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Privacy
Policy
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.
Introduction
The following information will describe the ways in which we may
use and disclose medical information about you. Not every use
or disclosure in a category will be listed but all of the ways
we are permitted to use and disclose information will fall within
one of the categories. We reserve the right to change this notice.
We reserve the right to make the revised notice effective for
medical information we already have about you as well as any information
we receive in the future. We will post a copy of the current notice
in plain view. Each time we revise our notice, we will post it
in our office and make it available to you upon request.
We also describe your rights and certain obligations
we have regarding the use and disclosure of medical information.
We are required by law to:
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Make sure that medical information that
identifies you is kept private
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Give you this notice of our legal duties
and privacy practices with respect to medical information
about you
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Make a good faith effort to obtain your
acknowledgment that you have received this notice
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Follow the terms of the notice that is
currently in effect
Examples of Disclosures for Treatment,
Payment, and Health Care Operations
We may use medical information about to provide
you with medical treatment services. We may disclose medical
information about you to doctors, nurses, or other personnel
in our organization who are involved in taking care of you.
For example, we may need to tell a nurse about your condition
in order to coordinate the different things you need, such as
lab work. We also may disclose medical information about to
health care providers outside our organization who are involved
in your treatment, such as consulting a physicians.
We may use and disclose medical information
about you so that the services you receive from us or other
providers may be billed and payment may be collected from you,
an insurance company or a third party. For example, we may need
to give your health plan information about treatment you received,
so your health plan will pay us or reimburse you for the treatment,
or to obtain prior approval or determine whether your plan will
cover the treatment.
We may use and disclose medical information
about you for our operations and make sure that all of our patients
receive quality care. For example, we may use medical information
to review our treatment and services and to evaluate the performance
of our staff in caring for you. We may also combine the medical
information we have with medical information from other similar
organizations to compare how we are doing and see where we can
make improvements in the care and services we offer. We will
remove information that identifies you from this set of medical
information so others may use it to study health care delivery
without learning who the specific patients are.
Other Uses of Medical Information
Other uses and disclosures of medical information
not covered by this notice or the laws that apply to use will
be made only with your written permission. All disclosures of
psychotherapy notes require your written authorization. If you
give us permission to use or disclose medical information about
you, you may revoke that permission, in writing, at any time.
If you revoke your permission, we will not longer use or disclose
medical information about you for the reasons covered by your
written authorization. You understand that we are unable to take
back any disclosures we have already made with your permission.
We may use and disclose medical information to
contact you as a reminder that you have an appointment for treatment
We may use and disclose medical information to
tell you about or recommend treatment options or alternatives
or other health-related benefits or services that may be of interest
to you
Unless you object, we may include certain limited
information about you in our directory while you are a patient
here. This information may include your name, location, your general
condition (e.g., fair, stable, etc.) and your religious affiliation.
The directory information, except for your religious affiliation,
may also be released to people who ask for you by name. Your religious
affiliation may be given to a member of the clergy, such as a
priest or rabbi, even if they do not ask for you by name. This
is so that your family, friends, and clergy can visit you while
you are a patient with us and generally know how you are doing.
If you do not object, we may release medical
information about to a friend or family member who is involved
in you medical care. In addition, we may disclose medical information
about you to an entity assisting in a disaster relief effort so
that your family can be notified about your condition, status
and location.
Under certain circumstances, we may use and disclose
medical information about you for research purposes. We will almost
always ask for your specific permission if the researcher will
have access to information that reveals who you are, or will be
involved in your care.
We will disclose medical information about you
when required to do so by federal, state, or local law.
We may use and disclose medical information about
you when necessary to prevent a serious threat to your health
and safety or the health and safety of the public or another person.
any disclosure, however, would only be to someone able to help
prevent the threat.
If you are an organ donor, we may release medical
information to organizations that handle organ procurement or
organ, eye or tissue transplantation or to an organ donation bank,
as necessary to facilitate donation and transplantation.
If you are a member of the armed forces, we may
release medical information about you as required by military
command authorities.
We may release medical information about you
for public health activities (such as reports of communicable
diseases, births and deaths, child abuse or neglect, reactions
to medications or problems with products), to notify a person
who may have been exposed to a disease or may be at risk for contracting
or spreading a disease, or to notify the appropriate authority
if we believe a patient has been the victim of abuse, neglect
or domestic violence.
We may disclose medical information to a health
oversight agency for activities such as audits and investigations
that are necessary for the government to monitor the health care
system, government programs, and compliance with civil rights
laws.
If you are involved in a lawsuit or dispute,
we may disclose medical information about you in response to a
court or administrative order. We may also disclose medical information
about you in response to a subpoena, discovery request, or other
lawful process by someone else involved in the dispute, but only
if a reasonable effort has been made to tell you about the request
or to obtain an order protecting the information requested.
We may release medical information if asked to
do so by a law enforcement official: in response to a court order,
subpoena, summons or similar process; to identify or locate a
suspect, fugitive, material witness, or missing person; about
the victim of a crime if, under certain limited circumstances,
we are unable to obtain the person's agreement; about a death
we believe may be the result of criminal conduct at this organization;
and in emergency circumstances to report a crime, the location
of the crime or victims, or the identity, description or location
of the person who committed the crime.
We may release medical information to a coroner
or medical examiner. This may be necessary, for example, to identify
a deceased person or determine the cause of death. We may also
release medical information about the patients to funeral directors
as necessary to carry out their duties.
We may release medical information about you
to authorized federal officials for intelligence, counterintelligence,
and other national security activities authorized by law.
We may disclose medical information about you
to authorized federal officials so they may provide protection
to the President of the United States, other authorized persons
or foreign heads of state or conduct special investigations.
If you are an inmate of a correctional institution
or under the custody of a law enforcement official, we may release
medical information about you to the correctional institution
or law enforcement official if necessary. Rights Regarding Medical Information
About You
You have the right to:
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Request a restriction or limitation on the medical
information we use or disclose about you for treatment, payment
or health care operations, or to someone who is involved in your
care. For example, you could ask that we not use or disclose information
about a procedure you had.
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Request that we communicate with you about medical
matters in a certain location. For example, you can ask that we
only contact you at work or by mail.
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Inspect and copy the medical records we have
about you.
If you feel that medical information we have
about you in incorrect or incomplete, you may ask us to amend
the information.
Request a list of the disclosures we made of
medical information about you, except for treatment, billing and
health care operations, or as a result of your written authorization.
To exercise these rights, make the request in
writing. Ask the receptionist for the proper form. We have the
right to deny your request in certain limited circumstances. Questions and Complaints
If you believe your privacy rights have been violated, you may
file a complaint with this organization or with the U.S. Secretary
of the Department of Health and Human Services. To file a complaint
with us, contact Judy Allen at (205) 595-8985, whose name is posted
at 860 Montclair Road, Suite 600, Birmingham, Alabama 35213. All
complaints must be submitted in writing. You will not be penalized
for filing a complaint. Please contact the Privacy Officer if
you need further information.
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