Notice
of Privacy Practices
This notice (Notice) describes how health information about you may be
used and disclosed and how you can get access to this information. Please
review it carefully.
Florida Endoscopy and Surgery Center will share Protected Health Information
(PHI) as necessary to carry out treatment, payment, or health care operations
as permitted by applicable law, or as stated in this Notice. We will do so
through access to a shared electronic medical record.
Who Will Follow This Notice
This Notice applies to the staff,
volunteers, business associates, physicians, and other healthcare partners who
provide services at Florida
Endoscopy and Surgery Center.
This Notice describes how we will
use and share your information, how we are required by law to maintain the
privacy of your PHI and to provide you with notice of our legal duties and
privacy practices with respect to your PHI. PHI is information about you,
including demographic information, that may identify you and that relates to
your health or condition and related health care services. We will tell you if
your PHI has been breached. We are required to abide by the terms of the Notice
currently in effect.
How We May Use and Disclose Health Information About You
We are committed to protecting the privacy of your health
information. The law permits us to use or disclose your health information for
the following purposes:
Treatment: We may use your PHI to provide you with medical treatment or
services. We may disclose PHI about you to doctors, nurses, technicians,
health care students, or other personnel who are involved in taking care of
you.
Payment: We may use and disclose your PHI to obtain payment for your health
care services, including with a collection agency or credit bureau. We may also
need to disclose planned treatment with your health plan to obtain prior
approval or to determine whether your plan will cover the treatment.
Health Care
Operations: We
may use and disclose health information about you for health care operations.
These uses and disclosures are necessary to run our offices and facilities and
make sure that all of our patients receive quality care. For example, we may use your PHI to
evaluate the quality of health care services that you received, to evaluate the
performance of the health care professionals who provided health care services
to you, for medical review purposes or auditing. In addition, we report
traumas, birth defects and cancer cases (Florida Cancer Registry) to the
Department of Health for quality improvement and licensing purposes and
quarterly data to the Agency for Health Care Administration as required for
licensing. We may also provide your PHI to accountants, attorneys, consultants,
accrediting agencies, outside funding sources and others to make sure we’re complying
with the laws that affect us, and to outside companies that assist us in our
operations and agree by contract to keep any PHI received from us confidential
in the same way we do.
Communication with Family Members and Friends: Unless you object, we may
disclose PHI about you to a family member, relative, or another person
identified by you who is involved in your health care or payment for your
health care. After your death, we may disclose PHI to a family member,
relative, or other person who was involved in your health care or payment as
long as that disclosure is consistent with your prior expressed preferences.
You have a right to withdraw your permission or restrict these disclosures at
any time. If you are unavailable, incapacitated or it is an emergency or
disaster relief situation, We will use our professional judgment to determine
whether disclosing limited PHI is in your best interest under the
circumstances.
Appointment Reminders and Health-related Benefits: We may use and disclose PHI
to contact you via phone, email, or text message as a reminder that you have an
appointment for treatment and about health-related benefits or services that
may be of interest to you.
Marketing, Sale of PHI: We will not sell your PHI. We
will not use or disclose your PHI for marketing purposes without your specific
permission.
Research Your PHI may be used or disclosed for research purposes. Your
medical record may be reviewed and data included in a research study in compliance with applicable federal and
state laws. Your health
information may be reviewed in preparation for research or to notify you about research studies in
which your provider may consider you a candidate or which you might have
interest. Your health information may be used or
disclosed in a
format that will not identify you. In some cases, very limited information may
be used or disclosed for research, and no additional authorization is required
from you. In some cases, an Institutional Review Board (IRB) or its designee may
determine whether your authorization is necessary for your health information
to be used or disclosed for research purposes. If required, your written
authorization will be requested.
Required By Law, Court or Law Enforcement: We may disclose PHI when a
law requires that we report information to government agencies and law
enforcement personnel about victims of abuse, neglect or domestic violence,
when dealing with crime when ordered by a court, or in response to a
lawfully-issued subpoena or request for information in a legal proceeding.
To Avert Serious Threat to Health or Safety: We may use and disclose your
PHI when necessary to prevent a serious threat to your health and safety or to
the health and safety of another person or the public. Any disclosure, however,
would only be to someone able to help prevent or lessen the threat.
