THIS\n NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND \nDISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW \nIT CAREFULLY.<\/strong><\/p>\n\n\n\n

The\n Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a\n federal program that requires that all medical and dental records and \nother individually identifiable health information used or disclosed by \nus in any form, whether electronically, on paper or orally, are kept \nproperly confidential. This Act gives you, the patient, significant new \nrights to understand and control how your health information is used. \nHIPAA provides penalties for covered entities that misuse Protected \nHealth Information (PHI).<\/p>\n\n\n\n

This\n Notice of Privacy Practices describes how we may use and disclose your \nProtected Health Information (PHI) to carry out treatment, payment or \nhealth care operations (TPO) and for other purposes that are permitted \nor required by law. It also describes your rights to access and control \nyour protected health information. “Protected health information” is \ninformation about you, including demographic information, that may \nidentify you and that relates to your past, present or future physical \nor mental health or condition and related health care services.<\/p>\n\n\n\n

Uses and Disclosures of Protected Health Information<\/strong>
Your\n Protected Health Information may be used and disclosed by your \nphysician, our office staff and others outside of our office that are \ninvolved in your care and treatment for the purpose of providing health \ncare services to you, to pay your health care bills, to support the \noperation of the practice, and any other use required by law.<\/p>\n\n\n\n

Treatment:<\/strong> We\n will use and disclose your Protected Health Information to provide, \ncoordinate, or manage your health care and any related services. This \nincludes the coordination or management of your health care with a third\n party. For example, your protected health information may be provided \nto a physician to whom you have been referred to ensure that the health \ncare professional has the necessary information to diagnose or treat \nyou.<\/p>\n\n\n\n

Payment:<\/strong> Your\n protected health information will be used, as needed, to obtain payment\n for health care services. For example, obtaining approval for a \nhospital stay may require that your relevant protected health \ninformation be disclosed to the health plan to obtain approval for the \nhospital admission.<\/p>\n\n\n\n

Healthcare Operations:<\/strong> We\n may use or disclose, as-needed, your protected health information in \norder to support the business activities of your physician\u2019s practice. \nThese activities include, but are not limited to, quality assessment \nactivities, employee review activities, and conducting or arranging for \nother business activities. We may use or disclose, as needed, your \nprotected health information to support the business activities of this \npractice. In addition, we may use a sign-in sheet at the registration \ndesk where you will be asked to sign your name and indicate your \nphysician. We may also call you by name in the waiting room when your \nphysician is ready to see you. We may use or disclose your protected \nhealth information, as necessary, to contact you to remind you of your \nappointment. We may call your home and leave a message (either on an \nanswering machine or with the person answering the phone) to remind you \nof an upcoming appointment, the need to schedule a new appointment or to\n call our office. We may also mail a postcard reminder to your home \naddress. If you would prefer that we call or contact you at another \ntelephone number or location, please let us know.<\/p>\n\n\n\n

We\n may use or disclose your protected health information in the following \nsituations without your authorization. These situations include: as \nRequired By Law, Public Health issues required by law, Communicable \nDiseases: Health Oversight: Abuse or Neglect: Food and Drug \nAdministration requirements: Legal Proceedings: Law Enforcement: \nCoroners, Funeral Directors, and Organ Donation: Research: Criminal \nActivity: Military Activity and National Security: Workers\u2019 \nCompensation: Inmates: Required Uses and Disclosures: Under the law, we \nmust make disclosures to you and when required by the Secretary of the \nDepartment of Health and Human Services to investigate or determine our \ncompliance with the requirements of HIPAA.<\/strong><\/p>\n\n\n\n

Other\n Permitted and Required Uses and Disclosures Will Be Made Only With Your\n Consent, Authorization or Opportunity to Object unless required by law.<\/p>\n\n\n\n

You may revoke this authorization<\/strong>,\n at any time, in writing, except to the extent that your physician or \nthe physician\u2019s practice has taken an action in reliance on the use or \ndisclosure indicated in the authorization.<\/p>\n\n\n\n

Your Rights<\/strong>
The Following is a statement of your rights with respect to your protected health information.<\/p>\n\n\n\n

You have the right to inspect and copy your protected health information.<\/strong> Under\n federal law, however, you may not inspect or copy the following \nrecords; psychotherapy notes; information compiled in reasonable \nanticipation of, or use in, a civil, criminal, or administrative action \nor proceeding, and protected health information that is subject to law \nthat prohibits access to protected health information.<\/p>\n\n\n\n

You\n have the right to request a restriction of your health information. \nThis means you may ask us not to use or disclose any part of your \nprotected health information for the purposes of treatment, payment or \nhealthcare operations. You may also request that any part of your \nprotected health information not be disclosed to family members or \nfriends who may be involved in you care or for notification purposes \ndescribed in this Notice of Privacy Practices. Your request must state \nthe specific restriction and to whom you want the restriction to apply.<\/p>\n\n\n\n

Your\n physician is not required to agree to a restriction you may request. If\n your physician believes it is in your best interest to permit use and \ndisclosure of your protected health information, your protected health \ninformation will not be restricted. You then have the right to use \nanother Healthcare Professional.<\/p>\n\n\n\n

You\n have the right to request to receive confidential communications from \nus by alternative means or at an alternative location. You have the \nright to obtain a paper copy of this Notice from us<\/strong>, upon request, even if you have agreed to accept this Notice alternatively (i.e. electronically).<\/p>\n\n\n\n

You may have the right to have your physician amend your protected health information.<\/strong> If\n we deny your request for amendment, you have the right to file a \nstatement of disagreement with us and we may prepare a rebuttal to your \nstatement and will provide you with a copy of any such rebuttal.<\/p>\n\n\n\n

You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information.<\/strong>
We\n reserve the right to change the terms of this Notice and will inform \nyou of any changes. You then have the right to object or withdraw as \nprovided in this Notice.<\/p>\n\n\n\n

Complaints<\/strong>
You\n may complain to us or to the Secretary of Health and Human Services if \nyou believe your privacy rights have been violated by us. You may file a\n complaint with us by notifying our privacy officer of your complaint at\n our office and main telephone number. We will not retaliate against you for filing a complaint.<\/strong><\/p>\n\n\n\n

This Notice was published and becomes effective on\/or before 3\/11\/2020<\/strong>.<\/p>\n\n\n\n

The name and address of the person you can contact for further information concerning our privacy practices are:<\/p>\n\n\n\n

Privacy Officer<\/h3>\n\n\n\n

Mid-South Workers\u2019 Compensation Association<\/strong>
P.O. Box 331147
Nashville, TN 37203<\/p>\n\n\n\n

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