ANESTHESIA ASSOCIATES OF GAINESVILLE, LLC

AMBULATORY ANESTHESIA OF NORTH GEORGIA, LLC

 

                                             NOTICE OF PRIVACY PRACTICES

 

THIS NOTICE DESCRIBES HOW PERSONAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

The Health, Insurance Portability and Accountability Act of 1996 ("HIPAA") requires us to maintain the privacy of your protected health information.  We are required under federal law to give you this notice of our privacy practices, your rights concerning your medical information and our legal duties.

     HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU.  

For Payment: We may use and disclose medical information about you so that the treatment and services you receive from us may be billed to and payment may be collected from you, an insurance company or a third party.  For example, it may be essential that you provide us with your health plan information regarding surgery you receive at the hospital so that your health plan will pay us or reimburse you for our services relating to the surgery.   In addition, we may tell your health plan about a treatment you are going to receive in order to obtain necessary approval or to determine whether your plan will cover the treatment. However you may request that we not disclose your medical information to any persons or entities responsible for paying any portion of the charges you incur as a patient provided that you pay all charges in full at the time of the request.

For Treatment: We may use your medical information to provide you with medical treatment or services to you.  For example, we may disclose medical information about you to doctors, nurses, technicians, medical students, or other hospital personnel who are involved in taking care of you.  We may also share medical information about you in order to coordinate the different services you need.  We also may disclose medical information about you to people outside the hospital who may be involved in your medical care after you leave the hospital, such as family members, home health provider or other persons that are part of your care.

For Health Care Operations: We may use and disclose medical information about you for health care operations such as risk management and regulatory compliance requirements.  For example, we may uses information in your medial record to assess the care and outcomes in your case and others like it.  We may also disclose information to doctors, nurses, technicians, medical students, and other hospital personnel for review and learning purposes.  We may remove information that identifies you from this set of medical information so that others may use it to study health care and health care delivery, without learning the identity of the patients.

Business Associates: There are some services provided by us through contracts with business associates.  A business associate is a person or organization that performs a function or activity on our behalf but is not part of our workforce.  Examples include a software supplier and a billing service.  To protect your health information we require the business associate to appropriately safeguard your health information.

POLICY REGARDING THE PROTECTION OF PROTECTED HEALTH INFORMATION

We understand that medical information pertaining to you and your health is personal.  We are committed to protecting your medical information.  We create a record of the care and services you receive from us at the hospital.  We need this record in order to provide you with quality care and to comply with certain legal requirements.  This notice applies to all of the records of your care generated by us. Your personal doctor may have different policies or notices regarding the doctors use and disclosure of your medical information created in the doctors office or clinic. This notice will inform you about the different ways in which we may use and disclose medical information about you.  We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.

 

The law requires us to:

 1.         Make sure that medical information that identifies you is kept private;

 2.         Give you this notice of your legal duties and privacy practices with respect to medical information about you; and   

 3.         Follow the terms of the notice that is currently in effect.

OTHER CATEGORIES OF USE OR DISCLOSURE OF INFORMATION ABOUT YOU

We may use and disclose protected health information about you in different ways.  All the ways in which we may use and disclose information will fall within one of the following categories but not every use or disclosure in a category will be listed.

As Required By Law. We will disclose medical information about you when required to do so by federal, state or local law.  For example, we must comply with  reporting laws requiring us to report certain diseases or injuries to state or federal agencies.

Fund-raising Activities. We may use medical information about you to contact you as part of a fund raising effort. Each time we contact you regarding fundraising efforts, we must ask you if you wish to opt out of all future fundraising communications.

Health-Related Benefits and Services. We may use and disclose medical information to tell you about health-related benefits or services that may be of interests to you. You may elect not to receive advertising by contacting the number provided or by notifying the Privacy Office in writing.

Individual Involved in Your Care or Payment for Your Care. We may release medical information about you to a friend or family member who is involved in your medical care.  We may also give information to someone who helps pay for your care.  We may also inform your family or friends about your condition and that you are in the hospital.  In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.

Research. Under certain circumstances, we may use and disclose medical information about you for research purposes, including clinical trials and experimental drugs.   Most research projects, however, are subject to a special approval process.  Most research projects require your permission if a researcher will be involved in your care or will have access to your name, address or other information that identifies you.  However, the law allows some research including Institutional Review Board to be done without requiring your authorization.

To Avert a Serious Threat to Health or Safety. Under applicable federal and state law, we may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or of the public or another person.  Any disclosure, however, would only be to someone able to help prevent the threat.

