{"id":51,"date":"2018-10-11T23:33:56","date_gmt":"2018-10-11T23:33:56","guid":{"rendered":"https:\/\/virginiahearingcenter.fm1.dev\/?page_id=51"},"modified":"2020-01-29T18:07:38","modified_gmt":"2020-01-29T23:07:38","slug":"hipaa-statement","status":"publish","type":"page","link":"https:\/\/virginiahearingcenter.com\/resources\/hipaa-statement\/","title":{"rendered":"HIPAA Statement"},"content":{"rendered":"\n

Effective Date<\/em>: 9\/23\/2013<\/em><\/p>\n\n\n\n

THIS NOTICE DESCRIBES HOW\nMEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET\nACCESS TO THIS INFORMATION.<\/h2>\n\n\n\n

PLEASE REVIEW\nIT CAREFULLY.<\/strong><\/p>\n\n\n\n

If you have any questions about\nthis notice, please contact our HIPAA Compliance Manager .<\/p>\n\n\n\n

OUR OBLIGATIONS:<\/h2>\n\n\n\n

We are required by law to:<\/p>\n\n\n\n

  • Maintain the privacy of protected health information<\/li>
  • Give you this notice of our legal duties and privacy\npractices regarding health information about you<\/li>
  • Follow the terms of our notice that is currently in effect<\/li><\/ul>\n\n\n\n

    HOW WE MAY USE\nAND DISCLOSE HEALTH INFORMATION:<\/h2>\n\n\n\n

    The following describes the ways\nwe may use and disclose health information that identifies you (\u201cHealth\nInformation\u201d). Except for the purposes described below, we will use and\ndisclose Health Information only with your written permission. You may revoke\nsuch permission at any time by writing to our practice Privacy Officer.<\/p>\n\n\n\n

    For Treatment<\/em><\/strong>. We may use and\ndisclose Health Information for your treatment and to provide you with\ntreatment-related health care services. For example, we may disclose Health\nInformation to doctors, nurses, technicians, or other personnel, including\npeople outside our office, who are involved in your medical care and need the information\nto provide you with medical care.<\/p>\n\n\n\n

    For Payment<\/em><\/strong>. We may use and\ndisclose Health Information so that\nwe or others may bill and receive payment from you, an insurance company or a\nthird party for the treatment and services you received. For example, we may\ngive your health plan information about you so that they will pay for your treatment.<\/p>\n\n\n\n

    For Health Care Operations<\/em><\/strong>. We may\nuse and disclose Health Information for health care operations purposes. These\nuses and disclosures are necessary to make sure that all of our patients\nreceive quality care and to operate and manage our office. For example, we may\nuse and disclose information to make sure the obstetrical or gynecological care\nyou receive is of the highest quality.<\/p>\n\n\n\n

    We also may share\ninformation with other entities that have a relationship with you (for example,\nyour health plan) for their health care operation activities.<\/p>\n\n\n\n

    Appointment Reminders, Treatment Alternatives and\nHealth Related Benefits and Services<\/em><\/strong>. We may use and disclose Health Information to\ncontact you to remind you that you have an appointment with us. We also may use\nand disclose Health Information to tell you about treatment alternatives or\nhealth-related benefits and services that may be of interest to you.<\/p>\n\n\n\n

    Individuals Involved in Your Care or Payment for Your Care<\/em><\/strong>. When appropriate, we may share Health Information with a person who is involved in your medical care or payment for your care, such as your family or a close friend. We also may notify your family about your location or general condition or disclose such information to an entity assisting in a disaster relief effort.<\/p>\n\n\n\n

    Research<\/em><\/strong>. Under certain\ncircumstances, we may use and disclose Health Information for research. For\nexample, a research project may involve comparing the health of patients who\nreceived one treatment to those who received another, for the same condition.\nBefore we use or disclose Health Information for research, the project will go\nthrough a special approval process. Even without special approval, we may\npermit researchers to look at records to help them identify patients who may be\nincluded in their research project or for other similar purposes, as long as\nthey do not remove or take a copy of any Health Information.<\/p>\n\n\n\n

