Patient Privacy

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.

 

THIS NOTICE APPLIES TO ALL OF THE RECORDS OF YOUR CARE GENERATED BY THE CENTER, WHETHER MADE BY THE CENTER OR AN ASSOCIATED ENTITY.

Our staff understands that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a medical record that details the care and services you receive. We refer to this as protected health information (PHI). We need that record in order to provide you with quality care and to comply with certain legal requirements. This notice applies to any medical records generated by our office. 

TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS

The most common reason why we use or disclose your health information is for treatment, payment or health care operations. Examples of how we use or disclose information for treatment purposes are: setting up an appointment for you; referring you to another doctor or clinic for additional or specialist services; or getting copies of your health information from another professional that you may have seen before us. Examples of how we use or disclose your health information for payment purposes are: asking you about sources of payment; preparing and sending bills or invoices; and collecting unpaid amounts (either ourselves or through a collection agency). "Health care operations" mean those administrative and managerial functions that we have to do in order to run the Practice or the Center more efficiently and make sure that all of our patients receive quality care. Examples of how we use or disclose your health information for health care operations are: financial or billing audits; internal quality assurance; reviewing our treatment and services to evaluate the performance of our staff; defense of legal matters; business planning; and outside storage of our records.

Under most circumstances, we are not required to obtain a signed consent for Treatment, Payment, or Operations. However, we will ask you to sign an authorization for certain purposes such as release of PHI to a referring provider or for claims payment in order to comply with State regulations.

We routinely use your health information inside the Practice and/or the Center for these purposes without any special permission. We will ask for your written authorization before we disclose PHI that pertains to HIV, AIDS, mental health treatment or substance abuse.

USES AND DISCLOSURES FOR OTHER REASONS WITHOUT PERMISSION

In some limited situations, the law allows or requires us to use or disclose your health information without your permission. Not all of these situations will apply to us; some may never come up at our office or Center at all. Such uses or disclosures are:

  • When a state or federal law mandates that certain health information be reported for a specific purpose;

  • For public health purposes, such as contagious disease reporting, investigation or surveillance; and notices to and from the Federal Food and Drug Administration regarding drugs or medical devices;

  • Disclosures to governmental authorities about victims of suspected abuse, neglect or domestic violence;

  • Uses and disclosures for health oversight activities, such as for the licensing of doctors, or for investigation of possible violations of health care laws;

  • We may release medical information about you for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.

  • Disclosures for judicial and administrative proceedings, such as in response to subpoenas or orders of courts or administrative agencies;

  • Disclosures for law enforcement purposes, such as to provide information about someone who is or is suspected to be a victim of a crime; to provide information about a crime at the Center; or to report a crime that happened somewhere else;

  • Disclosure to a correctional institution or law enforcement officials if you are an inmate or under the custody of a law enforcement official;

  • Disclosure to a medical examiner to identify a dead person or to determine the cause of death; or to funeral directors to aid in burial; or to organizations that handle organ or tissue donations;

  • Uses and disclosures to prevent a serious threat to health or safety;

  • Uses or disclosures for specialized government functions, such as for the protection of the president or high ranking government officials; for lawful national intelligence activities; 

  • Disclosures of de-identified information;

  • Disclosures of a "limited data set" for research, public health, or health care operations;

  • Incidental disclosures that are an unavoidable by-product of permitted uses or disclosures;

  • Disclosures to "business associates" who perform health care operations for us and who commit to respect the privacy of your health information.

APPOINTMENT REMINDERS

We may call, write, or email to remind you of scheduled appointment that it is time to make a routine appointment or to follow up after a procedure. We may also call or write to notify you of other treatments or services available at our Center that might help you. Unless you object, this contact may be on an answering machine or other method, which could (potentially) be received or intercepted by others. This call or message may be to a home or work number. In writing, you can ask us to use other methods and we will consider your request and determine our ability to comply.

OTHER USES AND DISCLOSURES

We will not make any other uses or disclosures of your health information unless you sign a written "authorization form." Federal law determines the content of an "authorization form". Sometimes, we may initiate the authorization process if the use or disclosure is our idea. Sometimes, you may initiate the process if it is your idea for us to send your information to someone else. Typically, in this situation you will give us a properly completed authorization form or you can use one of ours.

