Privacy
HIPAA Notice of Privacy Practices for Pediatric Pulmonary Associates. P.A.
601 5th St. South
Suite 708
St. Petersburg, FL 33701
(727) 767-4146
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. If you have any questions about this notice, please
contact our Privacy Officer who is Judith Martin. This notice is
effective April 14, 2003.
Following is a statement of your rights with respect to your PHI and a brief description of how you may exercise these rights. Although your health record is the physical property of our practice, the information belongs to you.
You have the right to obtain a paper copy of this notice from us, upon
request. You may obtain a copy by signing a release. We
reserve the right to deny you access to, and copies of, certain personal
health information as permitted, or required by law. Upon denial
of a request for access or request for information, we will provide you
with a written denial specifying the legal basis for denial.
Additionally, we may substitute a summary of the records in lieu of
actual records.
We are required by law to provide you with this notice that explains our
privacy practices with regard to your medical information and how we may
use and disclose your protected health information (PHI) for treatment,
payment, and for health care operations, as well as for other purposes
that are permitted or required by law. You have certain rights regarding
the privacy of your protected health information (PHI) and they will be
described in this notice.
Treatment: We will use and disclose your PHI to provide, coordinate, or
manage your health care and any related services. We will also disclose
PHI to other physicians who may be treating you. In addition, we may
disclose your PHI from time-to-time to another physician who we have
requested to be involved in your care. For example, we would disclose
your health information to a specialist to whom we have referred you for
a diagnosis to help in your treatment. We have an Organized Health Care
Arrangement with the hospitals we participate with to provide you with
their Notice of Privacy Practices if you are sent for testing or
admission to the hospital. We are concerned that the provision of
multiple notices to the patients while in the hospital setting could be
confusing.
Payment: Your PHI will be used, as needed, to obtain payment for your
health care services. For example, obtaining approval for a hospital
stay may require that your relevant PHI be disclosed to the health plan
to obtain approval for the hospital admission.
Healthcare Operations: We may use or disclose your PHI in order to
support the business activities of our practice. These activities might
include quality assessment activities, employee review activities, and
training of medical students; using a sign-in sheet at the registration
desk and calling you by name in the waiting room when our physician is
ready to see your child. We may use or disclose your PHI to contact you
to remind you of your appointment through our HouseCalls automated
software service.
We may share your PHI with third party "business associates" that
perform various activities (e.g., billing, transcription services) for
the practice. Whenever an arrangement between our office and a business
associate involves the use or disclosure of your PHI, we will have a
written contract that contains terms that will protect the privacy of
your PHI.
We may use or disclose your PHI, as necessary, to provide you with
information about treatment alternatives or other health-related
benefits and services that may be of interest to you.
Other Permitted and Required Uses and Disclosures That May Be Made With
Your Consent or Opportunity to Object:
We may use and disclose your PHI in the following instances. You have
the opportunity to agree or object to the use or disclosure of all or
part of your PHI. If you are not present or able to agree or object to
the use or disclosure of the PHI, then your physician may, using
professional judgment, determine whether the disclosure is in your best
interest. In this case, only the protected health information that is
relevant to your health care will be disclosed.
Others Involved in Your Healthcare: We may disclose to a relative, a
close friend or any other person you identify, protected health
information that directly relates to that person's involvement in the
patient's health care. If you are not present or able to agree or object
to such a disclosure, then your physician will determine whether it is
in the patient's best interest, using our professional judgment, to
disclose only the protected health information that is relevant to the
patient's health care.
Emergencies: We may use or disclose your PHI in an emergency treatment
situation. If this happens, our office shall try to obtain your consent
as soon as reasonably practicable after the delivery of treatment.
Other Permitted and Required Uses and Disclosures That May Be Made
Without Your Consent, Authorization or Opportunity to Object: We may use
or disclose your PHI in the following situations without your consent:
Public Heath: As required by law, we may disclose your health
information to public heath or legal authorities charged with preventing
or controlling disease, injury, or disability.
