Notice of Privacy Practices
As Required by the Privacy Regulations Created as a Results of the Health Insurance Portability and Accountability Act of 1996 (HIPPA)
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU (AS A PATIENT OF THIS PRACTICE) MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO YOUR INDIVIDUAL IDENTIFIABLE HEALTH INFORMATION.
PLEASE REVIEW THIS NOTICE CAREFULLY.
A. OUR COMMITMENT TO YOUR PRIVACY
Macaione and Papa Dermatology Associates 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.
This Notice of Privacy Practices describes how we may use and disclose your IIHI to carry out treatment, payment or health care operations and for the purposes that are permitted or required by law. It also describes your rights to access and control your IIHI. IIHI is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health condition and related health care services. This notice applies to all of the records of your care and billings for care that are created by Macaione and Papa Dermatology Associates.
The terms of this notice apply to all records containing your IIHI that are created or retained by Macaione and Papa Dermatology Associates. 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 Macaione and Papa Dermatology Associates has created or maintained in the past, and for any of your records that we may create or maintain in the future.
B. IF YOU HAVE ANY QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT:
Denise Freedman, Privacy Officer
Macaione and Papa Dermatology Associates
707 White Horse Road Suite C-103
Voorhees, NJ 08043
C. WE MAY USE AND DISCLOSE YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION (IIHI) IN THE FOLLOWING WAYS:
The following categories describe ways in which we may use and disclose your IIHI.
- Treatment. Macaione and Papa Dermatology Associates may use your IIHI to treat you. For example, we may ask you to have laboratory tests (such as blood or urine 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 other in your treatment. Additionally, we may disclose your IIHI to others who may assist in your care, such as your spouse, children and parents. Finally, we may also disclose your IIHI to other health care providers for purposes related to your treatment.
- Payment. Macaione and Papa Dermatology Associates 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. We may disclose your IIHI to other health care providers and entities to assist in the billing and collection efforts.
- Health Care Operations. Macaione and Papa Dermatology Associates may use your IIHI to operate our business. As examples of the ways 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. We may disclose your IIHI to other health care providers and entities to assist in their health care operations. We may disclose your IIHI to medical school students, residents or fellows that see patients at our office. We may also call your by name in the waiting room when your physician is ready to see you. We will share your IIHI with third party “business associates” that performs various activities (e.g., billing, computer services) for the practice. Whenever an arrangement between our office and a business associate involves the use of disclosure of your IIHI, we will have a written contract that contains terms that will protect the privacy of your IIHI.
- Appointment Reminders. Macaione and Papa Dermatology Associates use and disclose your IIHI to contact you and remind you of an appointment. We will leave a message for you at any telephone number you give us stating the time of the appointment and the name of the person with whom you have the appointment unless we have agreed in writing to your written request to handle appointment reminders differently.
- Treatment Options. Macaione and Papa Dermatology Associates may use and disclose your IIHI to inform you of potential treatment options or alternatives.
- Release of Information to Family/Friends. Macaione and Papa Dermatology Associates 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 give permission to a babysitter to take this child to the pediatrician’s office for treatment of a cold. In this example, the babysitter may have access to this child’s medical information.
- Disclosures Required By Law. Macaione and Papa Dermatology Associates will use and disclose your IIHI when we are required to do so by federal, state of local law.
- Emergencies. Macaione and Papa Dermatology Associates may use or disclose your PHI in an emergency treatment situation. If this happens, your physician shall try to obtain your consent as soon as reasonable possible after the delivery of treatment. If your physician has attempted to obtain your consent but is unable to obtain your consent, he or she may still use or disclose your PHI to treat you.
D. USE AND DISCLOSURE OF YOUR IIHI IN CERTAIN SPECIAL CIRCUMSTANCES
The following categories describe unique scenarios in which we may use or disclose your identifiable health information.
- Public Health Risks. Macaione and Papa Dermatology Associates may disclose your IIHI to public health authorities that are authorized by law to collect information for the purpose of:
- maintaining vital records, such as births and deaths
- 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.
- Health Oversight Activities. Macaione and Papa Dermatology Associates may disclose your IIHI to a health oversight 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 laws and the health care system in general.
- Lawsuits and Similar Proceedings. Macaione and Papa Dermatology may use and disclose your IIHI in 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 an order protecting the information the party has requested.
- Law Enforcement. We nay release IIHI if asked to do so by a law enforcement official:
- Regarding a crime in certain situations, if we are unable to obtain the person’s agreement
- Concerning a death we believe has resulted form criminal conduct
- Regarding criminal conduct at our offices
- In response to a warrant, summons, court order, subpoena or similar legal process
- In an emergency, to report a crime (including the location or victim(s) of the crime, or the descriptions, identity or location of the perpetrator)
- Deceased Patients. Macaione and Papa Dermatology Associates may release IIHI to a medical examiner or coroner to identify a deceased individual or to identify the cause of death. If necessary, we also may release information in order for funeral directors to perform their jobs.
