PRIVACY PRACTICES Effective Date: October 1, 2006
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.
Should you have any questions about this notice, please contact the office manager at Rapid Med or the compliance director.
WHO WILL FOLLOW THIS NOTICE
- Any health care professional that is authorized to enter or retrieve information into your clinic records.
- All employees and representatives of Rapid Med.
We understand that medical information about you and your health is personal, and we are committed to protecting this information. We create a record of the care and services you receive at Rapid Med. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all the records of your care generated by the clinic.
This notice will tell you about the ways in which we may use and disclose medical information about you. It also describes your rights and certain obligations we have regarding the use and disclosure of medical information.
By law, we are required to make sure that information that identifies you is kept private and to give you this notice of our legal duties and privacy practices with respect to medical information about you. We are also required by law to follow the terms of this notice that is currently in effect.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU
The following categories describe different ways that we may use and disclose medical information. We will explain what we mean and give some examples for each category of uses or disclosures. It is not possible to list every use or disclosure in each category. However, all the ways we are permitted to use and disclose information will fall within one of the categories.
- For Treatment. We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students, nursing students, or other clinic personnel who are involved in your care. We may also disclose medical information to people outside the clinic, who may be involved in your medical care, such as hospital personnel or other providers or agencies we use to provide services that are part of your care.
- For Payment. We may use and disclose medical information about you so that the treatment and services you receive may be billed and payment may be collected from you, an insurance company, or a third party. We may also tell your health plan about a treatment or procedure you are going to receive to obtain prior approval or to determine whether your plan will cover the services. We may also use an affiliated company or third party to assist with billing.
- As Required by Law. We will disclose medical information about you when required to do so by federal, state, or local law.
- To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary, to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent or resolve the threat.
- 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.
- Workers’ Compensation. We may release medical information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illnesses.
- Public Health Risks. We may disclose medical information about you for public health activities. These activities generally include the following:
- To prevent or control disease, injury, or disability.
- To report births and deaths.
- To report child abuse or neglect.
- To report reactions to medications or problems with products.
- To notify people of recalls of products they may be using.
- To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
- To notify 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.
- 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 licensure. These activities are necessary for the government programs, and compliance with civil rights laws.
- Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court order or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or 9ther 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.
- Law Enforcement. We may release medical information if asked to do so by a law enforcement official.
- Coroners, Medical Examiners and Funeral Directors. We may release medical information to a coroner or medical examiner when necessary.
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU
You have the following rights regarding medical information we collect and maintain about you:
- Right to inspect and copy. You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes.
- To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, or other supplies associated with your request.
- Right to Amend. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by the clinic.
- We may deny your request for an amendment if it is not in writing or if it does not include adequate reason to support the request. In addition, we may deny your request if you ask us to amend information that:
- Was not created by us, unless the person or entity that created the information is no longer available to make the amendment.
- Is not part of the medical information kept by the clinic.
- Is not part of the information which you would be permitted to inspect and copy.
- Is accurate and complete.
Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of your medical information.
To request this list, you must submit your request in writing to the office manager at Rapid Med. Your request must state a time period which may not be longer than six years and may not -include dates before October I, 2006. Your request should indicate in what form you want the list, either on paper, or electronically. The first list you request within a 12-month period will be free. For additional lists within the 12-month period, we may charge you for the cost of providing the list.
Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care.
We are not required to agree to your request. If we do, we will comply with your request unless the information is needed to provide you emergency treatment.
To request restrictions, you must make your request in writing to the office manager. You must tell us in the request what information you want to limit, whether you want to limit our use, disclosure or both and to whom you want the limits to apply.
Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you could ask that we contact you at work or by mail. To request confidential communications or a change to an already existing request, you must make your request in writing to the office manager. You do not have to state a reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
CHANGES TO THIS NOTICE
We reserve the right to change this notice at any time.
If you believe your; privacy rights have been violated, you may file a complaint with the clinic or with the Secretary of the Department of Health and Human Services. To file a complaint, please submit it in writing with the compliance director. You will not be penalized for filing a complaint.
Rapid Med Urgent Care Center
PATIENT’S BILL OF RIGHTS AND RESPONSIBILITIES
Rapid Med recognizes your rights while you are receiving medical care. Rapid Med also wants you to understand its expectations of its patients.
- A patient has the right to be treated with courtesy and respect, with appreciation of his or her individual dignity and with protection of his or her need for privacy.
- A patient has the right to a prompt and reasonable response to questions and requests.
- A patient has the right to know who is providing medical services and to view their credentials.
- A patient has the right to know what patient services are available, including whether an interpreter is available if he or she does not speak English.
- A patient has the right to be given information concerning diagnosis, planned course of treatment, alternatives, risks and prognosis by the health care provider.
- A patient has the right to appropriate assessment and management of pain.
- A patient has the right to refuse any treatment and expect compliance with a properly executed advance directive, except as otherwise provided by law.
- A patient has the right to receive, upon request, prior treatment, a reasonable estimate of charges for medical care.
- A patient has the right to receive a copy of a reasonably clear and understandable itemized bill and upon request to have the charges explained.
- A patient has the right to impartial access to medical treatment or accommodations, regardless of race, national origin, religion, handicap or source of payment.
- A patient who is eligible for Medicare has the right to know, upon request and in advance of treatment; whether the health care provider or health care facility accepts the Medicare assignment rate.
- A patient has the right to know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such experimental research.
- A patient has the right to express grievances regarding any violation of his or her rights, as stated in law, through the grievance procedure of the health care provider or health care facility which served him or her and to the appropriate state licensing agency.
- A patient has the right to receive a notice of all protected health information practices.
- A patient has the right to view all protected health information pertaining to him or her.
- A patient has the right to access an accounting of all disclosures.
- A patient has the right to request amendments and corrections to personal information that they feel is incorrect.
- A patient has the right to receive confidential communications.
- A patient has the right to complain to the covered entity and the Department of Health and Human Services.
- A patient is responsible for providing to the health care provider, to the best of his or her knowledge, accurate and complete information about present complaints, past illness, hospitalizations, medications and other matters relating to his or her health.
- A patient is responsible for reporting expected changes in his or her condition to the health care provider.
- A patient is responsible for following the treatment plan recommended by the healthcare provider.
- A patient is responsible for keeping appointments and when he or she is unable to do so for any reason, for notifying the healthcare provider or health care facility.
- A patient is responsible for his or her actions if he or she refuses treatment or does not follow the health care provider’s instructions.
- A patient is responsible for assuring that the financial obligations of his or her health care is fulfilled as promptly as possible.
- A patient is responsible for following health care facility rules and regulations affecting patient care and conduct.