Eastern Urological Associates, P.A.

Patient Privacy

Eastern Urological Associates, P.A.
Notice of Privacy Practices

Effective April 14, 2003

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.
Revised 1/3/13
USES AND DISCLOSURES OTHER THAN FOR TREATMENT, PAYMENT, AND HEALTHCARE OPERATIONS

We may use and/or disclose your PHI without your authorization for the following circumstances:

When required by law. This may include reporting a crime, responding to court order or subpoena, or any other federal, state, or local law or judicial proceeding. This may include reporting certain types of wounds or other physical injuries, or if we have suspicion that your health condition was the result of criminal conduct, such as suspected abuse, neglect, or domestic violence.

To public health officials or legal authorities charged with preventing or controlling disease, injury, or disability This may include reporting vital events such as birth or death, complying with public health investigations, such as audits necessary to ensure compliance with government regulations and civil rights laws. This may also include disclosures for military and veteran affairs, or national security and intelligence activities.

Consistent with applicable law, we may disclose health information to a coroner, medical examiner, funeral director, or organ rocurement organization for purposes of donation and transplant.

For research, provided that the researcher has obtained a required waiver from an Institutional Review Board/Privacy Board, who has reviewed the research protocol.

Consistent with applicable law, if we believe that disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or to the health and safety of the public.

We may release your PHI to comply with worker’s compensation laws or other similar programs established by law

We may disclose to the FDA health informa- tion relative to adverse events with respect to medications and/or medical devices to report defects which may enable product recalls, repairs, or replacement.

UNAUTHORIZED DISCLOSURES

We make every attempt to safeguard your informa-tion in every way that we can to minimize any incidental disclosures. In the event, that an unauthorized disclosure of your information is discovered, you will be notified. Under 2009 HITECH components of HIPAA Privacy Breach Notification Rules, we must inform the Department of Health and Human Services of all breaches. Our staff is trained on HIPAA regulations and privacy issues at time of initial employment, with annual updates, and are aware that they can face civil and even criminal penalties for intentional breaches of your information.

FOR MORE INFORMATION, OR TO FILE A COMPLAINT

If you have questions regarding our practice’s pri¬vacy policies, you may contact our Privacy Officer, Carla Griffin, at 252- 752-5077, extension 203. If you believe your privacy rights have been violated, you can file a complaint with our Privacy Office or with the Office of Civil Rights, US Department of Health and Human Services (OCR).

INTRODUCTION

This Privacy Notice is being provided to you as required by federal law, the Health Insurance Portability and Accountability Act (HIPAA). describes how Eastern Urological Associates may use and disclose your protected health information (PHI) to carry out treatment, payment, or health care operations and for other purposes permitted or required by law It also describes your rights regarding your protected health information. Your "protected health information" means any written, electronic and oral health information, including demographic data that can be used to identify you. This is health information that is created or received by us, that relates to your past, present, or future health condition. Eastern Urological Associates may not use/or disclose your PHI without your authorization for purposes other than treatment, payment, or health care operations, or where required by law.

SUMMARY OF YOUR RIGHTS TO PRIVACY

EUA has a legal duty to protect your health informa¬tion. You have several rights regarding your PHI:

The right to object to certain uses and disclosures.

The right to request restrictions on uses and disclosures of your PHI.

The right to request different ways to communicate with you.

The right to see and copy PHI about you.

The right to request an amendment of PHI about you.

The right to a listing of disclosures we have made about your PHI.

The right to a copy of this notice.

The right to file a complaint about our privacy practices.

EXAMPLES OF DISCLOSURE FOR TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS

We may use and disclose your PHI to provide, coor¬dinate, or manage your health care and any related services. For example: information obtained by our staff will be recorded in your record. This informa¬tion may be shared with your referring provider, or with any provider we refer you to, for the purposes of providing continuity of care.

We may disclose your information so that we can collect payment for services rendered. For example: if you have health insurance, we will disclose neces¬sary information to your insurer to obtain payment. We may also disclose PHI to your insurer to deter¬mine eligibility, or obtain prior approval for certain services, such as radiology or surgery.

We may use and disclose your PHI for health care operations. For example: we must disclose your information to the hospital staff when scheduling surgery on your behalf. Other examples of health care operations include such activities as quality assessment activities to improve our care to you, accreditation by outside organizations that certify and license our practice, employee training programs, and certain legitimate business management/administrative activities.

We may contact you to provide appointment reminders, or to provide information about treatment alternatives or other health-related services that may be of interest to you. You will be asked to designate in your record whether we have permission to leave messages on your answering machine, contact you at work, or leave messages with any other individuals.

OUR RESPONSIBILITIES

Our practice is required to maintain the privacy of your health information and to abide by the terms of this notice, which may be amended from time to time. A copy of the current revised notice is posted in the main lobby and paper copies are always avail¬able at the main reception desk.

You have the right to obtain a copy of your records. This requires that you must sign a “Release of Information Form”, available at the main reception desk (reasonable copy fees may apply in accordance with state law). If you feel an error has been made in your record, you have the right to request an amendment; however, this request may be denied if we determine it is unreasonable. For example, we cannot amend information that was not created by us, or if we believe the original information is correct and complete. You have the right to request communications from us by alternative means, such as by e-mail or mailing to an alternative location.

There are some services provided in our organization through contracts with business associates, such as transcription or document shredding services. Due to the nature of business associates’ services, they must receive your health information in order to perform the jobs we have asked them to do. To protect your health information, our business associates must sign a “Business Associate Agreement,” which legally binds them to safeguard your information in the same manner that HIPAA requires of us. Unless you object, our staff, using their best judgment, may disclose to a family member or close personal friend, health information relevant to that person’s involvement in your care or payment related to your care. We may notify these individuals of your location and general condition.