Patient Privacy
Bi-County Pediatrics, P.C.
PRIVACY NOTICE

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

If you have any questions about this notice, please contact the Bi-County Pediatrics, P.C. Privacy officer at 770-949-3888.

WHO WILL FOLLOW THIS NOTICE:
This notices describes the privacy practices of Bi-County Pediatrics, P.C. related to medical information generated at this office. This notice applies to Bi-County Pediatrics, P.C. and that of

  • All departments and units of Bi-County Pediatrics, P.C.
  • All employees, professional staff and other personnel
    This notice also describes the standards we will ask Business Associates of Bi-County Pediatrics, P.C. to adhere to should they have access to your child's medical information during routine work for the practice. For example, if a computer technician will be allowed to service a computer, that technician or that technician's company will be asked to sign an agreement that respects the privacy of your family's medical information.

    OUR PLEDGE REGARDING MEDICAL INFORMATION
    We understand that medical information about your child and your child's health is personal. We are committed to protecting medical information about your child. We create a record of the care and services your child receives. We need this record to provide your child with quality care and to comply with certain legal requirements. This notice applies to all of the records of your child's care created or maintained by this office.

    This notice will tell you about the ways in which we may use and disclose medical information about your child. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.

    We are required by law to:

  • Make sure that medical information that identifies your child is kept private;
  • Give you notice of our legal duties and privacy practices with respect to medical information about your child; and
  • Follow the terms of the notice that is currently in effect.

    DEFINITION
    Medical information about your child includes: medical history, physical findings, test results, diagnoses and treatments. It also includes medical information about your family that has relevance to your child's healthcare. It also includes social information about your family that may be relevant to your child's healthcare. For example, if a family has just moved to a new home, or if a parent has had a change in employment, this may be relevant to your child's evaluation and treatment.

    HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOUR CHILD
    The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

    1. For Treatment. We may use medical information about your child to provide your child with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students or other personnel of our practice who are involved in taking care of your child. We may also share medical information about your child in order to coordinate the different things you need, such as prescriptions, lab work and x-rays. We also may disclose medical information about your child to professionals outside of our office who may be involved in your child's medical care. For example, a doctor involved in treating a child's broken bone needs to know if that child as diabetes or other medical conditions that might complicate the healing process. Finally, we may disclose information to others, such as family members, clergy, etc, if 1) we are confident this would be acceptable to you, and 2) these individuals are clearly active in your child's care and/or support.

    2. For payment. We may use and disclose medical information about your child so that the treatment and services you receive at our office may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about a procedure your child received so your health plan will pay us or reimburse you for the procedure. We may also tell your health plan about a treatment your child is going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

    3. For health care operations. We may use and disclose medical information about your child for operations of our practice. These uses and disclosures are necessary to run the office and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and then evaluate the performance of our staff in caring for your child. We may also combine medical information about many patients in the office to decide what additional services we should offer, what services are not needed, and how effective selective treatments have been. We may also disclose information to medical students and other trainees for review and learning purposes. We may also combine the medical information we have with medical information from other practices to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that identifies your child from this set of medical information so others may use it to study health care and health care delivery without learning who the specific patients are. If we are unable to remove identifying information we will take steps to ensure that the information is used only as intended.

    4. Appointment reminders. We may use and disclose medical information to contact you as a reminder that your child has an appointment for treatment or medical care at our office.

    5. Treatment alternatives. We may use and disclose medical information to tell you about possible treatment options or alternatives that may be of interest to you.
    6. 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 interest to you.

    7. Individual involved in your care or payment for your care. We may release medical information about your child to a friend or family member who is clearly involved in your child's medical care. We may also give information to someone who helps pay for your child's care.

    8. Research. Under certain circumstances, we may use and disclose medical information about your child for research purposes. For example, a research project may involve comparing the health and recovery of all patients who received a medication to those who were treated prior to the availability of that medication. All research projects, however, are subject to a special approval process. This process evaluates a proposed research project and its use of medical information, trying to balance the research needs with patients’ need for privacy of their medical information. Before we use or disclose medical information for research, the project will have been approved through this research approval process. We may, however, disclose medical information about you to people preparing to conduct a research project, for example, to help them look for patients with specific medical needs, so long as the medical information they review does not leave the practice. We will always require that a researcher sign a pledge (a legal commitment) to honor the confidential nature of your child's medical information.

