                                 

 

NOTICE OF PRIVACY PRACTICES

 

 

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

Effective Date of This Notice:  September 1, 2007

 

If you have questions about any part of this notice or if you want more information about our privacy practices please contact:

 

Privacy Officer

Central Plains Cardiothoracic Surgery, L.L.C.

551 N. Hillside S-520

Wichita, KS 67214

(316) 858-0186 Phone

(316) 239-6747 Fax

 

 

We are committed to protecting the confidentiality of health information about you.  We collect health information from you and store it in a chart and on the computer creating a record of the care and services you receive in our facility.  We need this record to provide you with quality care and to comply with certain legal requirements.  We may obtain this information directly from you, such as information provided to us on your general exam/family history form or patient information form.  Information may also be collected from third parties, such as your insurance carrier, your employer (especially for workman’s compensation) and from any and all doctors, individuals, hospitals, labs or pharmacies for which you give permission, either in writing or verbally.  This also includes billing documents for those services.  This notice informs you of the ways in which we may use and disclose this health information about you.

 

We are required by law to maintain the privacy of your health information, give you this notice of our privacy practices and make a good faith effort to obtain your acknowledgement of receipt of this notice.  We must also follow the terms of the notice that is currently in effect.

 

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

 

The law permits us to use or disclose your health information for the following purposes without written consent from you:

 

Treatment.  We may use your health information to provide you with medical treatment or services.  We may disclose health information about you to doctors, nurses, technicians, medical students, or other office personnel who are involved in taking care of you.  Different departments in our office may share your health information in order to coordinate different treatments you may need, such as prescriptions, lab work and X-rays.  We also may disclose your health information to other health care providers who request such information for purposes of providing medical treatment to you.

 

We may use or disclose your health information in an emergency treatment situation.  If this happens, your physician will try to obtain your consent as soon as reasonably practical after the deliver of treatment.  If your physician or other provider is unable to obtain your consent, he or she may still use or disclose your health information to treat you.

 

Payment.   We may use and disclose your health information so the treatment and services you receive may be billed to and payment may be collected from you, your insurance company or other third party.  We submit requests for payment to your health insurance company.  The health insurance company will require information from us regarding medical care given.  We will provide information to them about you and the care given.  We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

 

Health Care Operations.   We may disclose, as needed, your protected health information in order to support the business activities of our practice.  These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical students, licensing activities, and conducting or arranging for other business activities.

 

OTHER POSSIBLE USES AND DISCLOSURES

 

Appointment Reminders/Messages.  We may use and disclose protected health information to contact you as a reminder that you have an appointment for treatment or medical care.  Unless you request otherwise, we may leave a message on an answering machine or with another person who may answer the phone identifying our office and asking you to return the call.

 

Health Related Benefits and Services.  We may use and disclose health information to tell you about health-related benefits, services or possible alternatives that may be of interest to you, or to provide you with promotional gifts of nominal value.

 

Individuals Involved in Your Care or Payment for Your Care.  We may release your health information to a friend or family member who is involved in your medical care or who helps pay for your care.  We may also disclose your health information to an organization assisting in a disaster relief effort so that your family can be notified about your condition, status, and location.  If you are able and available to agree or object, we will give you the opportunity prior to making notification.  If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.

 

Business Associates.  Some services in our organization may involve contracts or arrangements with business associates.  When these services are contracted, we may disclose your health information to our business associate so they can perform the job we’ve asked them to do.  To protect your health information, we require our business associates to appropriately safeguard your information.

 

Public Health Risks.  As authorized by law, we may disclose your protected health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability; to report reactions to medications or problems with products; to notify people of recalls; to report births and deaths; to notify a person who may have been exposed to a disease or who is at risk for contracting or spreading a disease or condition.

 

Abuse and Neglect. We may disclose your protected health information to public authorities as allowed by law to report child abuse or neglect or domestic violence.

 

Public Safety.  We may disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety to you, another person or the general public.  Any disclosure would only be to a person able to help prevent the threat.

 

Health Oversight Activities.  We may disclose health information about you to a health oversight agency for activities authorized by law.  These oversight activities may include, audits, investigations, inspections, licensure and other proceedings.

 

Food and Drug Administration.  We may disclose your health information to a person or company required by the FDA to report adverse events, problems with products and reactions to medications, product defects or problems, biologic product deviations, to track products, to enable product recalls, to make repairs or replacements, or to conduct post marketing surveillance, as necessary.

 

Lawsuits and Disputes.  We may disclose your health information in response to a court or administrative order.  We may also disclose your health information in response to a court order.

 

Inmates.  If you are an inmate of a correctional facility or under the custody of law enforcement official, we may disclose the health information necessary for your health and the health and safety of others.

 

Serious Threat.  Consistent with applicable federal and state laws, we may disclose your health information if we believe the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.

 

Deceased Person Information.  We may disclose your health information to coroners or medical examiners for identification purposes, determining the cause of death or for the coroner or medical examiner to perform other duties authorized by law.  We may also disclose your health information to a funeral director, as authorized by law, in order to permit the funeral director to carry out their duties.

 

Organ and Tissue Donation.  If you are an organ donor, we may use or disclose your health information to organizations involved in procuring, banking or transplanting organs and tissues, as necessary to facilitate organ or tissue donation and transplantation.

 

Specialized Governmental Functions.  We may disclose health information for specialized government functions as authorized by law such as to Armed Forces personnel, for national security purposes, or to public assistance program personnel.

 

Workers Compensation.  We may release health information about you if you are seeking compensation through workers compensation, or similar programs, as necessary to comply with laws relating to workers compensation.

 

Research.  We may use and disclose health information about you for research purposes.  For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another, for the same condition.  All research projects, however, are subject to a special approval process.

 

Surveys.  We may use and disclose health information about you to contact you to assess your satisfaction with our services.

 

Employers.  We may release your health information to your employer if we provide health care services to you at the request of your employer, and the health care services are provided either to conduct an evaluation relating to medical surveillance of the workplace or to evaluate whether you have a work related illness or injury.  In such circumstances, we will give you written notice of such release upon request.  Any other disclosures to your employer will be made only if you execute a specific authorization for the release of that information to your employer.

 

Fundraising Activities.  We may use your health information to contact you to participate in fund-raising activities for our organization.  We may disclose your health information to a foundation related to our office so they may contact you for raising money for our office.  We will only release information such as, your name, address, phone number, and dates you received treatment or services at our office.  If you do not want our office contacting you for fundraising efforts you must notify our office.

 

OTHER USES OF HEALTH INFORMATION

We will disclose your health information when required to do so by federal, state, or local law.

Other uses and disclosures of health information not covered by this notice will be made only with your written authorization.  If you provide us an authorization to use or disclose your health information you may revoke that authorization, in writing, at any time.  If you revoke your authorization, we will no longer use or disclose health information about you for the reasons covered by your written authorization.  We are unable to take back any disclosures previously made with your permission.

 

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

 

Right to Inspect and Copy.  You have the right to inspect and copy health information that may be used to make decisions about your care.  Typically this includes medical and billing records, but does not include psychotherapy notes, info