Comprehensive Pulmonary & Critical Care Associates
Where Caring is an Art and Healing is a Science
Alpha J. Anders MD FCCP
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 information. Please review it carefully. The privacy of your personal and health information is important. This requires no action on your part unless you have a request or complaint.
Comprehensive Pulmonary and Critical Care Associates understands the importance of keeping your personal and health information private. Personal health information includes both medical information and individually identifiable information, such as your name, address, telephone number or social security number. We are required by applicable federal and state laws to maintain the privacy of your personal and health information. Both under law and by our policy, we have the responsibility to protect the privacy of your personal and health information (PHI). We will:
- Protect your privacy by limiting who may see your PHI;
- Limit how we may use or disclose your PHI;
- Inform you of our legal duties with respect to your PHI;
- Explain our privacy policies; and strictly adhere to the policies currently in effect.
We may change the terms of this notice, at any time. The new notice will be effective for all PHI that we maintain at the time. Upon your request we will provide you with any revised notice of Privacy Practices. You may request a revised version by accessing our website, or by calling the office and requesting that a revised copy be sent to you in the mail or asking for one at the time of your next appointment.
Uses and disclosure of patient personal and health information
Your PHI may be used and disclosed by your physician, our office staff and others who are involved in your care and treatment, for the purpose of providing health care services to you. Your PHI may also be used and disclosed to pay your health care bills and to support the operations of the practice. The following are examples of the types of uses and disclosures of you PHI. These examples are not exhaustive, but they do describe the types of use and disclosures that may be made by our office.
- Treatment: We may disclose your PHI to a doctor, a hospital or other entity, such as a relative, a friend or another person you identify that is involved in your health care to coordinate and manage your treatment and care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest, based on our professional judgment.
- Public Health and Safety: We may disclose your PHI to the extent necessary to avert a serious and imminent threat to your health or safety or the health or safety of others. We may disclose your PHI to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, domestic violence or other crimes.
- Law Enforcement: We may disclose limited information to law enforcement officials concerning the personal and health information of a suspect, fugitive, material witness or missing person. We may disclose the PHI of an inmate or other person in lawful custody to a law enforcement official or correctional institution.
- Food and Drug Administration: We may disclose your PHI as required by law for the purpose of quality, safety, or effectiveness of FDA regulated products and activities.
- Payment: We may use and disclose your personal and health information to receive payment for services provided to you by our doctors, hospitals or other entities.
- Military and National Security: We may disclose armed forces personnel’s PHI to military and federal authorities as required for lawful determination of benefits eligibility, intelligence and other national security activities.
- Legal Process and Proceedings: We may disclose your PHI in response to a court or administrative order, subpoena, discovery request, or other lawful process.
- Coroners, Funeral Directors: We may disclose your PHI to a coroner, medical examiner, or funeral directors for identification purposes, determining cause of death or other lawful duties.
- Workers’ Compensation: We may disclose your PHI as authorized to comply with workers’ compensation laws and other similar legally established programs.
Authorizing Use and Disclosure of Protected Health Information
Comprehensive Pulmonary and Critical Care Associates will request written authorization from you to use our PHI or to disclose it to anyone for any purpose or situation not included in this document. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect. We will not use or disclose your personal and health information for any reason except those described in this notice without your written authorization.
Individual Rights for All Patients
As a patient, the following are your rights concerning your protected health information.
- Access: You have the right to inspect and obtain copies of your PHI as long as we maintain you PHI. Under federal law, however, you may not inspect or copy psychotherapy notes, information compiled in reasonable anticipation of, for use in, civil, criminal, or administrative action or proceeding; and laboratory results that are subject to law that prohibits access to PHI. Please contact our privacy officer if you have questions about access to your medical records. If you request copies, we may charge you a reasonable, cost based fee. You will be made aware of any and all charges prior to imposing such fees.
- Disclosure Accounting: You have the right to receive a list of instances in which we or our subcontractors disclosed your PHI for purposes other than treatment, payment and health care operations. Effective 4/14/2003 these types of disclosures records are kept for up to six years. If you request this list more than once in a 12-month period, we may charge you a reasonable, cost based fee for responding to these additional requests. You may submit this request in writing by obtaining a form using the contact information listed at the end of this notice.
- Restriction Requests: You have the right to request that we place additional restrictions on our use or disclosure of your PHI. Such as not to disclose your PHI to a family member. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in need for your emergency treatment). You also have the right to agree to, or terminate a previous submitted restriction. You may submit this request in writing by obtaining a form using the contact information listed at the end of this notice.
- Alternate Communications: You have the right to request that we communicate with you in confidence about your PHI by alternative means or to an alternative location. We will accommodate your request if it is reasonable and the request specifies the alternative means or location. If such a request is urgent, we will attempt to accommodate your request for alternative communications received verbally with the understanding that your written request follow at a later date. Routine requests may be submitted in writing by obtaining a form using the contact information listed at the end of this notice.
- Amendment: You have the right to request that we amend your PHI. Your request must be in writing, and it must explain why the information should be amended. We may deny your request if we did not create the information you want amended, we do not maintain the information, or the information is deemed accurate and complete. If we deny your request, we will provide u a written explanation of the denial. I we accept your request to amend the information we will make reasonable efforts to inform others of the amendment and to include the changes in any future disclosures of that information. You may submit this request in writing by obtaining a form using contact information listed at the end of this notice.
- Electronic and Paper Notice: You have the right to receive this notice in paper form upon request. Please contact us using the information listed at the end of this notice obtain this notice in written form.
- Complaints: If you have a concern that we may have violated your privacy rights or you disagree with a decision we made about access to your PHI, you may file a complaint with us using the contact information listed at the end of this notice. You also may submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request.
Contact the Privacy Officer
For all requests and communications regarding your protected health information and this privacy notice, you may email our privacy officer at email@example.com, call us at 661-633-5474 or write: Comprehensive Pulmonary and Critical Care Associates
Attn: Privacy Officer
P.O. Box 2809
Bakersfield, CA 93303
P.O. Box 2809
Bakersfield, CA 93303
We support your right to protect the privacy of your personal and health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services. It has always been our goal to ensure the protection and integrity of our patients’ personal and health information. Therefore, we will notify you of any potential situations where your information would be used for reasons other than payment and health treatment operations.