II.
HOW WE MAY USE AND DISCLOSE PROTECTED HEALTH INFORMATION ABOUT YOU USES
AND DISCLOSURES FOR TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS
The
following categories describe the different ways we may use and disclose PHI for
treatment, payment, or health care operations without your consent or authorization.
The examples included in each category do not list every type of use or disclosure
that may fall within that category. Treatment:
We may use and disclose PHI about you to provide, coordinate, or manage your health
care and related services. We may consult with other health care providers regarding
your treatment and coordinate and manage your health care with others. For example,
we may use and disclose PHI when you need a prescription, lab work, an X-ray,
or other health care services. In addition, we may use and disclose PHI about
you when referring you to another health care provider. For example, if you are
referred to another physician, we may disclose PHI to your new physician regarding
whether you are allergic to any medications. In emergencies, we may use and disclose
PHI to provide the treatment you need. We
may also disclose PHI about you for the treatment activities of another health
care provider. For example, we may send a report about you to a physician that
we refer you to so that the other physician may treat you. Payment:
We may use and disclose PHI so that we can bill and collect payment for the treatment
and services provided to you. Before providing treatment or services, we may share
details with your health plan concerning the services you are scheduled to receive.
For example, we may ask for payment approval from your health plan before we provide
care or services. We may use and disclose PHI to find out if your health plan
will cover the cost of care and services we provide. We may use and disclose PHI
to confirm you are receiving the appropriate amount of care to obtain payment
for services. We may use and disclose PHI for billing, claims management, and
collection activities. We may disclose PHI to insurance companies providing you
with additional coverage. We may disclose limited PHI to consumer reporting agencies
relating to collection of payments owed to us. We
may also disclose PHI to another health care provider or to a company or health
plan required to comply with the HIPAA Privacy Rule for the payment activities
of that health care provider, company, or health plan. For example, we may allow
a health insurance company to review PHI for the insurance company's activities
to determine the insurance benefits to be paid for your care Health
Care Operations: We may use and disclose PHI in performing business activities
that are called health care operations. Health care operations include doing things
that allow us to improve the quality of care we provide and to reduce health care
costs. We may use and disclose PHI about you in the following health care operations: Reviewing
and improving the quality, efficiency, and cost of care that we provide to our
patients. For example, we may use PHI about you to develop ways to assist our
physicians and staff in deciding how we can improve the medical treatment we provide
to others.
Improving health care and lowering costs for groups of people who have similar
health problems and helping to manage and coordinate the care for these groups
of people. We may use PHI to identify groups of people with similar health problems
to give them information, for instance, about treatment alternatives and educational
classes.
Reviewing and evaluating the skills, qualifications, and performance of health
care providers taking care of you and our other patients.
Providing training programs for students, trainees, health care providers, or
non-health care professionals (for example, billing personnel) to help them practice
or improve their skills.
Cooperating with outside organizations that assess the quality of the care that
we provide. These organizations might include government agencies or accrediting
bodies such as the Accreditation Association for Ambulatory Health Care, Inc.
(AAAHC).
Cooperating with outside organizations that evaluate, certify, or license health
care providers or staff in a particular field or specialty. For example, we may
use or disclose PHI so that one of our nurses may become certified as having expertise
in a specific field of nursing.
Cooperating with various people who review our activities. For example, PHI may
be seen by doctors reviewing the services provided to you, and by accountants,
lawyers, and others who assist us in complying with the law and managing our business.
Assisting
us in making plans for our practice's future operations. · Resolving grievances
within our practice.
Reviewing our activities and using or disclosing PHI in the event that we sell
our practice to someone else or combine with another practice.
Business planning and development, such as cost-management analyses.
Business management and general administrative activities of our practice, including
managing our activities related to complying with the HIPAA Privacy Rule and other
legal requirements.
Creating "de-identified" information that is not identifiable to any individual,
and disclosing PHI to a business associate for the purpose of creating de-identified
information, regardless of whether we will use the de-identified information.
Creating
a "limited data set" of information that does not contain information directly
identifying a patient. Our ability to disclose this information to others under
limited conditions is discussed later in this Notice. If
another health care provider, company, or health plan that is required to comply
with the HIPAA Privacy Rule also has or once had a relationship with you, we may
disclose PHI about you for certain health care operations of that health care
provider or company. For example, such health care operations may include: reviewing
and improving the quality, efficiency, and cost of care provided to you; reviewing
and evaluating the skills, qualifications, and performance of health care providers;
providing training programs for students, trainees, health care providers, or
non-health care professionals; cooperating with outside organizations that evaluate,
certify, or license health care providers or staff in a particular field or specialty;
and assisting with legal compliance activities of that health care provider or
company. We
may also disclose PHI for the health care operations of any "organized health
care arrangement" in which we participate. An example of an organized health care
arrangement is the joint care provided by a hospital and the physicians who see
patients at the hospital. Communication
From Our Office:
We may contact you to remind you of appointments. If we attempt to contact you
by phone and you are not available, them we may leave a message on your answering
machine or voice mail. Appoint reminders may be sent by mail. We may also provide
you with information about treatment alternatives or other health-related benefits
and services that may be of interest to you. OTHER
USES AND DISCLOSURES WE CAN MAKE WITHOUT YOUR WRITTEN AUTHORIZATION FOR WHICH
YOU HAVE THE OPPORTUNITY TO AGREE OR OBJECT Individuals Involved
in Your Care or Payment for Your Care: We may use and disclose PHI about you in
some situations where you have the opportunity to agree or object to certain uses
and disclosures of PHI about you. If you do not object, we may make these types
of uses and disclosures of PHI. |
