Notice Of Privacy Practices
Western Neurological Associates, PC.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Western Neurological Associates, P.C. (WNA) understands that your medical and health information is personal. Protecting your health information is important. We follow strict federal and state laws that require us to maintain the privacy of your health information.
Understanding Your Health Record Information
Each time you visit WNA we make a record. This record contains your health history, current symptoms, examination and test results, diagnoses, treatment, a plan for future care or treatment and is used as: (1) a basis for planning your care and treatment; (2) a means of communication among health professionals who contribute to your care; (3) a legal document describing the care that you received; (4) a means by which you or a third-party payer can verify that services billed were actually provided; and (5) a source of information for public health officials charged with improving the health of the nation
Your Rights Under The Federal Privacy Standard
Although your health records are the physical property of WNA, or the facility that compiled them, the information belongs to you and you have a right to the following: (1) Obtain a paper copy of this notice of privacy practices upon request. (2) Review and get a paper copy of your medical or billing records, as law allows, within 30 day of your written request. For health information for which you have a right of access, you have the right to access and receive your health information in an electronic format if it is readily producible in such format. (3) Request in writing amendments to your health information if you think they are incorrect or incomplete. WNA may not always be able to grant those requests. (4) Request restrictions on how we use and share your health information. WNA will consider your request but is not required to agree to it unless the requested restriction involves disclosure that is not required by law to a health plan for payment or health care operations and not for treatment, and you have paid for the service in full out-of-pocket (to ensure that we don’t automatically bill your health plan for these services, you will need to notify WNA staff before receiving those services if you want this restriction to apply). If we agree to a restriction on disclosure we will confirm the restrictions in writing and abide by them, except in emergency situations when the disclosure is for treatment. (5) Request in writing an accounting of disclosures of your health information made by us. Your request must state the period of time desired for the accounting, and be within six years prior to your request. The first accounting is free but a fee will apply if more than one request is made in a 12-month period. (6) Ask us to contact you at a specific address or phone number in order to allow for confidential communications. (7) You may revoke authorizations to use or disclose health information except to the extent that action has been already been taken.
Our Responsibilities Under The Federal Privacy Standard
WNA is required to maintain the privacy of your protected health information. We are also required to provide this notice that describes our legal duties and privacy practices, and to notify affected individuals following a breach of unsecured health information. We are required to abide by the terms of our privacy practice currently in effect. The current terms of our privacy practice are contained in this notice. We reserve the right to make changes to this notice at any time and make the new privacy practices effective for all information we maintain. Current notices will be posted in all offices and on our web site www.wna-pc.com
WNA will notify affected individuals if WNA discovers a breach of their unsecured health information unless there is a determination, based on a risk assessment, that there is a low probability that the health information has been compromised. Such notification will include information about what happened and what can be done to mitigate any harm
How To Get More Information Or To Report A Problem
If you have questions and/or would like additional information, you may contact the:
Privacy Officer, Western Neurological Associates, P.C.
1151 East 3900 So B150, SLC, UT 84124, Ph: 801-262-3441
If you believe that your privacy rights have been violated, you can file a written complaint with the WNA Privacy Officer at the address above or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.
Examples Of Disclosures For Treatement, Payment And Health Operations
We will use your health information for treatment. Example: A physician, or health care team member, will record health information in your record to diagnose your condition and determine the best course of treatment for you. Your physician, other health care professionals, or subsequent health care provider will use your health information to assist them in treating you. We will use your health information for payment. Example: We may send a bill to you or to a third-party payer, such as a health insurer. The information on or accompanying the bill may include information that identifies you, your diagnosis, treatment received, and supplies used. We will use your health information for our health care operations. Example: We may use health information in your record to assess the quality of care and outcomes in your case and similar cases. We will share health information with third parties who contract with us as business associates to assist with treatment, payment and health care operations. Business associates are required to comply with the privacy regulations in order to safeguard your information.
Other Uses Of Your Health Information
We may use your health information to: (1) recommend treatment alternatives; (2) tell you about health services and products that may benefit you; (3) share information with family or friends involved in your care or payment for your care; (4) remind you of an appointment by phone (notify the scheduler if you do not wish to be reminded); and (5) for medical research.
Sharing Your Health Information
There are limited situations when we are permitted or required to disclose health information without your signed authorization: (1) For health oversight activities and public health purposes such as reporting communicable disease, work-related illnesses, or other disease and injuries as permitted by law. (2) Reporting deaths, reactions to drugs and problems with medical devices. (3) To protect victims of abuse, neglect, or domestic violence. (4) For health over-site activities such as investigations, audits and inspections. (5) For lawsuits and similar proceedings. (6) When required by federal, state or local law or by court or administrative order. (7) As authorized by applicable laws, for worker’s compensations or similar programs if you are injured at work. (8) To a coroner, medical examiner or funeral director as necessary for their duties. (9) For research purposes. (10) For government functions including health information of military personnel as required by military command authorities or for law enforcement or national security. WNA may also use and disclose health information that has been de-identified by removing certain information by which you could be identified.
Uses With Your Authorization
Any sharing of your health information, other than explained above, requires your written authorization. For example, we will not use your health information unless you authorize us in writing to: for marketing purposes or to any marketing company; or sell any of your health information. You may revoke your authorization at any time by delivering a written request to the WNA Privacy Officer.
Effective: April 14, 2003 Revised: April 30, 2013
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