Treatment Alternatives. We may use and disclose medical information to inform you about, recommend possible treatment options or alternatives that may be of interest to you.

SPECIAL SITUATIONS REGARDING USES AND DISCLOSURES OF YOUR PERSONAL INFORMATION INVOLVING THOSE NOT DIRECTLY INVOLVED IN YOUR CARE COULD INCLUDE:

Coroners, Medical Examiners and Funeral Directors. We may release medical information to a coroner or medical examiner, as necessary to carry our services.

Health Oversight Activities. We may disclose medical information to a health oversight agency for activities authorized by law.  These oversight activities include, for example, audits, investigations, inspections, and licensor.  These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil right laws.

Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official.  This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; (3) for the safety and security of the correctional institution.

Law Enforcement. We may release medical information if asked to do so by a law enforcement official response to a court order, subpoena, warrant, summons or similar process; to identify or locate a suspect, fugitive, material witness, or missing person; about the victim of a crime if, under certain limited circumstances, we are unable obtain the persons agreement; about a death we believe may be the result of criminal conduct; about criminal conduct at our practice; and in emergency circumstances to report a crime; the location of the crime or victims; or to identify, description or location of the person who committed the crime.

Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose medical about you in response to a court or administrative order.  We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Military and Veterans. If you are a member of the armed forces, we may release medical information about you as required by military command authorities.  We may also release medical information about foreign military personnel to the appropriate foreign military authority.

National Security and Intelligence Activities. We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Organ and Tissue Donation. If you are an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to organ donation bank, as necessary to facilitate organ or tissue donation and transplants.

Protective Services for the President and Others. We may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons, and foreign heads of state or conduct special investigations.

Public Health Risks. We may disclose medical information about you for public health activities.  These activities generally include the following, but are not limited to: preventing or controlling disease, injury or disability; reporting births and deaths; reporting child abuse or neglect; reporting reactions to medications or problems with products; notifying people of recalls of products they may be using; notifying a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; notifying the appropriate government authority if we believe a patient has been a victim of abuse, neglect or domestic violence.  We will only make this disclosure if you agree or when required or authorized by law.

Worker’s Compensation. We may release medical information about you for workers compensation or similar programs.  These programs provide benefits for work-related injuries or illness.

NOTICE OF INDIVIDUAL RIGHTS

We will provide you with a Summary of our Privacy Practice in addition to this Notice of Privacy Practices. You have the following rights regarding medical information we maintain about you:

Right to an Accounting of Disclosures. You have the right to request an accounting of disclosures of your protected health information.

Right to Amend. If you feel that your protected health  information we have about you is incorrect or incomplete, you may ask us to amend the information.

Right to Inspect and Copy.  Generally , you have the right to inspect and copy protected health information for a reasonable fee.

Right to a Paper Copy of this Notice. You have the right to a paper copy of this Notice of Privacy Practices.  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 stilled entitled to a paper copy of this notice.   To obtain a paper copy of this notice contact us at the above address.

Right to Request Confidential Communication. You have the right to request that we communicate with you about medical matters in a certain way or certain location.  

Right to Request Restrictions. You have the right to request a restriction or limitation on the protected health information we use or disclose about you

Investigation of Breach: If we determine that the disclosure of your medical information constitutes a breach of the federal privacy or security regulations governing unsecured protected health information, we will (1) provide a notice of the breach (2) advise you of what we plan to do to mitigate the damage (if ay) caused by the breach and (3) advise on steps you should take to protect yourself from potential harm from the breach. 

CHANGES TO THIS NOTICE

We reserve the right to change this notice.  We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future.  We will post a copy of the current notice at our office.  The notice will contain the effective date.  In addition, each time you register at or are admitted to the hospital for treatment or health care services as an inpatient or outpatient, we will offer you a copy of the current notice in effect.

 COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with the us or with the Secretary of the Department of Health and Human Services.  To file a complaint with us, contact our Privacy Officer at the above address.   All complaints must be submitted in writing.  You will not be penalized for filing a complaint.

OTHER USES OF MEDICAL INFORMATION

Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission.  If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time.  If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization.  You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provide to you. If you have any questions about this notice, please contact this organization’s Privacy Officer.

Effective Date: April 01, 2013

 
1488 Jesse Jewell Parkway
Suite 100
Gainesville, Georgia 30501
Tel: (770) 532-7179
Fax: (770) 534-1312
2014 Anesthesia Associates of Gainesville, LLC