Notice of Health Information 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 carefully.
Understanding Your Health Record/Information:
Each time you visit a hospital, physician, 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, which we refer to as your health or medical record, is an essential part of the healthcare we provide to you. It serves as a:
- Basis for planning your care and treatment.
- Means of communication among the many health professionals who contribute to your care.
- Legal document describing the care you received.
- Means by which you or a third-party payer can verify that services billed were actually provided.
- Tool in educating health professionals.
- Source of data for medical research.
- Source of information for public health officials charged with improving the health of the nation.
- Source of data for facility planning and marketing.
- Tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.
Your health record contains personal health information, the confidentiality of which is protected under both state and federal law. We expect to use and disclose your health information helps you to:
- Ensure its accuracy,
- Better understand who, what, where, and why your health care providers and others may access your health information, and
- Make more informed decisions when authorizing disclosures to others.
Your Health Information Rights
Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. Under the Federal Privacy Rules, 45 CFR Part 164, you have the right to:
- Receive notice of the uses and disclosures we expect to make of your health information, including a paper copy of the notice if requested, as provided in Rule 520.
- Request additional restrictions on uses and disclosures of your health information (though we are not required to agree to any such request), or request that we send you confidential communications by alternative means or at alternative locations, as provided 45CFR 164.522.
- Inspect and obtain a copy of your health record as provided in rule 524.
- Request that your health record be amended as provided in rule 526.
- Obtain an accounting of disclosures of your health information for purposes other than treatment, payment or health care operations, as provided in rule 4528.
Please direct any requests to:
Naples Urgent Care
Attn: HIPAA Compliance Officer
1713 SW Health Pkwy, Suite 1
Naples FL 34109.
We are required by the Federal Privacy Rules to:
- Maintain the privacy of your health information.
- Provide you with notice as to our legal duties and privacy practices with respect to health information we collect and maintain about you.
- Abide by the terms of this notice, subject to the following reservation of rights: We reserve the right to change our health information privacy practices and the terms of this notice, and to make the new provisions effective for all health information we maintain, including health information created or received prior to the effective date of any such notice. We will not use or disclose your health information without your consent or authorization, except as described in this notice.
What We Will Use Your Health Information For:
We will use your information for treatment within our own office, or to coordinate your overall care with other physicians and healthcare professionals involved. We may send information to your other healthcare professionals at your specific request and/or when we need to relay information about care you received from us. We may also send your information to specialists who you may be referred to for additional evaluation and treatment. We reserve the right to charge the requesting party no more than $1.00 per page for the first 25 pages of copies and $0.25 per page for copies of each additional page, and the actual cost of reproducing non written records such as x-rays (per rule 64B8-10.0003, Florida Administrative Code. Section 395-3025, Florida Statues).
An exception to the copy charges exists for medical records that are related to workers’ compensation claims. In that case, the physician may charge an injured employee, or his attorney up to $0.50 per page and the actual cost to reproduce x-rays, microfilm, etc. (per Rule 38F-7.601 Florida Administrative Code).
We may use and disclose health information about you when calling your home or sending you written correspondence regarding appointments, treatment options, test results, etc.
We will use your information for the purposes of securing payment for your services. This includes members of our administrative team (such as our billing staff), your insurance company or health reimbursement plan, employer’s representatives (in work injury cases), and others who have legal rights to access your records.
We will use your information to conduct normal operations of our facility. Members of our medical staff, managers, and our quality assurance team may use information in your record to assess care and outcomes in order to collect data to help us improve the quality and effectiveness of care you receive from us.
We will share your information with “Business Associates” as defined by HIPAA legislation. We provide some services with Business Associates who are independent professionals that use health information provided by us in order to perform such services. Examples include physician services in the emergency department, Radiologists, laboratory personnel, copy services (when contracted outside our office), billing services, etc. Each Business Associate is required to keep your information confidential under the federal laws that protect it.
Uses and Disclosures That We May Make Unless You Object:
Family or friends involved in care: Unless you object in writing, health professionals can, using their best judgment, disclose to your family member(s), friend(s), or other persons you identify, health information relevant to that person you identify who is involved in your care or can assist in TPO (treatment, payment, operations of our facility).
The Federal Privacy Rules require us to disclose your personal health information in two circumstances: to you at your own request and to the Secretary of Health and Human Services when requested as a part of an investigation or compliance review. Other required disclosures (for which we do not need your consent):
- When required by state or federal law.
- To representatives from agencies charged with preventing or controlling disease (FDA, CDC, etc.).
- To government authorities, protective service agencies, and others authorized to receive reports of abuse, neglect, or domestic violence.
- To government health oversight agencies, such as the Dept of Health and Human Services, Medicare or other federal government payers or auditors, state Boards of Medicine, and other licensing authorities.
- When required by court order, subpoena, or other judicial or administrative action.
- To law enforcement officials for the purpose of law enforcement, locating a fugitive, subject, material witness, missing person, or victim, providing that the conditions in the federal rule are met.
- To coroners, medical examiners, or funeral directors for the purposes of identifying a deceased person or carrying out their duties as required by law.
- To organ procurement organizations for the purpose of organ or tissue donation and transplantation, consistent with applicable law.
- For research approved by an Institutional Review Board (IRB) or Privacy Board that has reviewed the research proposal and has established protocols to ensure the privacy of your health information.
- When required to avert a serious threat to health or safety.
- When requested for certain specialized government functions authorized by law, including military and similar situations.
- As authorized by law in connection with workers’ compensation programs.
Use and Disclosure Specifically Authorized by You:
We expect to make other uses and disclosures of your protected health information only on the basis of specific written consent signed by you. You have the right to revoke your authorization at any time via written document, except to the extent that we have already relied on it for making authorized use or disclosure.
If you feel our facility has violated your rights, please contact the HIPAA Privacy Officer at (239) 597-8000 or in writing to:
Naples Urgent Care
Attn: HIPAA Privacy Officer
1713 SW Health Pkwy, Suite 1
Naples FL 34109.
Naples Urgent Care, Attn: HIPAA Privacy Officer; 1713 SW Health Pkwy, Suite 1; Naples, FL 34109.
If you believe your rights have been violated, you have the right to file a complaint with the Department of Civil Rights. There will be no retaliation for filing a complaint.