EXIGENT NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU (AS A PATIENT OF THIS PRACTICE) MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW THIS NOTICE CAREFULLY.
A. OUR COMMITMENT TO YOUR PRIVACY
Our practice is dedicated to maintaining the privacy of your individually identifiable health information (IIHI). In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We also are required by law to provide you with this notice of our legal duties and the privacy practices that we maintain in our practice concerning your IIHI. By federal and state law, we must follow the terms of the notice of privacy practices that we have in effect at the time.
We realize that these laws are complicated, but we must provide you with the following important information:
- How we may use and disclose your IIHI
- Your privacy rights in your IIHI
- Our obligations concerning the use and disclosure of your IIHI
The terms of this notice apply to all records containing your IIHI that are created or retained by our practice. We reserve the right to revise or amend this Notice of Privacy Practices. Any revision or amendment to this notice will be effective for all of your records that our practice has created or maintained in the past, and for any of your records that we may create or maintain in the future. Our practice will post a copy of our current Notice in our office in a visible location at all times, and you may request a copy of our most current Notice at any time.
B. IF YOU HAVE QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT:
Joan Lark, Exigent Privacy Information Officer, at (864) 292-5915.
C. WE MAY USE AND DISCLOSE YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION (IIHI) IN THE FOLLOWING WAYS:
The following categories describe the different ways in which we may use and disclose your IIHI.
1. Treatment. Our practice may use your IIHI to treat you. For example, we may ask you to have laboratory tests (such as blood tests) and we may use the results to help us reach a diagnosis. We might use your IIHI in order to write a prescription for you, or we might disclose your IIHI to a pharmacy when we order a prescription for you. Many of the people who work for our practice including, but not limited to, our doctors and nurses, may use or disclose your IIHI in order to treat you or to assist in your care, such as your spouse, children or parents.
Here is how your health record might be used for treatment reasons:
- We may send your record to a specialist your doctors here may want to consult or refer you to.
- Your record may be sent to a doctor to whom you have been referred.
- We would share your record with a facility you are being transferred to or one that you are considering transfer to once you leave Exigent.
- We may use or release your health record to provide material on treatment options.
2. Payment. Our practice may use and disclose your IIHI in order to bill and collect payment for the services and items you may receive from us. For example, we may contact your health insurer to certify that you are eligible for benefits (and for what range of benefits), and we may provide your insurer with details regarding your treatment to determine if your insurer will cover, or pay for, your treatment. We also may use and disclose your IIHI to obtain payment from third parties that may be responsible for such costs, such as family members. Also, we may use your IIHI to bill you directly for services and items.
Here is how your health record might be used for payment purposes.
- We may call your health plan for pre-approval of a service.
- We may give your health plan details about your treatment, so it will pay us or reimburse you.
- If someone else is responsible for your payment, we may call that person.
3. Health Care Operations:Our practice may use and disclose your IIHI to operate our business. An example of the ways in which we may use and disclose your information for our operations, our practice may use your IIHI to evaluate the quality of care you received from us or to conduct cost-management and business planning activities for our practice.
4. Appointment Reminders: Our practice may use and disclose your IIHI to contact you and remind of an appointment or referral.
5. Treatment Options: Our practice may use and disclose your IIHI to inform you of potential treatment options or alternatives.
6. Health Related Benefits and Services: Our practice may use or disclose your IIHI to inform you of health related benefits or services that may be of interest to you.
7. Release of Information to Family/Friends: Our practice may release your IIHI to a friend or family member that is involved in your care or who assists in taking care of you. For example, a parent or guardian may ask that a babysitter take a child to the doctor's office for treatment of a cold. In this example, the babysitter may have access to this child's medical information.
8. Disclosures Required By Law: Our practice will use and disclose your IIHI when we are required to do so by federal, state or local law.
D. USE AND DISCLOSURE OF YOUR IIHI IN CERTAIN SPECIAL CIRCUMSTANCES.
1. The following categories describe unique scenarios in which we may use or disclose your identifiable health information:
- maintaining vital records
- reporting child abuse or neglect
- preventing or controlling disease, injury or disability
- notifying a person regarding potential exposure to a communicable disease
- notifying a person regarding a potential risk for spreading or contracting a disease or condition
- reporting reactions to drugs or problems with products or devices
- notifying individuals if a product or device they may be using has been recalled
- notifying appropriate government agency(ies) and authority(ies) regarding the potential abuse or neglect of an adult patient (including domestic violence); however, we will only disclose this information if the patient agrees or we are required or authorized by law to disclose this information.
- notifying your employer under limited circumstances related primarily to workplace injury or illness or medical surveillance.
2. Health Oversight Activities: Our practice may disclose your IIHI to a health oversight agency for activities authorized by law. Oversight activities can include, for example investigations, inspections, audits, surveys, licensure and disciplinary actions; civil, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights law and the health care health care system in general.
