Rockdale Anesthesia Services, P. C.

HIPPA NOTICE OF PRIVACY PRACTICES

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

This Notice of Privacy Practices describes how we may use ad disclose your protected health information (PHI) to carry out treatment, payment or health operations (TPO) and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. "Protected health Information" is information about you, including demographic information that may identify you and that relates to your past, present or future physical or mental health condition or related health care services.

1.Uses and Disclosures of Protected Health Information
Your protected health information may be used and disclosed by your physician, office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operation of the physician's practice and any other uses required by law.

Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your healthcare and any related services. This includes the coordination or management of your heath care with a third party. For example, we would disclose your (PHI) as necessary to a home health agency that provides care to you. Your (PHI) may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.

Payment: Your (PHI) will be used as needed to obtain payment for your health care services. For example obtaining approval for a hospital stay may require that your relevant protected health information be disclosed to the health plan to obtain approval for the hospital admission.

Healthcare Operations: We may use or disclose as needed your (PHI) in order to support business activities of your physician's practice. These activities include but are not limited to, employee review activities, training of medical students, licensing and conducting or arranging for other business activities. .For example we may use or disclose your (PHI) as necessary to contact you to remind you of your appointment.

We may use or disclose your protected health information in the following situations without your authorization. These situations include as Required By Law, Public Health Issues as required by law; Communicable Diseases; Health Oversight: Abuse or Neglect: Food and Drug Administration requirements: Legal Proceedings; Law Enforcement: Coroners, Funeral Directors, and Organ Donation; Research: Criminal Activity; Military Activity and National Security; Worker Compensation; Inmates: Required Uses and Disclosures: Under the law, we must make disclosures to you and when required by the secretary of the department of health and human Services to investigate or determine our compliance with the requirements of Section 164.500.

Other permitted and required uses and Disclosures Will be made with only your Consent, Authorization or Opportunity to Object unless required by law.

You may revoke this authorization, at any time, in writing, except to the extent that your physician or the physician's practice has taken an action in reliance on the use or disclosure indicated in the authorization.

YOUR HEALTH INFORMATION RIGHTS
The health and billing records we maintain are the physical property of the Physicians office. The information in it belongs to you. You have a right to:
" Request a restriction on certain uses and disclosures of your (PHI) by delivering the request in writing to our office. We are not required to grant the request but will comply with any request granted.
" Request that you be allowed to inspect and copy your health record -you may exercise that right by delivering the request in writing to our office using the form we provide. This request will be reviewed within 10 business days.
" Appeal a denial of access to you (PHI) except in certain circumstances.
" Request that your health care record be amended to correct incomplete or incorrect information by delivering a written request to our office using the form we provide to you upon request.( The physician or healthcare provider is not required to make such amendments).
" File a statement of disagreement if your amendment is denied
" Obtain an accounting of disclosures of your health information as required to be maintained by law by delivering a written request to our office using the form we provide. An accounting will not include internal uses of information for payment, treatment and operations or disclosures made to family members or friends in the course of providing care.
" Request that communications of your health information be made by alternative means or to an alternative location by delivering the request in writing using the form we will provide you.
" Revoke authorizations that you made previously to use or disclose information except to the extent information or action has already been taken by delivering a written revocation to our office.

Our Responsibilities:
The office is required to:
" Maintain the privacy of your health information as required by law.
" Provide you with a notice as to our duties and privacy practices as to the information we collect and maintain about you.
" Abide by the terms of this notice.
" Notify you if we cannot accommodate a requested restriction or request.
Accommodate your reasonable request regarding methods to communicate health information to you.

To Request Information or File A Complaint:
If you have questions, would like additional information or want to report a problem regarding the handling of your information, you may contact, Valerie Lowery Privacy Officer/Office Manager Rockdale Anesthesia Services 770-388-7745