HIPAA Notice of Privacy Practices
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.
Pursuant to the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), this Notice describes the practices of Chia Endocrinology & Wellness (CE&W), Dr. Hasan, and other providers for its Patients, detailing how your medical information may be used or disclosed and how you can access this information. Please review it carefully. You have the right to obtain a paper copy of this Notice upon request and may print a copy from our website. CEW also respects privacy regarding credit card information acquired during payments through its electronic health record. No information collected during payments will be shared in any way.
Our Pledge Regarding Medical Information
We understand that your medical information is personal and are committed to protecting it. We create records of the care and services you receive to provide quality care and comply with legal requirements. This notice applies to all records of your care generated by our facilities, whether by our personnel or your personal doctor. Your personal doctor may have different policies regarding the use and disclosure of your medical information created in their office or clinic. This notice will explain how we may use and disclose your medical information and describe your rights and our obligations regarding its use and disclosure.
Patient Health Information
Under Federal law, your patient health information is protected and confidential. This includes information about your symptoms, test results, diagnosis, treatment, and related medical details, as well as payment and billing information.
How We Use Your Patient Health Information
CE&W uses health information about you for treatment, analyzing procedures, and lab results. We use this information to obtain payment and for healthcare operations, including administrative purposes and evaluating the quality of care you receive. In certain circumstances, we may be required to use or disclose information without your permission.
Examples of Treatment, Payment, and Healthcare Operations
Treatment: CE&W will use and disclose your health information to provide medical treatment or services. For example, nurses, physicians, and other members of your treatment team will record information in your medical record and use it to determine the most appropriate care. We may also communicate with other healthcare providers involved in your treatment, pharmacies filling your prescriptions, and family members assisting with your care.
Payment: CE&W will use and disclose your health information for billing and payment purposes. For example, we will submit bills and maintain payment records.
Medicare: CE&W will use and disclose your health information for Medicare billing purposes for services not covered under the chosen package.
Healthcare Operations: CE&W will use and disclose your health information for standard internal operations, including record administration, quality assessment, and evaluating care outcomes.
Appointment Reminders: We may use and disclose medical information to remind you of appointments for treatment or medical care at our facilities.
Release of Information to Family and Friends
CE&W acknowledges the importance of family and friends in a patient’s care. If you wish to authorize a family member or friend to discuss your care or test results with us, please provide their name and contact information on the Patient Contact Authorization Form or in writing. We will not release your information to any friend or family without your written consent.
Special Uses
CE&W may use your information to contact you with appointment reminders by phone, mail, or secured electronic means. We may also contact you about treatment alternatives or other health-related benefits and services that may interest you. If you have granted written permission, this information may also be sent via email. By providing your email address on the New Patient Information and Enrollment Form, you authorize CE&W to use email for communication.
Other Uses and Disclosures
CE&W may use or disclose identifiable health information about you without your consent in certain situations, including:
Required by Law: Reporting gunshot wounds, suspected abuse or neglect, or similar events.
Public Health Activities: Disclosing vital statistics, disease information, product recalls, and similar information to public health authorities.
Health Oversight: Assisting in investigations, audits, eligibility for government programs, and similar activities.
Judicial and Administrative Proceedings: Responding to subpoenas or court orders.
Law Enforcement Purposes: Disclosing information required by law enforcement officials.
Deaths: Reporting deaths to coroners, medical examiners, funeral, and organ donation agencies.
Serious Threat to Health or Safety: Using and disclosing information to prevent serious threats to your health and safety or the public or another person.
Military and Special Government Functions: Releasing information as required by military command authorities or for national security purposes.
Workers’ Compensation: Releasing information for workers’ compensation or similar programs providing benefits for work-related injuries or illness.
Individual Rights
You have the following rights regarding your health information. Submit any concerns in writing to CE&W’s Office Manager and/or Dr. Hasan:
Request Restrictions: Request restrictions on certain uses and disclosures of your health information. CE&W is not required to agree, but if we do, we must abide by those restrictions.
Confidential Communications: Request confidential communication methods.
Inspect and Obtain Copies: See or receive a copy of your health information. There may be a small charge for these copies.
Amend Information: Request corrections or amendments to your health records. Your CE&W physician can refuse the request, but a letter concerning your request will be sent within 30 days.
Accounting of Disclosures: Request a list of instances where we disclosed health information for reasons other than treatment, payment, or healthcare operations.
Authorization: Your authorization is required for uses or disclosures of psychotherapy notes, marketing purposes, and the sale of Protected Health Information.
Notification of Breach: You have a legal right to be notified of a breach of unsecured electronic protected health information.
Our Legal Duty
We are required by law to protect and maintain the privacy of your health information, provide this Notice about our legal duties and privacy practices regarding protected health information, and abide by the terms of the Notice currently in effect.
Changes in Privacy Practices
We may change our policies at any time. You can request a copy of our Notice at any time. For more information about our privacy practices, contact Dr. Hasan or CE&W’s office.
Complaints
If you believe your privacy rights have been violated or disagree with a decision about your records, you may contact Dr. Hasan or CE&W’s office. You can also send a written complaint to the U.S. Department of Health and Human Services. Dr. Hasan or CE&W’s office will provide you with the appropriate address upon request. You will not be penalized for filing a complaint.