- Research. Macaione and Papa Dermatology Associates may use and disclose your IIHI for research purposes in certain limited circumstances. We will obtain your written authorization to use your IIHI for research purposes except when internal or Review Board or Privacy Board has determined that the waiver of your authorization satisfies the following: (i) the use or disclosure involves no more than an animal risk to your privacy based on the following: (A) an adequate plan to protect the identifiers form improper use and disclosure; (B) an adequate plan to destroy the identifiers at the earliest time consistent with the research (unless there is health or research justification for retaining the identifiers or such retention is otherwise required by law); and (C) adequate written assurance that the PHI will not be re-used or disclosed to any other person or entity (except as required by law) for authorized oversight of the research study, or for other research for which the use or disclosure would otherwise be permitted; (ii) the research could not be conducted without the waiver; and (iii) the research could not be conducted without access to and use of the PHI.
- Serious Threats to Health or Safety. Macaione and Papa Dermatology Associates may use and disclose your IIHI when necessary to reduce or prevent a serious threat to your health and 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.
- Military. Macaione and Papa Dermatology may disclose our IIHI if you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate authorities.
- National Security. Macaione and Papa Dermatology Associates 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 heads of state, or to conduct investigations.
- Inmates. Macaione and Papa Dermatology Associates may disclose your IHHI 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 your health and safety or the health and safety of other individuals.
- Workers’ Compensation. Macaione and Papa Dermatology Associates may release your IIHI for workers’ compensation and similar programs.
E. YOUR RIGHTS REGARDING YOUR IIHI
You have the following rights regarding the IIHI that we maintain about you.
- Confidential Communications. You have the right to request that Macaione and Papa Dermatology Associates communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than work. In order to request a type of confidential communication, you must make a written request to: Denise Freedman, Privacy Officer, Macaione and Papa Dermatology Associates, 707 White Horse Road, Suite C-103, Voorhees, NJ 08043, (856) 627-1900 specifying the request method of contact, or the location where you wish to be contacted. Our practice will accommodate reasonable requests. You do not need to give a reason for your request.
- 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 IIHI to only certain individuals involved in your care or the payment for 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 with otherwise required by law, or 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 Denise Freedman, Privacy Officer, 707 White Horse Road, Suite C-103, Voorhees, NJ 08043, (856) 627-1900. 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
- Inspection and Copies. You have the right to inspect and obtain a copy of the IIHI that may be used to make decision about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to Denise Freedman, Privacy Officer, 707 White Horse Road, Suite C-103, Voorhees, NJ 08043, (856) 627-1900 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 professionals chosen by us will conduct reviews.
- Amendment. You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request and amendment for as long as the information is kept by or for our practice. To request and amendment, your request must be made in writing and submitted to Denise Freedman, Privacy Officer, 707 White Horse Road, Suite C-103, Voorhees, NJ 08043, (856) 627-1900. 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 inspected and copy; or (d) not created by our practice, unless the individual or entity that created the information is not available to amend the information.
- Accounting of Disclosures. All of our patients have the right to request an “accounting of disclosures.” An “accounting of disclosures” is a list of certain non-routine disclosures our practice has made of your IIHI for non-treatment, non-payment or non-operations purposes. Use of your IIHI as part of the routine patient care in our practice is not required to be documented. For example, the doctor sharing information with the nurse; or the billing department using your information to file your insurance claim. In order to obtain an accounting of disclosures, you must submit your request in writing to Denise Freedman, Privacy Officer, Macaione and Papa Dermatology Associates, 707 White Horse Road, Suite C-103, Voorhees, NJ 08043, (856) 627-1900. All requests for an “accounting of disclosures” must state a time period, which may not be longer than six (6) years from the date of disclosure and may not include dates before April 14, 2003. The first list you request with in a 12-month period is free of charge, but our practice may charge you for additional lists within the same 12-month period. Macaione and Papa Dermatology Associates will notify you of the cost involved with additional requests, and you may withdraw your request before you incur any cost.
- Right to a Paper Copy of This Notice. You are entitled to receive a paper copy of our notice of privacy practices. You may ask us to give you a copy of this notice at any time. To obtain a paper copy of this notice, contact Denise Freedman, Privacy Officer, Macaione and Papa Dermatology Associates, 707 White Horse Road, Suite C-103, Voorhees, NJ 08043, (856)627-1900.
- Right to File a Complaint. If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with our practice, Denise Freedman, Privacy Officer, Macaione and Papa Dermatology Associates, 707 White Horse Road, Suite C-103, Voorhees, NJ 08043, (856)627-1900. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
- Right to Provide an Authorization for Other Uses and 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 reason described in the authorization. Please not, 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:
Denise Freedman, Privacy Officer
Macaione and Papa Dermatology Associates
707 White Horse Road, Suite C-103
Voorhees, NJ 08043