NOTICE OF PRIVACY PRACTICESTHIS 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.
Original Effective Date: April 14, 2003
Last Updated: April 14, 2003
A federal regulation, known as the "HIPAA Privacy Rule,"
requires that we provide detailed notice in writing of our
privacy practices. This Notice is long. The HIPAA Privacy
Rule requires us to provide you with information on many
things.
I. OUR COMMITMENT TO PROTECTING HEALTH
INFORMATION ABOUT YOU
In this Notice, we describe the ways that we may use and
disclose health information about our patients. The HIPAA
Privacy Rule requires that we protect the privacy of health
information about you and that can be used to identify you.
This information is called "protected health information"
or "PHI." In addition to the protections under
HIPAA, North Carolina Law and other Federal law may also
provide additional protections of health information about
you in some circumstances. This Notice describes your rights
as our patient and our obligations regarding the use and
disclosure of PHI under HIPAA and other applicable laws.
We are required by law to:
• Maintain the privacy
of PHI about you;
• Give you this Notice of our
legal duties and privacy practices with respect to PHI;
and
• Comply with the terms of our Notice of Privacy Practices
that is currently in effect.
As permitted by the HIPAA Privacy Rule, we reserve the right
to make changes to this Notice and to make such changes
effective for all PHI we may already have about you. If
and when this Notice is changed, we will post a copy in
our facility in a prominent location. We will also provide
you with a copy of the revised Notice upon your request
made to our Privacy Office.
You will be asked to sign a form that you received this
Notice. Even if you do not sign this form, we will still
provide you treatment.
II. HOW WE MAY USE AND DISCLOSE PROTECTED
HEALTH INFORMATION ABOUT YOU
A. Uses and Disclosures to You, to Your
Personal Representative, and for Treatment, Payment, and
Health Care Operations
Subject to other laws that we discuss later in this Notice,
the following categories describe the different ways we
may use and disclose PHI to you, to your personal representative,
and for treatment, payment, or health care operations without
your authorization. The examples included in each category
do not list every type of use or disclosure that may fall
within that category.
Disclosures to You: We may disclose
PHI about you to you.
Disclosures to Your Personal Representative:
We may make disclosures to your personal representative.
Your personal representative is someone who has the authority
under state law to act on your behalf in making decisions
related to your health care. For example, if you are deceased,
your personal representative would be the person who has
the authority under state law to act on your behalf or on
behalf of your estate.
If you are a minor, your personal representative will be
a parent, guardian, or person acting in the place of a parent
who has the authority under state law to make decisions
related to your healthcare. However, we may only disclose
to your parent, guardian, or person acting in the place
of a parent where disclosure is permitted or required by
state law. For example, under North Carolina law, we generally
cannot disclose to the parent of a minor information related
to the treatment of the minor that was provided on the minor’s
own consent.
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