Rainbow Pediatrics: HIPPA

NOTICE OF PATIENT INFORMATION PRACTICES

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please read carefully.

LEGAL DUTY: Our Practice is required by law to protect the privacy of your personal health information, provide this notice about our information practices and follow the information practices that are described below.

UNDERSTANDING HEALTH INFORMATION: Each time you visit our practice, a record of the visit is made. Typically this record contains your history, symptoms, examination and test results, diagnoses, treatment and a plan for your future care or treatment. This information, often referred to as your health or medical record, serves as a:

· Means of communication among health professionals who care for you or your child
· Legal document describing the care you received
· Means by which you are identified for a third party payor so they may verify the services billed and provided
· Tool in training health care professionals
· Source of data for medical research
· Source of data for public health officials

Understanding what is in your record and how your health information is used helps you to ensure it is correct, better understand how your health information is shared with others and allows you to make informed decisions when authorizing disclosure to others.

We will not use or disclose your health information without your authorization except as described in this notice.

HOW WE WILL USE OR DISCLOSE HEALTH INFORMATION:
-Treatment: We will use for health information for treatment. For example, we may communicate health information to the hospital when you are admitted.
-Payment: We will use your health information for payment. For example, we may send a bill to your insurance company that may include information about your diagnoses and procedures.
-Health Care Operations: We will use your health information for regular health operations. For example, we may review your information to ensure the accuracy and quality of the documentation.
-Business Associates: There are some services provided in our practice through contacts with business associates. Examples include our accountant, attorney, and consultant. We only disclose information necessary to perform the job we have requested and we require they protect the privacy of this information.
-Communication with Family: Health professionals, using their best judgement, may disclose to a family member, other relative or close personal friend or any other person you identify, health information relevant to that person's involvement in your care or the care of your child or payment of services provided.
-Research: We may disclose information to researchers when their research has been approved by an Institutional Review Board or appropriate entity that has reviewed the research proposal and established methods to ensure the privacy of the information.
-Funeral Directors: We may disclose health information to funeral directors and coroners to carry out the duties consistent with the law.
-Organ Procurement Organizations: Consistent with the law, we may disclose health information to organ procurement organizations for their designated services.
-Marketing and Communication: We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
-Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs or replacement.
-Workers Compensation: We may disclose health information to the extent authorized by state law governing workers compensation health care services.
-Public Health: As required by law, we may disclose health information to public health officials charged with preventing or controlling disease, injury or disability. For example, we are required to report certain communicable diseases we may be treating you for.
-Law Enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. We may disclose information to correctional facilities as required by law.
-Reports: We may disclose health information when directed by the appropriate federal oversight agency related to any complaints surveys or requests.

YOUR HEALTH INFORMATION RIGHTS: Although your health record is the physical property of the practice, the information in the health record belongs to you or your child. You have the following rights:
- You may request that we not use or disclose your information related to treatment, payment or health care operations. We ask that such requests be done in writing on a form we will provide. We will review each request individually. Although we will consider your request, we are not obligated to honor it. We will inform you of our decision as quickly as possible.
- You may request to be contacted by alternate means or at alternate locations. Such a request must be made in writing on a form we will provide. We will review each request individually and will attempt to honor all reasonable requests.
- You may request to inspect or copy your medical record. We may charge a reasonable fee for copies. We will attempt to provide you with this information with thirty (30) days.
- If you believe that any information in the record is incorrect or if you believe important information is missing, you may request that we correct the existing information or add the missing information. Such requests must be made in writing on a form we will provide.
- You may request a written accounting of disclosures we have made of your health information after April 14th, 2003. This is limited to disclosures OTHER THAN treatment, payment or health care operations. We will maintain these records for six years. We will respond to your request within thirty (30) days if possible. If you request an accounting more than once in a twelve-month period, you may be charged a reasonable fee.

You have the right to a paper copy of this notice. We must obtain a written authorization from you to disclose information for purposes other than treatment, payment or health care operations. You have the right to revoke this authorization, except to the extent we have already used or disclosed the information.

CONCERNS AND COMPLAINTS: If you are concerned that Rainbow Pediatrics may have violated your privacy rights or if you disagree with any decision we have made regarding the use or disclosure of your information, please contact our Privacy Officer at the address listed below. You may also send a written complaint to the US Department of Health and Human Services. For further information or complaints, contact the following person:

Zanna Shew
110-A Chadwick Square Court, Hendersonville, NC 28739
(828) 698-8135

CHANGES TO THIS POLICY: Rainbow Pediatrics may change or update this policy at any time. When changes are made, a new "Notice of Privacy Practices" will be posted in the waiting room and on our website and will be provided at check-in at your next visit. You may request an updated copy of our notice at any time.