Your Information ♥ Your Rights ♥ Our Responsibilities
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.
You have the right to:
- Get a copy of your paper or electronic medical record
- Request a correction of your paper or electronic medical record
- Request confidential communication
- Ask us to limit the information we share
- Get a list of those with whom we’ve shared your information
- Get a copy of this privacy notice
- Choose someone to act on your behalf
- File a complaint if you believe your privacy rights have been violated
When it comes to your health information, you have rights.
This section explains your rights and some of our responsibilities to help you.
|Get an electronic or paper copy of your medical record||
|Ask us to correct your medical record||
|Request confidential communications||
|Ask us to limit what we use or share||
|Get a list of those with whom we’ve shared information||
|Get a copy of this privacy notice|
|Choose someone to act on your behalf||
|File a complaint if you feel your rights are violated||
You have choices in the way that we use and share information as we:
- Tell family and friends about your condition
- Provide disaster relief
- Provide mental health care
- Market our services
For certain health information, you can tell us your choices about what we share.
If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
|In these cases, you have both the right and choice to tell us to:||
If you are not able to tell us your preference (for example, if you are unconscious), we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
|In these cases, we never share your information unless you give us written permission:||
Our Uses & Disclosures
We may use and share your information as we:
- Treat you
- Run our organization
- Bill for your services
- Help with public health and safety issues
- Do research
- Comply with the law
- Respond to organ and tissue donation requests
- Work with a medical examiner or funeral director
- Respond to lawsuits and legal actions
- Address workers’ compensation, law enforcement, and other government requests
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
||Example: A doctor treating you for an injury asks another doctor about your overall health condition.|
|Run our organization||
||Example: We use health information about you to manage your treatment and services within our group.|
|Bill for your services||
||Example: We give information about you to your health insurance plan so it will pay for your services.|
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.
- For more information, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
|Help with public health and safety issues||We can share health information about you for certain situations, such as:
|Comply with the law||
|Respond to organ and tissue donation requests||
|Work with a medical examiner or funeral director||
|Respond to lawsuits and legal actions||
|Address workers’ compensation, law enforcement, and other government requests||We can use or share health information about you:
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
- For more information, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.
|This notice is effective as of September 23, 2013, and applies to all Metropolitan Pediatrics, LLC locations.|