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Patient Privacy Information

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

If you consent, Chest Medicine Associates is permitted by federal privacy laws to make uses and disclosures of your protected health information for purposes of treatment, payment, and health care operations.  Protected health information is the information we create and and obtain in providing our services to you.  Such information may include documenting your symptoms, examination and test results, diagnoses, treatment and applying for future care or treatment.  It also includes billing documents for those services.

Examples of Uses of Your Health Information for Treatment Purposes:

Nurse obtains treatment information about you and records it in a health record.  After your appointment with the physician, the physician may call the primary care physician to report his findings and suggestions for treatment.

Example of Use of Your Health Information for Payment Purposes:

Chest Medicine Associates submits requests for payment to your health insurance company.  The health insurance company requests information from us regarding your medical care given.  We provide them with information regarding the treatment given to get paid for our services.

Example of Use of Your Information for Healthcare Operations:

We may obtain services from business associates such as quality improvement, protocol and clinical guidelines development, training programs, credentialing, medical review, legal services, and insurance.  We share information about you as necessary to obtain these services.

Your Health Information Rights:

The health and billing records we maintain are the physical property of Chest Medicine Associates.  You have the following rights with respect to your Protected Health Information.

Request a restriction on certain uses and disclosures of your health information in writing to our office.  We are not required to grant the request but will comply with any request granted.

Right to inspect and copy your health and billing record.  You may deliver the request in writing to our main location on Newburg Road in Louisville Kentucky.

In the event the request for access is denied, you have the right to appeal to the Compliance Officer.

Right to request your health care record be amended to correct incomplete or incorrect information by delivering a written request to our main location using the form provided upon request.  Chest Medicine Associates is not required to make such amendments:  you may file a statement of disagreement if your amendment is denied, and require that the request for amendment and any denial be attached in all future disclosures of your protected health information.

Right to receive an accounting of disclosures of your health information as required to be maintained by law by delivering a written request to our main location using the form we provide upon request.  An accounting will not include internal uses of information for treatment, payment, or operations, disclosures made to your or made at your request, or disclosures made to family members or friends in the course of providing care.

Right to confidential communication by requesting that communication of your health information is made by alternative means or at an alternative location by delivering the request in writing to our main location using the form we provide upon request.

If you want to exercise any of the above rights, please contact the Compliance Officer of Chest Medicine Associates in person or in writing during normal business hours at the main location. The Compliance Officer will provide you with assistance on the steps to take to exercise your rights.

YOUR HAVE THE RIGHT TO REVIEW THIS NOTICE BEFORE SIGNING THE CONSENT AUTHORIZING USE AND DISCLOSURE OF YOUR PROTECTED HEALTH INFORMATION FOR TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS PURPOSES.

Chest Medicine Associates Responsibilities to Our Patients:

  • Maintain the privacy of your health information as required by law;
  • Provide you with a notice as to our duties and privacy practices as to the information we collect and maintain;
  • Abide by the terms of this Notice;
  • Notify you if we cannot accommodate a requested restriction or request; and
  • Accommodate your reasonable requests regarding Methods to communicate health information with you.
  • Accommodate your request for an accounting of disclosures.

Chest Medicine Associates reserves the right to amend, change, or eliminate provisions in our privacy practices and access practices and to enact new provisions regarding the protected health information we maintain.  If our information practices changes, we will amend our Notice.  You are entitled to receive a revised copy of the Notice by calling and requesting a copy or by visiting our office and picking up a coy.

To Request Information or File a Complaint:

If you have questions, need additional information, or want to report a problem regarding the handling of your information, you may contact the Compliance Officer at Chest Medicine Associates.

Additionally, if you believe your privacy rights have been violated, you may file a written complaint to our office to the Compliance Officer.  You may also file a complaint by mailing it to the Secretary of Health and Human Services.

WE CANNOT AND WILL NOT REQUIRE YOU TO WAIVE THE RIGHT TO FILE A COMPLAINT WITH THE SECRETARY OF HEALTH AND HUMAN SERVICES (HHS) AS A CONDITION OF RECEIVING TREATMENT FROM THIS OFFICE.

WE CANNOT AND WILL NOT RETALIATE AGAINST YOU FOR FILING A COMPLAINT WITH THE SECRETARY OF HEALTH AND HUMAN SERVICES (HHS).

Other Disclosures:

Patient Contact:  We may contact you with appointment reminders, with information about treatment alternatives, or with information about other health-related benefits and services that may be of interest to you.

Communication with Family:  Using our best judgment, we may disclose to a family member, other relative, close personal friend, or any other person you identify, health information relevant to that person’s involvement in your care or in payment for such care if you do not object or in an emergency.

Unless you object, we may use or disclose your protected health information to notify, or assist in notifying a family member, personal representative, or other person responsible for your care, about your location, and about your general condition, or your death.

Required by law: We may be required by law to report suspected abuse or neglect, or similar injuries and events.

Public Health Activities:  As required by law, we may disclose vital statistics, diseases, or information related to recalls of dangerous products to public health authorities, and similar information.

Health Oversight Agencies:  We may be required to release your information to assist in investigations and audits, eligibility for government programs, and other reasons related to the administration of healthcare.

Judicial/Administrative Proceedings:  We may disclose information in response to a subpoena, discovery request, or other lawful purpose.

Law Enforcement:  We may disclose your protected health information when required by court order, or when law requires reporting of wounds or other physical injury.

Deaths:  we may report information regarding deaths to coroners, medical examiners, and funeral directors.

Research:  We may use or disclose information for approved medical research.

Threat to Health and Safety:  To avert a serious treat to health or safety, we may disclose your information consistent with applicable laws.

Government Function:  We may disclose your information as authorized by law for national security purposes, Armed Forces personnel, or public assistance program personnel.

Workers Compensation:  We may disclose your protected health information to the extent necessary to comply with laws relating to Workers Compensation.

Other Uses and Disclosures:  For any disclosure not mentioned, we will ask for your written authorization before using or disclosing any identifiable health information about you.  Any authorized disclosure may be evoked for any future uses and disclosures.