This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
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, which will be effective for all protected health information that we maintain at that time. We will provide you with any revised Notice of Privacy Practices by updating our website (suvidahealthcare.com), or you may email the office at email@example.com and request that a revised copy be sent to you in the mail or ask for one at the time of your next appointment.
Following are examples of the types of uses and disclosures of your protected health care information that Suvida 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.
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 a third-party provider. For example, we would disclose protected health information to another physician or health care provider (e.g., a specialist or laboratory) who, at the request of your physician, becomes involved in your care.
Your protected health information will be used, as needed, to obtain payment for your health care services. This may include providing health information for making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities.
We may use or disclose, as-needed, your protected health information in order to support the business activities of Suvida. These activities include, but are not limited to, quality assessment activities, training of medical students, licensing, and auditing activities.
For example, we may use your protected health information to assess the quality of care at Suvida. We may use or disclose your protected health information, as necessary, for appointment reminders or to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you. You may contact our Compliance & Privacy Office to request that these materials not be sent to you.
Suvida is committed to limiting the use of health information to the minimum necessary to perform the activity, and physicians or employees whose job functions require review of health information will be required to sign a confidentiality statement. In addition, third party “business associates” that perform various activities (e.g., billing, transcription services) may need to have access to certain health information. Suvida will have a written contract with its business associates that contains terms that will protect the privacy of your protected health information. Suvida will collect your health information only in a lawful manner, and will notintimidate or deceive you into providing such information.
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, at any time, in writing, except to the extent that we have taken an action in reliance on the use or disclosure indicated in the authorization.
Unless you object, we may disclose protected health information to a person present with you during your visit (such as a member of your family, a relative, a close friend or any other person you identify), or to your emergency contact 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 disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.
We may use or disclose your protected health information in the following situations without your authorization. These situations include:
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.
This notice was published and becomes effective on October 12, 2022. If you have any questions about this Notice, please contact our Compliance & Privacy Office at firstname.lastname@example.org.
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