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UNDERSTANDING YOUR HEALTH RECORD / INFORMATION

Each time you visit a hospital, physician, dentist, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment.

This information, often referred to as your health or medical record, serves as a basis for planning your care and treatment and as a means of communication among the many health professionals who contribute to your care. Understanding what is in your record and how your health information is used helps you ensure its accuracy, better understand who, what, when, where, and why others may access your health information, and helps you make more informed decisions when authorizing disclosure to others.

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YOUR HEALTH INFORMATION RIGHTS

Unless otherwise required by law, your health record is the physical property of the healthcare practitioner or facility that compiled it. However, you have certain rights with respect to the information. You have the right to:
• Receive a copy of this Notice of Privacy Practices from us upon enrollment or upon request.
• Request restrictions on our uses and disclosures of your protected health information for treatment, payment, and health care operations. This includes your right to request that we not disclose your health information to a health plan for payment or health care operations if you have paid in full and out of pocket for the services provided. We reserve the right not to agree to a given requested restriction.
• Request to receive communications of protected health information in confidence.
• Inspect and obtain a copy of the protected health information contained in your medical and billing records and in any other Practice records used by us to make decisions about you. If we maintain or use electronic health records, you will also have the right to obtain a copy or forward a copy of your electronic health record to a third party. A reasonable copying/labor charge may apply.
• Request an amendment to your protected health information. However, we may deny your request for an amendment if we determine that the protected health information or record that is the subject of the request:
• was not created by us, unless you provide a reasonable basis to believe that the originator of the protected health information is no longer available to act on the requested amendment;
• is not part of your medical or billing records;
• is not available for inspection as set forth above; or
• is accurate and complete.
In any event, any agreed-upon amendment will be included as an addition to, and not a replacement of, already existing records.
• Receive an accounting of disclosures of protected health information made by us to individuals or entities other than to you, except for disclosures:
• to carry out treatment, payment, and health care operations as provided above;
• to persons involved in your care or for other notification purposes as provided by law;
• to correctional institutions or law enforcement officials as provided by law;
• for national security or intelligence purposes;
• that occurred prior to the date of compliance with privacy standards (April 14, 2003);
• incidental to other permissible uses or disclosures;
• that are part of a limited data set (does not contain protected health information that directly identifies individuals);
• made to the patient or their personal representatives;
• for which a written authorization form from the patient has been received.
• Revoke your authorization to use or disclose health information, except to the extent that we have already taken action in reliance on your authorization, or if the authorization was obtained as a condition of obtaining insurance coverage and other applicable law provides the insurer that obtained the authorization with the right to contest a claim under the policy.
• Receive notification if affected by a breach of unsecured PHI.

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HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED

This organization may use and/or disclose your medical information for the following purposes:

Treatment:
We may use and disclose protected health information in the provision, coordination, or management of your health care, including consultations between health care providers regarding your care and referrals for health care from one provider to another.

Payment:
We may use and disclose protected health information to obtain reimbursement for the health care provided to you, including determinations of eligibility and coverage and other utilization review activities.

Regular Health Care Operations:
We may use and disclose protected health information to support functions of our practice related to treatment and payment, such as quality assurance activities, case management, receiving and responding to patient complaints, physician reviews, compliance programs, audits, business planning, development, management, and administrative activities.

Appointment Reminders:
We may use and disclose protected health information to contact you to provide appointment reminders.

Treatment Alternatives:
We may use and disclose protected health information to tell you about or recommend possible treatment alternatives or other health-related benefits and services that may be of interest to you.

Health-Related Benefits and Services:
We may use and disclose protected health information to tell you about health-related benefits, services, or medical education classes that may be of interest to you.

Individuals Involved in Your Care or Payment for Your Care:
Unless you object, we may disclose your protected health information to your family, friends, or any other individual identified by you when they are involved in your care or payment for your care. We will only disclose the protected health information directly relevant to their involvement. We may also disclose your protected health information to notify a person responsible for your care (or to identify such person) of your location, general condition, or death.

Business Associates:
Some services are provided through contracts with Business Associates. Examples include physician services in the emergency department, radiology, certain laboratory tests, and copy services. We may disclose health information to these Business Associates so they can perform services on our behalf. We require Business Associates to appropriately safeguard your information.

Organ and Tissue Donation:
If you are an organ donor, we may release medical information to organizations involved in organ procurement or transplantation as necessary to facilitate donation.

Worker’s Compensation:
We may release protected health information for programs that provide benefits for work-related injuries or illness.

Communicable Diseases:
We may disclose protected health information to notify a person who may have been exposed to a disease or may be at risk of contracting or spreading a disease.

Health Oversight Activities:
We may disclose protected health information to federal or state agencies that oversee our activities.

Law Enforcement:
We may disclose protected health information as required by law or in response to a valid court-ordered subpoena.

Military and Veterans:
If you are a member of the armed forces, we may release protected health information as required by military command authorities.

Lawsuits and Disputes:
We may disclose protected health information in response to a court or administrative order or other lawful process.

Inmates:
If you are an inmate of a correctional institution or under the custody of law enforcement, we may release protected health information to the correctional institution or law enforcement official. An inmate does not have the right to the Notice of Privacy Practices.

Abuse or Neglect:
We may disclose protected health information to notify appropriate government authorities if we believe a patient has been the victim of abuse, neglect, or domestic violence.

Fundraising:
Unless you notify us that you object, we may contact you as part of a fundraising effort. You may opt out by notifying the practice’s Privacy Officer.

Coroners, Medical Examiners, and Funeral Directors:
We may release protected health information to coroners, medical examiners, or funeral directors as necessary.

Public Health Risks:
We may disclose protected health information to public health authorities for disease control or prevention.

Serious Threats:
We may use and disclose protected health information if necessary to prevent or lessen a serious and imminent threat.

Food and Drug Administration (FDA):
We may disclose health information to the FDA as required by law.

Research (Inpatient):
We may disclose information to researchers when approved by an institutional review board.

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OUR RESPONSIBILITIES

We are required to maintain the privacy of your health information and to provide you with this notice. We must follow the terms of this notice and reserve the right to change our practices. Revised notices will be made available upon request and posted on our website, if applicable.

Your health information will not be used or disclosed without your written authorization, except as described in this notice.

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No user mobile SMS opt in will be sold or shared by third parties.

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FOR MORE INFORMATION OR TO REPORT A PROBLEM

If you have questions or believe your privacy rights have been violated, you may contact:

My Diabetes Tutor
Edmaund Davis, Privacy Officer
880 W. 7th Street, Suite 103
Hanford, CA 93230
Tel: 844-623-0999
Fax: 844-306-5999

You may also file a complaint with:

U.S. Department of Health and Human Services
Office of the Secretary
200 Independence Avenue, S.W.
Washington, D.C. 20201
Tel: (202) 619-0257
Toll Free: 1-877-696-6775
http://www.hhs.gov/contacts

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