    9. As required by law. We will disclose medical information about your child when required to do so by federal, state or local law.

    10. To avert a serious threat to health and safety. We may use and disclose medical information about your child when necessary to prevent a serious threat to your child's 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 the threat.

    SPECIAL SITUATIONS

    11. Organ and tissue donation. If your child is an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

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

    13. Public Health Risks. We may disclose medical information about your child 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 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 the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.

    14. 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 to monitor the health care system, government programs and compliance with civil rights laws.

    15. Lawsuits and disputes. If you or your child is involved in a lawsuit or a dispute, we may disclose medical information about your child in response to a court or administrative order. We may also disclose medical information about your child 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 abut the request or to obtain an order protecting the information requested.

    16. Law enforcement. We may release medical information if asked to do so by a law enforcement official:

  • In 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 to obtain the person's agreement;
  • About a death we believe may be the result of criminal conduct;
  • About criminal conduct at our office; and
  • In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.

    17. Coroners, medical examiners and funeral directors. We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death.

    18. National security and intelligence activities. We may release medical information about your child to authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law.

    19. Protective services for the President and others. We may disclose medical information about your child to authorized federal official so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.

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

    YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU

    You have the following rights regarding medical information we maintain about your child:

    21. Right to inspect and copy. You have the right to inspect and copy medical information that may be used to make decisions about your child's care. Usually, this includes medical and billing records, but does not include psychotherapy notes or notes made as a result of a confidential visit by an adolescent if 1) you have approved this confidential visit, or 2) the law otherwise protects the confidentiality of this visit.

    To inspect and copy medical information that may be used to make decisions about your child, you must submit your request in writing to our office. 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.

    We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by Bi-County Pediatrics, P.C. will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of this review.

    22. Right to amend. If you feel that medical information we have about your child 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 or for our office.

    To request an amendment, your request must be made in writing and submitted to our office. In addition, you must provide a reason that supports your request.

    We may deny your request for an amendment if it is not in writing or does not include a 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 or for this office;
  • is not part of the information which you would be permitted to inspect and copy; or
  • is without question accurate and complete.

    23. 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 medical information about your child. Exception: disclosures to individual made as part of activities 1-7 above are not tracked (every therapist, every nurse, etc involved with your care) and, therefore, will not be included in the accounting of disclosures provided to you. To request this list or accounting of disclosures, you must submit your request in writing to our office. Your request must state a time period which may not be longer than six years and may not include dates before April 26, 2003. Your request should indicate in what form you want the list. The first list you request within a 12 month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

    24. Right to request restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about your child for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about your child to someone who is involved in your care or the payment for your child's care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery your child had to a specific family member.

    We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide your child emergency treatment.

    To request restrictions, you must make your request in writing to our office. In your request, you must tell us; 1) what information you want to limit; 2) whether you want to limit our sue, disclosure or both; and 3) to whom you want the limits to apply, for example, disclosures to a grandparent.

    25. 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 can ask that we only contact you at work or by mail.

    To request confidential communications, you must make your request in writing to Bi-County Pediatrics, P.C. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

    26. Right to a paper copy of this notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time.

    27. 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 your child as well as any information we receive in the future. We will post a copy of the notice in our office.

    28. Complaints. If you believe your privacy rights have been violated please contact the HIPAA Privacy Officer at Bi-County Pediatrics, P.C. Alternatively, you may submit a complaint in writing with the Secretary of the Department of Health and Human Services.

    Neither you nor you child will be penalized in any way for filing a complaint.

    29. Other uses of medical information: Other uses and disclosures of medical information not covered by this notice or state or federal laws that apply to this office will be made only with your written permission. If you provide us permission to use or disclose medical information about your child, 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 your child for the reasons covered by your written authorization Bi-County Pediatrics, P.C. is unable to the back any disclosures we have already made prior to your revocation of permission to disclose.

    *We will recall your child using postcards when they are in need of a follow up visit and to remind you of an appointment. We will send this postcard to the child's custodial address. If you prefer not to receive these mailings, please submit a written request to the office manager.

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