NOTICE OF PRIVACY PRACTICES FOR PATRICK M. McDONOUGH, D.D.S., M.S., P.A.
This Notice describes how medical information about you may be used and disclosed. Please review it carefully.
- OUR RESPONSIBILITIES
Patrick M. McDonough, DDS, MS, PA is required by law to maintain the privacy of your protected health information, to provide you with this Notice of Privacy Practices, and to abide by the terms of the Notice that is currently in effect. We reserve the right to change this Notice and our privacy policies at any time. Any such changes will apply to the protected
health information we already have. When we make an important change to our policies, we will post the new Notice in our waiting areas. You can receive a copy of the current Notice by contacting out Privacy Officer.
II. HOW WE MAY USE AND DISCLOSE YOUR PROTECTED INFORMATION UNDER FEDERAL LAW
We will share medical information about you with each other as necessary to provide you with health care, to obtain payment for that health care, and to operate our business effectively. We may also use and disclose medical information about you for a number of different purposes, which we describe below. For each of the categories of uses or disclosures described, we will explain what we mean and try to give an example. Not every use or disclosure in a category will be listed; however, all of the ways we are permitted to use and disclose your health information will fall within one of the categories.
A. Treatment, Payment & Health Care Operations
- Uses and Disclosures of Your Protected Health Information for Treatment and Payment Purposes That Do Not Require Your Prior Written Consent. We may use and disclose your protected health information in order to provide, receive payment for, coordinate, or manage your health care and related services without obtaining your prior written consent. This means that we can share your protected health information with all of the health care personnel who are involved in your care for these purposes. For example, if your doctor refers you to a specialist for testing and treatment, we can share your protected health information with that specialist. Similarly, our billing, accounts receivable and collection employees may access your protected health information to arrange for payment of our services.
- Uses and Disclosures of Your Protected Health Information for Our Health Care Operations That Do Not Require Your Prior Consent. We may use and disclose your protected health information for a variety of business activities that we call “health care operations” so that we can improve the quality of care we provide. For example, we may access your protected health information to evaluate the skills of our dental technicians who provide services to you.
B. Certain Other Uses and Disclosures That Do Not Require Your Prior Written Consent
- When disclosure is required by federal or local law, judicial or administrative proceedings, or law enforcement. We will disclose protected health information when a law requires us to report information to a government agency, to a law enforcement agency, or when we receive a valid court order or We also will disclose information when we suspect abuse or neglect of a child or disabled adult.
- When the use and/or disclosure is for health oversight For example, when required, we may disclose protected health information about you to the North Carolina State Board of Dental Examiners.
- For public health activities or to avert a serious threat to health and We may report information about certain diseases to the local health department, and we may provide information to law enforcement or another person if we believe, in good faith, that the use or disclosure is necessary to prevent serious and imminent threat to the health or safety of a person or the public.
- For specialized government functions. We may disclose protected health information to authorized federal officials for the conduct of lawful intelligence, counterintelligence and other national security activities authorized by law.
- For workers’ In the event your visit is related to a workers’ compensation claim, we may disclose protected health information about you in order to comply with workers’ compensation laws.
- Appointment reminders and health related benefits or service. We may use your protected health information to remind you that you have a specific appointment with us and about any required action on your part for such appointment, to tell you about treatment alternatives or other health care services we This may be done by phone call, letter, text, postcard or a combination of these communication methods.
- Uses and Disclosures Where You Have the Opportunity to Object. We may provide protected health information to your family members, a friend, or other Person that you have indicated is involved in your care or the payment of your care, unless you object. For example, if you have an appointment with us and you bring a family member with you and ask them to sit in the treatment room with you, we may disclose protected health information to that family member unless you object. In emergency situa- tions, you will have the opportunity to object once you are able to do so.
C. Uses and Disclosures That Require Your Prior Written Authorization
Uses and disclosures of your protected health information that are not listed above will only be made with your written authorization. If you sign an authorization to disclose your protected health information, you can later revoke that authorization in writing (except in very limited circumstances). If you revoke your authorization, we will stop any future uses and disclosures except to the extent we have not already taken some action in reliance on your authorization.
III. MORE STRINGENT PROTECTION FOR YOUR HEALTH INFORMATION
In some cases, North Carolina law provides you with more stringent privacy protections of your health information than federal law, and where applicable, we will follow the requirements of those state laws. For instance, for us to disclose confidential information in your medical record for treatment, payment, or health care operations, North Carolina law requires us to request that you sign a consent form (which differs from the authorization form mentioned in other parts of this Notice). After obtaining your consent, we may share portions of your medical record with your insurance company to ask about coverage under your plan, or with our Business Associates who help us in complying with this Notice and other applicable laws. We must disclose health information if one of our doctors believes that a patient has a communicable disease or is infected with HIV and is not following safety measures.
IV. YOUR HEALTH INFORMATION RIGHTS
- The Right to Request Restrictions on Uses and Disclosures of Your Protected Health You have the right to ask us to limit how we use and disclose your protected health information. We will consider your request, but we are not legally required to accept it. If we do accept your request, we will note the accepted limitations in writing and foIlow those restrictions, except in emergency circumstances. You may not limit the uses and disclosures that we are legally required to make.
- The Right to Choose How We Send Protected Health Information. You have the right to ask that we send information to you to an alternate address (for example, to your home address instead of your work address), or by alternative means. If we can easily provide the information in the format you request, then we will agree to your request and abide by it.
- The Right to See and Get Copies of Your Protected Health In most cases you have the right to look at or get copies of your protected health information. We will charge a fee to cover the costs of providing you access to the information you request. You must make any request to look at or get copies of your protected health information in writing to our Privacy Officer. Should you wish to discuss such information, this will be done with one of the doctors, by appointment, with a minimum fee and an hourly rate.
- The Right to Correct or Update Your Protected Health Information. If you believe there is a mistake in your protected health information or that a piece of important information is missing, you have the right to ask us to correct the information or add the missing information to your record. You must make a request for us to correct the information in writing to our Privacy Officer, on the forms we will provide to you.
- The Right to Obtain a Paper Copy of this You have the right, at any time, to get a paper copy of this Notice, even if you have agreed that we may provide the Notice and any changes to you via e-mail or other electronic means. To obtain a paper copy of this Notice, please contact our Privacy Officer.
V. IF YOU HAVE QUESTIONS OR WANT TO COMPLAIN ABOUT OUR PRIVACY PRACTICES
You may contact our Privacy Officer at (252) 633-1631 to get answers to any of your questions, or to file a complaint with us. You may also send a written complaint to the United States Secretary of the Department of Health and Human Services at: Office for Civil Rights, U.S. Department of Health and Human Services, Atlanta Federal Center, Suite 3B70, 61 Forsyth Street SW, Atlanta, GA 30303-8909. Washington, DC 20201. We will not take adverse action against you for filing a complaint.