3. Lawsuits and Similar Proceedings:: Our practice may use and disclose your IIHI in a response to a court or administrative order, if you are involved in a lawsuit or similar proceeding. We also may disclose your IIHI in response to a discovery request, subpoena or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain a court or administrative order protecting the information the party has requested.
4. Law Enforcement: We may release IIHI if asked to do so by a law enforcement official:
- Regarding a crime victim in certain situations, if we are unable to obtain the person’s agreement.
- Concerning a death we believe has resulted from criminal conduct
- Regarding criminal conduct at our office
- In response to a warrant, summons, court order, subpoena or similar legal process.
- To identify/locate a suspect, material witness, fugitive or missing person.
- In an emergency, to report a crime (including the location or victim(s) of the crime, or the description, identity of location or the perpetrator).
5. Serious Threats to Health or Safety: Our practice may use or disclose your IIHI when necessary to reduce or prevent a serious threat to your health or safety or the health and safety of another individual or the public. Under these circumstances, we will only make disclosures to a person or organization able to help prevent the threat.
6. Military:Our practice may disclose your IIHI if you are a member of US or foreign military forces (including veterans) and if required by the appropriate authorities.
7. National Security:Our practice may disclose your IIHI to federal officials for intelligence and national security activities authorized by law. We also may disclose your IIHI to federal officials in order to protect the President, other officials or foreign health of state, or to conduct investigations.
8. Inmates:: Our practice may disclose your IIHI to correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. Disclosure for these purposes would be necessary: (a) for the institution to provide health care services to you, (b) for the safety and security of the institution, and/or (c) to protect yours and other individuals health and safety.
9. Workers’ Compensation: Our practice may release your IIHI for workers' compensation and similar programs.
10. Healthcare Operations
We may use and release your record to support our business functions (i.e., administrative, financial and legal activities). These uses and disclosures are needed to run Exigent, support, treatment and payment, help patients receive high quality care. Activities may include measuring quality, reviewing employee performance and training students.
Here is how your health record might be used for business operations.
- We may call to confirm your appointment with us or referral appointments.
- We may ask you to list your name and your doctor’s name when you arrive for a visit.
- We may also call you by name in the waiting area.
- We may use health information to review our treatment and services.
- We may combine information to review our treatment and services.
- We may combine health information on many Exigent patients to decide what services to offer.
- We may give information to doctors, nurses, technicians, students and other staff for review and learning purposes.
- We may combine our records with those from other medical organizations to compare how we are doing and where we can improve.
E. YOUR RIGHTS REGARDING YOUR IIHI
You have the following rights regarding the IIHI that we maintain about you:
1. Confidential Communications:You have the right to request that our practice communicate with you about your health and related issues in a particular manner. In order to request a type of confidential communication, you must make a written request to Exigent, specifying the requested method of contact or location you wish to be contacted. Our practice will accommodate reasonable requests. You do not need to give a reason for your request.
2. Requesting Restrictions: You have the right to request a restriction in our use or disclosure of your IIHI for treatment, payment or health care operations. Additionally, you have the right to request that we restrict our disclosure of your care, such as family members and friends. We are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you. In order to request a restriction in our use or disclosure of your IIHI, you must make your request in writing to Exigent, Inc. Your request must describe in a clear and concise fashion:
a) the information you wish restricted;
b) whether you are requesting to limit our practice’s use, disclosure or both; and
c) to whom you want the limits to apply.
3. Inspection and Copies:You have the right to inspect and obtain a copy of the IIHI that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to Exigent, Inc., in order to inspect and/or obtain a copy of your IIHI. Our practice may charge a fee for the costs of copying, mailing, labor and supplies associated with your request. Our practice may deny your request to inspect and/or copy in certain limited circumstances; however, you may request a review of our denial. Another licensed health care professional chosen by us will conduct reviews.
4. Amendment:: You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for our practice. To request an amendment, your must be made in writing and submitted to Exigent, Inc. Attn: Joan Lark at 2310 Wade Hampton Blvd., Greenville, SC 29615. You must provide us with a reason that supports your request for amendment. Our practice will deny your request if you fail to submit your request (and the reason supporting your request) in writing. Also, we may deny your request if you ask us to amend information that is in our opinion: (a) accurate and complete; (b) not part of the IIHI kept by or for the practice; (c) not part of the IIHI which you would be permitted to inspect and copy; or (d) not created by out practice, unless the individual or entity that created the information is not available to amend the information.
5. Accounting of Disclosures:: Our practice will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. Any authorization you provide to us regarding the use and disclosure of your IIHI may be revoked at any time in writing. After you revoke your authorization, we will no longer use or disclose your IIHI for the purposes described in the authorization. Please note, we are required to retain records of your care.
Again, if you have any questions, regarding this notice or our health information privacy policies, please contact Joan Lark, Privacy Information Officer, at (864) 292-5915.