    SPECIAL SITUATIONS:<\/h2>\n\n\n\n

    As\nRequired by Law<\/em><\/strong>. We will disclose Health Information when\nrequired to do so by international, federal, state or local law.<\/p>\n\n\n\n

    To Avert a Serious Threat to Health or Safety<\/em><\/strong>.\nWe may use and disclose Health Information when necessary to prevent a serious\nthreat to your health and safety or the health and safety of the public or\nanother person. Disclosures, however, will be made only to someone who may be\nable to help prevent the threat.<\/p>\n\n\n\n

    Business Associates<\/em><\/strong>. We may\ndisclose Health Information to our business associates that perform functions\non our behalf or provide us with services if the information is necessary for\nsuch functions or services. For example, we may use another company to perform\nbilling services on our behalf. All of our business associates are obligated to\nprotect the privacy of your information and are not allowed to use or disclose\nany information other than as specified in our contract.<\/p>\n\n\n\n

    Organ and Tissue Donation<\/em><\/strong>. If you\nare an organ donor, we may use or release Health Information to organizations\nthat handle organ procurement or other entities engaged in procurement, banking\nor transportation of organs, eyes or tissues to facilitate organ, eye or tissue\ndonation and transplantation.<\/p>\n\n\n\n

    Military and Veterans<\/em><\/strong>. If you are a\nmember of the armed forces, we may release Health Information as required by\nmilitary command authorities. We also may release Health Information to the\nappropriate foreign military authority if you are a member of a foreign\nmilitary.<\/p>\n\n\n\n

    Workers\u2019 Compensation<\/em><\/strong>.\nWe may release Health Information for workers\u2019 compensation or similar\nprograms. These programs provide benefits for work-related injuries or illness.<\/p>\n\n\n\n

    Public Health Risks<\/em><\/strong>. We may\ndisclose Health Information for public health activities. These activities\ngenerally include disclosures to prevent or control disease, injury or\ndisability; report births and deaths; report child abuse or neglect; report\nreactions to medications or problems with products; notify people of recalls of\nproducts they may be using; a person who may have been exposed to a disease or\nmay be at risk for contracting or spreading a disease or condition; and the\nappropriate government authority if we believe a patient has been the victim of\nabuse, neglect or domestic violence. We will only make this disclosure if you\nagree or when required or authorized by law.<\/p>\n\n\n\n

    Health Oversight Activities<\/em><\/strong>. We may disclose Health Information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.<\/p>\n\n\n\n

    Data\nBreach Notification Purposes. <\/em><\/strong>We may use or disclose your\nProtected Health Information to provide legally required notices of\nunauthorized access to or disclosure of your health information.<\/p>\n\n\n\n

    Lawsuits and Disputes<\/em><\/strong>. If you are\ninvolved in a lawsuit or a dispute, we may disclose Health Information in\nresponse to a court or administrative order. We also may disclose Health\nInformation in response to a subpoena, discovery request, or other lawful\nprocess by someone else involved in the dispute, but only if efforts have been\nmade to tell you about the request or to obtain an order protecting the\ninformation requested.<\/p>\n\n\n\n

    Law\nEnforcement<\/em><\/strong>. We may release Health Information if asked by a law\nenforcement official if the information is: (1) in response to a court order,\nsubpoena, warrant, summons or similar process; (2) limited information to\nidentify or locate a suspect, fugitive, material witness, or missing person;\n(3) about the victim of a crime even if, under certain very limited\ncircumstances, we are unable to obtain the person\u2019s agreement; (4) about a\ndeath we believe may be the result of criminal conduct; (5) about criminal\nconduct on our premises; and (6) in an emergency to report a crime, the\nlocation of the crime or victims, or the identity, description or location of\nthe person who committed the crime.<\/p>\n\n\n\n

    Coroners, Medical Examiners and Funeral Directors<\/em><\/strong>.\nWe may release Health Information to a coroner or medical examiner. This may be\nnecessary, for example, to identify a deceased person or determine the cause of\ndeath. We also may release Health Information to funeral directors as necessary\nfor their duties.<\/p>\n\n\n\n