If we initiate the process and ask you to sign an authorization form, you do not have to sign it. If you do not sign the authorization, we cannot make the use or disclosure. If you do sign the authorization, you may revoke it at any time unless we have already acted in reliance upon it. Revocations must be in writing. Send them to the contact person named at the beginning of this Notice.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION 

 

The law gives you many rights regarding your health information.

  • Restrictions: You can ask us to restrict our uses and disclosures for purposes of treatment (except emergency treatment), payment or health care operations. We do not have to agree to do this, but if we agree, we must honor the restrictions that you want. To ask for a restriction, send a written request to the contact person at the address shown at the beginning of this Notice.

  • Communications: You can ask us to communicate with you in a confidential way, such as phoning you at work rather than at home, or by mailing health information to a different address. We will accommodate these requests if they are reasonable. If you want to ask for confidential communications, send a written request to the contact person at the address shown at the beginning of this Notice.

  • Photocopies: You can ask to see or to get photocopies of your health information. By law, there are a few limited situations in which we can refuse to permit access or receiving a copy of your health information. For the most part, however, you will be able to review or receive a copy of your health information within 30 days of asking us (or sixty days if the information is stored off-site).  We will send you a written explanation and instructions about how to get an impartial review of our denial if one is legally available. By law, we can have one 30-day extension of the time for us to give you access or photocopies if we send you a written notice of extension. If you want to review or get photocopies of your health information, send a written request to the contact person at the address shown at the beginning of this Notice.

  • Amendments: You can ask us to amend your health information if you think that it is incorrect or incomplete. If we agree, we will amend the information within 60 days from when you ask us. We will send the corrected information to persons who we know got the wrong information and others that you specify. If we do not agree, you can write a statement of your position and we will include it with your health information along with any rebuttal statement that we may write. Once your statement of position and/or rebuttal is included in your health information, we will send it along whenever we make a permitted disclosure of your health information. By law, we can have on 30-day extension of time to consider a request for amendment if we notify you in writing of the extension. If you want to ask us to amend your health information, send a written request, including your reasons for the amendment, to the office contact person at the address shown at the beginning of this Notice.

  • Disclosures: You can get a list of the disclosures that we have made of your health information within the past six years (or a shorter period if you want). By law, the list will not include: disclosures for purposes of treatment, payment, or health care operations; disclosures that were made with your authorization; incidental disclosures; disclosures required by law; and some other limited disclosures. You are entitled to one such list per year without charge. If you want more frequent lists, you will have to pay for them in advance. We will usually respond to your request within 60 days of receiving it, but by law we can have one 30-day extension of time if we notify you of the extension in writing. If you want a list, send a written request to the contact person at the address shown at the beginning of this Notice.

  • Notice: You can get additional paper copies of this Notice of Privacy Practices upon request. It does not matter whether you got one electronically or in paper form already. If you want additional paper copies, send a written request to the contact person at the address shown at the beginning of this Notice.

 

OUR NOTICE OF PRIVACY PRACTICES

By law, we must abide by the terms of this Notice of Privacy Practices. We reserve the right to change this notice at any time as allowed by law. If we change this Notice, the new privacy practices will apply to your health information that we already have as well as to such information that we may generate in the future. If we change our Notice of Privacy Practices, we will post the new notice in our Center, have copies available in our office and post it on our website.

COMPLAINTS

If you think that we have not properly respected the privacy of your health information, you are free to complain to us or to the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you if you make a complaint. If you want to complain to us, send a written complaint to the contact person at the address shown at the beginning of this Notice. If you prefer, you can discuss your complaint in person or by phone.

FOR MORE INFORMATION

If you want more information about our privacy practices, call or visit the contact person at the address or phone number shown at the beginning of this Notice.

 

Information regarding evaluation and ongoing treatment can only be disclosed with written permission of the client or the legal guardian of the child or adolescent client.  Exceptions to confidentiality include legislation and professional codes of conduct that require mental health providers to break confidentiality when (1) the client presents themselves at being at risk of imminent danger to themselves or to others; (2) when a child or adolescent client is suspected to be at risk of child abuse or neglect; (3) when there is a court subpoena for the patient records maintained by the clinician and/or clinician testimony; (4) when insurance companies gather information about a client's treatment in the process of reimbursing clients for out-of-network treatment. In the event that an exception to confidentiality occurs, I will always notify the client and legal guardian of the child or adolescent prior to releasing any information. As of April 14, 2003, the new federal HIPAA act clarifies you rights regarding your medical records. As such, I have a revised document on confidentiality, privacy and rights re: medical records available immediately at your request. Also see section Patient Privacy. Disclaimer for use of any and all of my web pages: This Terms of Use Agreement (this “Agreement”) is entered into by and between Mark W. Wilson, MD, PC (the “Author”) and “you,” the user of this web page or my other web pages listed above. Access to, use of and/or browsing of the Site or any of my other web pages/sites is provided subject to the terms and conditions set forth herein. By accessing, using and/or browsing the Site, you hereby agree to these terms and conditions.