Abuse or Neglect: We may disclose your PHI to a public health authority
that is authorized by law to receive reports of child abuse or neglect.
In addition, we may disclose your PHI if we believe that there has been
a victim of abuse or neglect to the agency or governmental entity
authorized to receive such information. In this case, the disclosure
will be made consistent with the requirements of applicable federal and
state laws.
Required By Law: We may use or disclose your PHI for law enforcement
purposes or to the extent that law requires the use or disclosure. The
use or disclosure will be made in compliance with the law and will be
limited to the relevant requirements of the law. You will be notified,
as required by law, of any such uses or disclosures.
Legal Proceedings: We may disclose PHI in the course of any judicial or
administrative proceeding, in response to an order of a court or
administrative tribunal (to the extent such disclosure is expressly
authorized), in certain conditions in response to a subpoena, discovery
request or other lawful process. We may also disclose PHI in the defense
of medical professional liability claims asserted by patients.
Research:: We may disclose your PHI to researchers when their research
has been approved by an institutional review board that has reviewed the
research proposal and established protocols to ensure the privacy of
your protected health information
YOUR RIGHTS
Following is a statement of your rights with respect to your PHI and a
brief description of how you may exercise these rights. Although your
health record is the physical property of our practice, the information
belongs to you.
You have the right to obtain a paper copy of this notice from us, upon
request. You may obtain a copy by asking our receptionist.
You have the right to inspect and receive a copy of the PHI that we
maintain about you in our medical chart, for as long as we maintain this
record. The record includes your medical and billing records as well as
any other records we use for making decisions about you, such as test
results. We may charge you a fee for the costs of copying, mailing or
for other supplies used in fulfilling your request.
If you wish to inspect or receive a copy of your medical information,
you must submit your request in writing to our practice manager, Judith
Martin c/o Pediatric Pulmonary Associates, 601 5th Street South, Suite
708, St. Petersburg, FL 33701. You may mail in
your request, or bring it to our office. We will have 30 days to respond
to your request for information that we maintain at our practice site.
If the information is stored off site, we are allowed up to 60 days to
respond but must inform you of this delay.
You have the right to request that we amend your medical information if
you feel that it is incomplete or inaccurate. You must make this request
in writing to our practice manager, stating exactly what information is
incomplete or inaccurate and your reasoning that supports your request.
We are permitted to deny your request if it is not in writing or does
not include a reason to support the request. We may also deny your
request if the information was not created by us, or the person who
created it, is no longer available to make the amendment, or if our
physicians opinion that the information is accurate and complete.
You have the right to request a restriction or limitation of how we use
or disclose your PHI for treatment, payment, or health care operations.
Your request must be made in writing to our practice manager. We are not
required to agree to your request if we feel it is in your best interest
to use or disclose that information. However, if we do agree, we will
comply with your request unless this information is needed for emergency
treatment.
You have the right to request a list of the disclosures of your health
information that we have made outside of our practice that were not for
treatment, or payment of health care operations. Your request must be
made in writing and must state the time period for the requested
information. You may not request information for any dates prior to
April 14, 2003, which is the compliance date for this federal
regulation.
You have the right to request how we communicate with you to preserve
your privacy; for example, you may request that we call you only at your
work number or by mail at a special address. Your request must be made
in writing and must be specific. We will accommodate all reasonable
requests.
If you believe that we have violated your medical information privacy
rights, you have the right to file a complaint with our manager or
directly to the Secretary of Health and Human Services. To file a
complaint with our Manager, you must make it in writing within 180 days
of the suspected violation. Provide as much detail as you can and send
it to Judith Martin, c/o Pediatric Pulmonary Associates. PPA, 601 5th So Street
South, Suite 708, St. Petersburg, FL 33701. There will be no retaliation
for your filing a complaint.
Uses and disclosures of your health information not covered by this
notice or the laws that apply to us may only be made with your
written authorization. You may revoke such authorization in writing at
any time and we will no longer disclose health information about you for
the reasons stated in your authorization.