    National Security and Intelligence Activities<\/em><\/strong>. We may release Health\nInformation to authorized federal officials for intelligence,\ncounter-intelligence, and other national security activities authorized by law.<\/p>\n\n\n\n

    Protective Services for the President and Others<\/em><\/strong>.\nWe may disclose Health Information to authorized federal officials so they may\nprovide protection to the President, other authorized persons or foreign heads\nof state or to conduct special investigations.<\/p>\n\n\n\n

    Inmates or Individuals in Custody<\/em><\/strong>.\nIf you are an inmate of a correctional institution or under the custody of a\nlaw enforcement official, we may release Health Information to the correctional\ninstitution or law enforcement official. This release would be if necessary:\n(1) for the institution to provide you with health care; (2) to protect your\nhealth and safety or the health and safety of others; or (3) the safety and\nsecurity of the correctional institution.<\/p>\n\n\n\n

    USES\nAND DISCLOSURES THAT REQUIRE US TO GIVE YOU AN OPPORTUNITY TO OBJECT AND OPT<\/h2>\n\n\n\n

    Individuals\nInvolved in Your Care or Payment for Your Care. <\/em><\/strong>Unless you\nobject, we may disclose to a member of your family, a relative, a close friend\nor any other person you identify, your Protected Health Information that\ndirectly relates to that person\u2019s involvement in your health care., If you are\nunable to agree or object to such a disclosure, we may disclose such\ninformation as necessary if we determine that it is in your best interest based\non our professional judgment.<\/p>\n\n\n\n

    Disaster Relief. <\/em><\/strong>We may disclose\nyour Protected Health Information to disaster relief organizations that seek\nyour Protected Health Information to coordinate your care, or notify family and\nfriends of your location or condition in a disaster. We will provide you with\nan opportunity to agree or object to such a disclosure whenever we practically\ncan do so.<\/p>\n\n\n\n

    YOUR WRITTEN AUTHORIZATION IS REQUIRED FOR\nOTHER USES AND DISCLOSURES<\/h2>\n\n\n\n

    The following uses\nand disclosures of your Protected Health Information will be made only with\nyour written authorization:<\/p>\n\n\n\n

    1. Uses and disclosures of\nProtected Health Information for marketing purposes; and<\/li>
    2. Disclosures that constitute\na sale of your Protected Health Information<\/li><\/ol>\n\n\n\n

      Other uses and disclosures of\nProtected Health Information not covered by this Notice or the laws that apply\nto us will be made only with your written authorization. If you do give us an\nauthorization, you may revoke it at any time by submitting a written revocation\nto our Privacy Officer and we will no longer disclose Protected Health\nInformation under the authorization. But disclosure that we made in reliance on\nyour authorization before you revoked it will not be affected by the\nrevocation.<\/p>\n\n\n\n

      YOUR RIGHTS:<\/h2>\n\n\n\n

      You have the following rights\nregarding Health Information we have about you:<\/p>\n\n\n\n

      Right to Inspect and Copy<\/em><\/strong>. You have\na right to inspect and copy Health Information that may be used to make\ndecisions about your care or payment for your care. This includes medical and\nbilling records, other than psychotherapy notes. To inspect and copy this\nHealth Information, you must make your request, in writing, to us attn: Medical\nRecords Clerk. We have up to 30 days to make your Protected Health Information\navailable to you and we may charge you a reasonable fee for the costs of\ncopying, mailing or other supplies associated with your request. We may not\ncharge you a fee if you need the information for a claim for benefits under the\nSocial Security Act or any other state of federal needs-based benefit program.\nWe may deny your request in certain limited circumstances. If we do deny your\nrequest, you have the right to have the denial reviewed by a licensed\nhealthcare professional who was not directly involved in the denial of your\nrequest, and we will comply with the outcome of the review.<\/p>\n\n\n\n

