HIPAA 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. THIS NOTICE APPLIES TO ALL OF THE RECORDS OF YOUR CARE GENERATED BY STEVEN C. JACKS, D.D.S., INC. OR AN ASSOCIATED FACILITY.
This notice describes Dr. Jacks‘ policies, which extend to:
Any health care professional authorized to enter information into your chart (including physicians, PAs, RNs, etc.);
- All areas of the office of Dr. Jacks (front desk, administration, billing and collection, etc.);
- All employees, staff and other personnel that work for or with Dr. Jacks;
- Our business associates (including facilities to which we refer patients), on-call physicians, etc.
Dr. Jacks provides this Notice to comply with the Privacy Regulations issued by the Department of Health and Human Services in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
OUR THOUGHTS ABOUT YOUR PROTECTED HEALTH INFORMATION:
We understand that your medical information is personal to you, and we are committed to protecting the information about you. As our patient, we create paper and electronic medical records about your health, our care for you, and the services and/or items we provide to you as our patient. We need this record to provide for your care and to comply with certain legal requirements.
We are required by law to:
Make sure that the protected health information about you is kept private;
- Provide you with a Notice of our Privacy Practices and your legal rights with respect to protected health information about you;
- Follow the conditions of the Notice that is currently in effect.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU:
The following categories describe different ways that we use and disclose protected health information that we have and share with others. Each category of uses or disclosures provides a general explanation and provides some examples of uses. Not every use or disclosure in a category is either listed or actually in place. The explanation is provided for your general information only.
Medical Treatment – We use previously given medical information about you to provide you with current or prospective medical treatment or services. Therefore we may, and most likely will, disclose medical information about you to doctors, nurses, technicians, medical students or hospital personnel who are involved in taking care of you. For example, a doctor to whom we refer you for ongoing or further care may need your medical records. Different areas of Dr. Jacks‘ office also may share medical information about you including your records, prescriptions, request of lab work and x-rays. We may also discuss your medical information with you to recommend possible treatment options or alternatives that may be of interest to you. We may also disclose medical information about you to people outside the office of Dr. Jacks who may be involved in your medical care after you leave the office of Dr. Jacks; this may include your family members, or other personal representative authorized by you or by legal mandate (a guardian or other person who has been named to handle your medical decisions, should you become incompetent.)
Payment – We may use and disclose and disclose medical information about you for services and procedures so they may be billed and collected from you, an insurance company, or other third party. For example, we may need to give your health care information about treatment you received at the office of Dr. Jacks, to obtain payment or reimbursement for the care. We may also tell your health plan and/or referring physician about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment, to facilitate payment of a referring physician, or the like.
Health Care Operations – We may use and disclose medical information about you so that we can run our office more efficiently and make sure that all of our patients receive quality care. These uses may include reviewing our treatment and services to evaluate the performance of our staff, deciding what additional services to offer and where, deciding what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, medical students, and other personnel for review and learning purposes. We may also combine the medical information we have with medical information from other offices to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that identifies you from this set of medical information so others may use it to study health care and health care delivery without learning who the specific patients are.
We may also use or disclose information about you for internal or external utilization review and/or quality assurance, to business associates for purposes of helping us to comply with our legal requirements, to auditors to verify our records to billing companies and aid us in this process and the like. We shall endeavor at all times when business associates are used, to advise them of their continued obligation to maintain the privacy of your medical records.
Appointment and Patient Recall Reminders – We may ask that you sign in writing at the Reception Desk, a “Sign In” log on the day of your appointment with Dr. Jacks or that you are due to receive periodic care from Dr. Jacks; This contact may be by phone, in writing, via e-mail, or otherwise which could (potentially) be received or intercepted by others.
Emergency Situations – In addition, we may disclose medical information about you to an organization assisting in a disaster relief effort or in an emergency situation so that your family can be notified about your condition, status and location.
Research – Under certain circumstances, we may use and disclose medical information about you for research purposes regarding medications, efficiency of treatment protocols and the like. All research projects are subject to an approval process, which evaluates a proposed research project and its use of medical information. Before we use or disclose medical information for research, the project will have been approved through this research approval process. We will obtain an Authorization from you before using or disclosing your individually identifiable health information unless the authorization requirement has been waived. If possible, we will make the information non-identifiable to a specific patient. If the information has been sufficiently de-identified, an authorization for the use or disclosure is not required.
Required by Law – We will disclose medical information about you when required to do so by federal, state or local law.
To Avert a Serious Threat to Health or Safety – We may use and disclose medical information about you when necessary to prevent a serious threat either to your specific health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
Organ and Tissue Donation – If you are an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.