The ChildHealth Center, P.A.
We are required to abide by the terms of this Notice of Privacy
Practices. We may change the terms of our notice, at any time. The new notice
will be effective for all protected health information that we maintain at that
time. Upon your request, we will provide you with any revised Notice of Privacy
Practices. You may request a revised version by accessing our
Your protected health information may be used and disclosed by
your physician, our office staff and others outside of our offices who are
involved in your care and treatment for the purpose of providing health
Following are examples of the types of uses and disclosures of your protected health information that your physician’s office is permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office.
Treatment: We will
use and disclose your protected health information to provide, coordinate, or
manage your health care and any related services. This includes the coordination
or management of your health care with another provider. For example, we would
disclose your protected health information, as necessary, to a home health
agency that provides care
protected health information will be used and disclosed, as needed, to obtain
payment for your health care services provided by us or by another provider.
This may include certain activities that your health insurance plan may
undertake before it approves or pays for the health care services we recommend
for you such as: making a determination
Health Care Operations:
We may use or disclose, as needed, your protected health information in order to
support the business activities of your physician’s practice. These activities
include, but are not limited
We will share your protected health information with third party
“business associates” that perform various activities (for example, billing or
transcription services) for our practice. Whenever an arrangement
We may use or disclose your protected health information, as
necessary, to provide you with information about treatment alternatives or other
Other Permitted and Required Uses and
We may use or disclose your protected health information in the
following situations without your authorization or providing you the opportunity
Required By Law:
We may use or disclose your protected health information to the extent
that the use or disclosure is required by law. The use or disclosure will be
made in compliance with the law and will be
Public Health: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. For example, a disclosure may be made for the purpose of preventing or controlling disease, injury or disability.
Health Oversight: We
may disclose protected health information to a health oversight agency for
activities authorized by law, such as audits, investigations, and inspections.
Oversight agencies seeking this
Abuse or Neglect: We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.
Legal Proceedings: We may disclose protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), or in certain conditions in response to a subpoena, discovery request or other lawful process.
Law Enforcement: We
may also disclose protected health information, so long as applicable legal
requirements are met, for law enforcement purposes. These law enforcement
purposes include (1) legal processes and otherwise required by law, (2) limited
information requests for identification and location purposes, (3) pertaining to
victims of a crime,
Coroners, Funeral Directors, and
Organ Donation: We may disclose protected health information to a
coroner or medical examiner for identification purposes, determining cause of
death or for the coroner or medical examiner to perform other duties authorized
by law. We may also disclose protected health information to a funeral director,
as authorizedby law, in order to permit the funeral director to carry out their
duties. We may disclose such information in reasonable anticipation of death.
Protected health information may be used and disclosed for cadaveric
Research: We may
disclose your protected health information to researchers when their research
has been approved by an institutional review board that has reviewed the
research proposal and established
Consistent with applicable federal and state laws, we may disclose your
protected health information, if we believe that the use or disclosure is
necessary to prevent or lessen a serious and imminent threat to the health or
safety of a person or the public. We may also disclose protected health
information if it is necessary for law enforcement
Uses and Disclosures of Protected
Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke this authorization in writing at any time. If you revoke your authorization, we will no longer use or disclose your protected health information for the reasons covered by your written authorization. Please understand that we are unable to take back any disclosures already made with your authorization.
Other Permitted and Required Uses and
We may use and disclose your protected health information in the
following instances. You have the opportunity to agree or object to the use or
disclosure of all or part of your protected health information. If you are not
present or able to agree or object to the use or disclosure of the protected
health information, then your physician may, using professional
Others Involved in Your Health Care
or Payment for your Care: Unless you object, we may disclose to a
member of your family, a relative, a close friend or any other person you
identify, your protected health information that directly relates to that
person’s involvement in your health 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.
We may use or disclose protected health information to notify or assist in
notifying a family member, personal representative or any other person that is
responsible for your care of your location, general condition or death. Finally,
we may use or
2. YOUR RIGHTS
Following is a statement of your rights with respect to your protected health information and a brief description of how you may exercise these rights.
You have the right to inspect and
copy your protected health information. This means you may
inspect and obtain a copy of protected health information about you for so long
as we maintain the protected health information. You may obtain your medical
record that contains medical and billing records and any other records that your
Under federal law, however, you may not inspect or copy the
following records: psychotherapy notes; information compiled in reasonable
anticipation of, or use in, a civil, criminal, or administrative action or
You have the right to request a
restriction of your protected health information. This
means you may ask us not to use or disclose ay part of your protected health
information for the purposes of treatment, payment or health care operations.
You may also request that any part of your protected health information not be
disclosed to family members or
Your physician is not required to agree to a restriction that
you may request. If your physician does agree to the requested restriction, we
may not use or disclose your protected health information in violation of that
You have the right to request to
receive confidential communications from us by alternative means or at an
alternative location. We will accommodate reasonable requests. We
may also condition this accommodation by asking you for information as to how
payment will be handled or specification of an alternative address or other
You have the right to receive an
accounting of certain disclosures we have made, if any, of your protected health
information. This right applies to disclosures for purposes other
than treatment, payment or health care operations as described in this Notice of
Privacy Practices. It excludes disclosures we may have made to you if you
authorized us to
You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice electronically.
You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our Privacy Officer of your complaint. We will not retaliate against you for filing a complaint.
You may contact our Privacy Officer, at (828) 322-4453 for further information about the complaint process.
The ChildHealth Center P.A.
Last modified: Monday February 16, 2015