      Right to an Electronic Copy of Electronic Medical\nRecords. <\/em><\/strong>If your Protected Health Information is maintained in\nan electronic format (known as an electronic medical record or an electronic\nhealth record), you have the right to request that an electronic copy of your\nrecord be given to you or transmitted to another individual or entity. We will\nmake every effort to provide access to your Protected Health Information in the\nform or format you request, if it is readily producible in such form or format.\nIf the Protected Health Information is not readily producible in the form or\nformat you request your record will be provided in either our standard\nelectronic format or if you do not want this form or format, a readable hard\ncopy form. We may charge you a reasonable, cost-based fee for the labor associated\nwith transmitting the electronic medical record.<\/p>\n\n\n\n

      Right to Get\nNotice of a Breach. <\/em><\/strong>You have the right to be notified upon a breach of any\nof your unsecured Protected Health Information.<\/p>\n\n\n\n

      Right to Amend<\/em><\/strong>. If you feel that\nHealth Information we have is incorrect or incomplete, you may ask us to amend\nthe information. You have the right to request an amendment for as long as the\ninformation is kept by or for our office. To request an amendment, you must\nmake your request, in writing, to us attn: Medical Records Clerk.<\/p>\n\n\n\n

      Right to an Accounting of Disclosures<\/em><\/strong>.\nYou have the right to request a list of certain disclosures we made of Health\nInformation for purposes other than treatment, payment and health care\noperations or for which you provided written authorization. To request an\naccounting of disclosures, you must make your request, in writing, to us attn:\nMedical Records Clerk.
      <\/p>\n\n\n\n

      Right\nto Request Restrictions<\/em><\/strong>. You have the right to request a\nrestriction or limitation on the Health Information we use or disclose for\ntreatment, payment, or health care operations. You also have the right to\nrequest a limit on the Health Information we disclose to someone involved in your care or the payment for your care,\nlike a family member or friend. For example, you could ask that we not share\ninformation about a particular diagnosis or treatment with your spouse. To\nrequest a restriction, you must make your request, in writing, to us attn:\nMedical Records Clerk. We are not required to\nagree to your request unless you are asking us to restrict the use and\ndisclosure of your Protected Health Information to a health plan for payment or\nhealth care operation purposes and such information you wish to restrict\npertains solely to a health care\nitem or service for which you have paid us \u201cout-of- pocket\u201d in full. If we\nagree, we will comply with your request unless the information is needed to\nprovide you with emergency treatment.<\/p>\n\n\n\n

      Out-of-Pocket-Payments. <\/em><\/strong>If you paid\nout-of-pocket (or in other words, you have requested that we not bill your\nhealth plan) in full for a specific item or service, you have the right to ask\nthat your Protected Health Information with respect to that item or service not\nbe disclosed to a health plan for purposes of payment or health care\noperations, and we will honor that request.<\/p>\n\n\n\n

      Right to Request Confidential Communications<\/em><\/strong>.\nYou have the right to request that we communicate\nwith you about medical matters in a certain way or at a certain location. For\nexample, you can ask that we only contact you by mail or at work.  To request confidential communications, you\nmust make your request, in writing,\nto us attn: Medical Records Clerk. Your request must specify how or where you\nwish to be contacted. We will accommodate reasonable requests.<\/p>\n\n\n\n

      Right to a Paper Copy of This Notice<\/em><\/strong>. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our web site, www.shaiamd.com. To obtain a paper copy of this notice, contact our HIPAA Compliance Manager.<\/p>\n\n\n\n

      CHANGES TO THIS NOTICE:<\/h2>\n\n\n\n

      We reserve the\nright to change this notice and make the new notice apply to Health Information\nwe already have as well as any information we receive in the future. We will\npost a copy of our current notice at our office. The notice will contain the\neffective date on the first page, in the top right-hand corner.<\/p>\n\n\n\n

      COMPLAINTS:<\/h2>\n\n\n\n

      If you believe\nyour privacy rights have been violated, you may file a complaint with our\noffice or with the Secretary of the Department of Health and Human Services. To\nfile a complaint with our office, contact our Practice Manager. All complaints\nmust be made in writing. You will not be\npenalized for filing a complaint<\/strong>.<\/p>\n","protected":false},"excerpt":{"rendered":"

      Effective Date: 9\/23\/2013 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 HIPAA Compliance Manager . 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