PIEDMONT SLEEP CENTER, INC.
1022 3 RD AVE. DR., NW
HICKORY, N.C. 28601
THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Piedmont Sleep Center, Inc is here to serve your sleep related healthcare needs. We appreciate the trust you have placed in us, and we are committed to using protected health information about you responsibly.
UNDERSTANDING YOUR HEALTH INFORMATION
Each time you visit Piedmont Sleep Center, Inc, a record of your visit is made. Typically, this record contains your symptoms, examinations and test results, diagnoses, treatment. This information, often referred to as your health or medical record, serves as:
- A basis for planning your care and treatment
- A means of communication among the many health professionals who contribute to your care
- A legal document describing the care you received
- A tool in educating health professionals
- A source of information for public health officials charged with improving the health of the nation
- A source of data for our practice, planning and marketing
- A tool with which we can assess and continually work to improve the care we render and the outcomes we achieve
An understanding of what is in your record and how your health information used will help you to (1) ensure its accuracy, (2) better understand who, what, when, where and why others may access your health information, and (3) make more informed decisions when authorizing discloser to others.
YOUR HEALTH INFORMATION RIGHTS
Although your health record is the physical property of Piedmont Sleep, the information belongs to you. As provided for in the HIPAA Privacy Regulations, 45 CFR Part 160, you have the right to:
- Request a restriction on certain uses and disclosures of your information
- Obtain a paper copy of this Notice of Privacy Practices upon request
- Inspect and copy your health record
- Request an amendment to your health record
- Obtain an accounting of disclosures of your health information
- Request communications of your health information by alternative means or at alternative locations
- Revoke your authorization to use or disclose health information except to the extent that action has already been taken
Responsibilities of Piedmont Sleep Center, Inc.
Our practice is required to:
- Provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
- Abide by the terms of this notice
- Notify you if we are unable to agree to a requested restriction
- Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations
We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will post a copy in our office in a prominent location. We will provide you with a copy of the revised Notice upon your request.
We will not use or disclose your health information without your authorization, except as described in this notice.
FOR MORE INFORMATION OR TO REPORT A PROBLEM
If you have questions and would like additional information, you may contact the Privacy Officer of Piedmont Sleep Center, Inc at 828-322-3111
If you believe your privacy rights have been violated, you can file a complaint with the privacy officer of Piedmont Sleep Center, Inc or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.
EXAMPLES OF DISCLOSURES FOR TREATMENT, PAYMENT, AND HEALTH OPERATIONS
We will use your health information for treatment.
For example: Information obtained by physician or another member of our staff will be recorded in your record and used to determine the course of treatment that should work best for you. Your provider will document in your record any expectations he or she has for the members of our staff. Our staff will then record the action they took and their observations. In that way, the provider will know how you are responding to treatment.
We will also provide your physician or a subsequent health care provider with copies of various reports that should assist him or her in treating you.
We will use your health information for payment.
For example: A bill may be sent to you or a third party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.
We will use your health information for regular health operations.
For example: Members of our staff may use information in your health record to assess the care and outcome in your case and others like it. This information will then be used in an effort to continually improve the quality and service we provide.
Business Associates: There are some services provided in our practice through contracts with Business Associates. (Examples include diagnostic services.) When these service are contracted, we may disclose your health information to our Business Associates so that they can perform the job we’ve asked them to do. To protect your health information, however, we require the business associate to appropriately safeguard your information.
Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location and general condition.
Communication with family: Our staff, using their best judgment, may disclose to a family member, other relative, close personal friend or another person you identify, health information relevant to that person’s involvement in your care or payment related to your care.
Research: We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.
Marketing: We may contact you to provide appointment reminders or information about treatment or information about treatment alternatives or other health-related benefits and services that may be of interest to you. PLEASE NOTE that we do try to call and remind of appointments and if we cannot speak to you directly, we may leave a message with someone or on an answering machine.
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 replacements.
Workers Compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.
Public Health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
Correctional Institution: Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals.
Law Enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.
Federal Law makes provisions for your health information to be released to an appropriate health oversight agency, public health authority, or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards are potentially endangering one or more patients, workers, or the public.
Effective January 1, 2005