THIS AGREEMENT CONTAINS WARRANTY DISCLAIMERS AND OTHER PROVISIONS THAT LIMIT THE AUTHOR’S LIABILITY TO YOU. PLEASE READ THESE TERMS AND CONDITIONS CAREFULLY AND IN THEIR ENTIRETY, AS USING, ACCESSING AND/OR BROWSING THE SITE CONSTITUTES ACCEPTANCE OF THESE TERMS AND CONDITIONS. IF YOU DO NOT AGREE TO BE BOUND TO EACH AND EVERY TERM AND CONDITION SET FORTH HEREIN, PLEASE EXIT THE SITE IMMEDIATELY AND DO NOT USE, ACCESS AND/OR BROWSE THE SITE. BY ENTERING THE SITE, YOU ACKNOWLEDGE AND AGREE THAT YOU HAVE READ AND UNDERSTAND THESE TERMS AND CONDITIONS, THAT THE PROVISIONS, DISCLOSURES AND DISCLAIMERS SET FORTH HEREIN ARE FAIR AND REASONABLE, AND THAT YOUR AGREEMENT TO FOLLOW AND BE BOUND BY THESE TERMS AND CONDITIONS IS VOLUNTARY AND IS NOT THE RESULT OF FRAUD, DURESS OR UNDUE INFLUENCE EXERCISED UPON YOU BY ANY PERSON OR ENTITY. MEDICAL ADVICE DISCLAIMER. 

The Author provides the Site and the services, information, content and/or data (collectively, “Information”) contained therein for informational purposes only. The Author does not provide any medical advice on the Site, and the Information should not be so construed or used. Using, accessing and/or browsing the Site and/or providing personal or medical information to the Author does not create a physician-patient relationship between you and the Author. Nothing contained in the Site is intended to create a physician-patient relationship, to replace the services of a licensed, trained physician or health professional or to be a substitute for medical advice of a physician or trained health professional licensed in your state. You should not rely on anything contained in the Site, and you should consult a physician licensed in your state in all matters relating to your health. You hereby agree that you shall not make any health or medical related decision based in whole or in part on anything contained in the Site.

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POSTING GUIDELINES

 

The Site is open to the public. Therefore, consider your comments carefully and do not include anything in a comment that you would like to keep private. By uploading or otherwise making available any information to the Author in the form of user generated comments or otherwise, you grant the Author the unlimited, perpetual right to distribute, display, publish, reproduce, reuse and copy the information contained therein. You are responsible for the content you post. You may not impersonate any other person through the Site. You may not post content that is obscene, defamatory, threatening, fraudulent, invasive of another person’s privacy rights, or is otherwise unlawful. You may not post content that infringes the intellectual property rights of any other person or entity. You may not post any content that contains any computer viruses or any other code designed to disrupt, damage, or limit the functioning of any computer software or hardware. By submitting or posting content on the Site, you grant the Author and any company substantially under the control of the Author, the right to remove any content or comment that, in Author’s sole judgment, does not comply with the terms and conditions of this Agreement or is otherwise objectionable. You also grant the Author and any company substantially under the control of Author the right to modify, adapt, and edit any content.

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The Site may, from time to time, contain links to third party web sites. These links are provided solely as a convenience to you and not as a guarantee, warranty, or recommendation by the Author of the services, information, content and/or data on such third party web sites or as an indication of any affiliation, sponsorship or endorsement of such third party web sites. The Author is not responsible for the content of linked third party web sites and does not make any representations or warranties regarding the privacy practices of, or the content or accuracy of materials on, such third party websites. If you decide to access linked third-party web sites, you do so at your own risk. Your use of third-party websites is subject to the terms of use for such sites.

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The Author may, in the Author’s sole and absolute discretion, modify the terms and conditions of this Agreement in whole or in party at any time for any reason without any notice to you, whether prior or otherwise. Such modified terms and conditions shall supersede these terms and conditions and shall become binding when published online on the Site.

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