Notice of Privacy Practices

HIPAA Privacy Rule of Patient Authorization Agreement

Authorization for the Disclosure of Protected Health Information for Treatment, Payment, or Healthcare Operations

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

Scheen & Smith, PSC is required by law to maintain the privacy of protected health information and to provide individuals with notice of its legal duties and privacy practices with respect to health information. This notice describes how Scheen & Smith, PSC may use or disclose your protected health information (PHI) for various purposes. It also describes your rights to access and control your protected health information. "Protected health information" is information about you that may identify you and relates to your past, present or future physical or mental health or condition and related health services.

Scheen & Smith, PSC is required to abide by the terms of the Notice of Privacy Practices currently in effect. We reserve the right to change the terms of this Notice’s provisions effective for all protected health information that we maintain. You may request a written copy of a revised Notice of Privacy Practices at any time.

Scheen & Smith, P.S.C. may use and disclose your medical records for treatment, payment and healthcare operations:

Treatment means providing, coordinating, or managing healthcare and related services by or between one or more healthcare providers. An example of this would include a physical examination.
Payment means such activities as obtaining a reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example of this would be sending a bill for your visit to your insurance company for payment.
Healthcare operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost management analysis, and customer services. An example would be an internal quality assessment.

We may contact you to provide appointment reminders or information about treatment alternatives or other health related benefits and services.

We may use a sign-in sheet at the registration desk where you will be asked to sign your name and give other necessary information. The sign-in sheet will not display medical information. We may also call you by name in the waiting room when your physician is ready to see you.

We may disclose health information to our business associates that perform various activities (e.g. billing) for the practice. We will have a written contract with these business associates which contains terms protecting the privacy of your protected health information.

When appropriate, we may share protected health information with a person, identified by you as authorized to receive this information, and who is involved in your care or payment for your care.

Emergency situations when protected health information may be disclosed:

Required by Law: The use or disclosure of protected health information will be made only in compliance with the law and will be limited to medical information.

Public Health: We may disclose protected information to a public health authority that is permitted by law to collect or receive the information for the purpose of controlling disease, injury or disability.

Communicable Diseases: We may disclose protected health information, as authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

Health Oversight: We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections.

Abuse or Neglect: We may disclose your protected health information to public officials who are authorized by law to receive reports of abuse, neglect or domestic violence.

Food and Drug Administration: We may disclose your protected health information to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biological product deviations, track products; to enable product recalls; to make repairs or replacements; or to conduct post marketing surveillance as required.

Legal Proceedings: We may disclose protected health information in response to a court order and in certain conditions in response to a subpoena, discovery requests or other lawful process.

Law Enforcement: We may disclose protected health information for legal purposes, requests for limited information for identification and locations purposes, requests pertaining to the victims of a crime, and alerting law enforcement officials when a crime has occurred.

Coroners, Funeral Directors, and Organ Donation: We may use or disclose protected health information for identification purposes, determining cause of death or other duties authorized by law.

Research: We may disclose protected health information to researchers when an institutional review board has reviewed the research proposal and established protocols to insure the privacy of your protected health information.

Threatening Activity: Consistent with applicable Federal and state laws, we may disclose your protected health information, if we believe this is necessary to prevent or lessen a serious or imminent threat to health or safety of a person or the public.

Military Activity and National Security: When appropriate conditions apply, we may disclose protected health information about individuals who are Armed Forces personnel. Disclosure may be made to authorized Federal officials for conducting national security and intelligence activities.

Workers Compensation: We may disclose protected health information to comply with workers compensation laws and other similar legally established programs.

Required Uses and Disclosures: Under the law, we must make disclosures to you in most circumstances and when required by the Secretary of Department of Health and Human Services to investigate or determine our compliance with the privacy standards applicable to your protected health information.

Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.

YOUR RIGHTS

You have the following rights regarding your protected health information that (except as noted below) you can exercise by presenting a written request to a Privacy Officer:

The right to request restrictions on certain uses and disclosures of protected health information we use or disclose for treatment, payment or healthcare operations. You also have the right to request a limit on health information we disclose to someone involved in your care or with the payment of your care. We are not required to agree to the request. If we agree, we will comply unless the information is needed to provide you with emergency treatment.
The right to request that we communicate with you about medical matters in a certain way or at a certain location. Your request must specify how or where you wish to be contacted. We will accommodate a reasonable request.
The right to ask that we amend your protected health information.
The right to ask to see and get a copy of your protected health information. The request for a copy of your protected health information must be made in writing to our Medical Records Department.
The right to ask for a list of those getting your protected information from us. The list will not cover your protected health information that we give to you or your personnel representative, that was given out for law enforcement purposes, or that was given out for the purpose of treatment, payment, or healthcare operations.
The right to obtain a paper copy of this notice from us upon request.

If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. To file a complaint with our office, or if you want additional information about our privacy practices or this notice, contact our Privacy Officer at 502-896-8803, 3950 Kresge Way, Suite 404, Louisville, KY 40207. All complaints must be made in writing. You will not be penalized for filing a complaint.

This notice updated as of May 20, 2018.