Special Situations
Organ and Tissue Donations: If you are an organ donor, we may release health
information to organizations that handle organ procurement or organ, eye or
tissue transplant or to an organ donation bank, as necessary to facilitate
organ or tissue donation and transplantation.
Military and Veterans: If you are a member of the armed forces, we may release health
information about you as required by military authorities. We may also release
health information about foreign military personnel to the appropriate foreign
military authority.
Workers’ Compensation: We may release health information about you for workers’
compensation or similar programs. These programs provide benefits for
work-related injuries or illness.
Public Health: We may disclose health information
about you for public health activities. These activities generally include the
following to: prevent or control disease; injury or disability; report births
and deaths; report child abuse or neglect; report reactions to medications or
problems with products; notify a person who may have been exposed to a disease
or may be at risk for contracting or spreading a disease or condition; or notify
your employer of a work-related illness or injury, if the health care was
provided at the request of the employer and the employer is required to record
the information
Health
Oversight Activities: We
may disclose health information to a health oversight agency for activities
authorized by law. These oversight activities include, for example, audits,
investigations, inspections and licensure. These activities are necessary for
the government to monitor the health care system, government programs and
compliance with civil rights laws.
Deceased
Person Information: We may
release your health information to a coroner, medical examiner, or funeral
director.
Specific
Government Functions: We
may release health information about you to authorized federal officials for
intelligence, counter-intelligence, protection of the President and other
authorized persons or foreign heads of state, and other national security
activities authorized by law.
Inmates:
If you are an inmate of a
correctional institution or under the custody of a law enforcement official, we
may release health information about you to the correctional official.
Shared
Medical Record/Health Information Exchanges: We maintain PHI about you in shared electronic medical
records that allow us to share PHI. We may also participate in various
electronic health information exchanges (HIE) that facilitate access to PHI by
other health care providers who provide you care. For example, if you are
admitted on an emergency basis to a hospital that participates in the health
information exchange with us, the exchange will allow us to make your PHI
available electronically to those who need it to treat you. You may choose to opt
out of participating in the HIE, however, any PHI disclosed prior to you opting
out of participating in a HIE will remain available.
Your
Rights Regarding Health Information About You
You have
the following rights regarding health information we maintain about you:
Right
to Inspect and Receive a Copy: You
have the right to inspect and receive a copy of health information that may be
used to make decisions about your care. For PHI maintained in an electronic
format, you can request an electronic copy of such information. If you request
a copy of the information, we may charge a fee for the costs associated with
providing the requested information in paper or electronic format. We may
deny your request to inspect and receive a copy in certain very limited
circumstances. If you are denied access to health information related to these
limited circumstances, you may request that the denial be reviewed as per the
review policy of the denying entity.
Right
to Request an Amendment or Addendum: You
have a right to request that we correct or update information that may be
incorrect or incomplete. Your request must be in writing and include a reason
that supports your request. If we deny your request, we will provide you with information
about our denial and how you may request that the denial be reviewed as per the
review policy.
Right to an Accounting of Disclosures: You have the right to request information
relating to certain disclosures of PHI we may have made about your health
care. We do not
have to account for the disclosures
described under treatment, payment, health care operations, information
provided to you, information released incident to an allowed disclosure (see
Incidental Disclosures section in this notice), information released based on
your written authorization, directory listings, information released for
certain government functions, disclosures of a limited data set (which may only include date information
and limited address information) and disclosures to correctional institutions
or law enforcement in custodial situations. These requests must be in writing
and must state a time period, which may not be longer than six years.
Right
to Request Restrictions: You
have the right to request a restriction or limitation on the PHI we use or
disclose about you for treatment, payment or healthcare operations. We will
consider your request but are not required to accept it unless you do not want
information about an item or service sent to your health plan and you have paid
for the item or service in full. You also have the right to request a limit on
the PHI we disclose about you to someone who is involved in your care or the
payment for your care, like a family member or friend.
Right
to Request Confidential Communications: You have the right to request that we communicate with you
about medical matters in a certain way or at a certain location. For example,
you can ask that we only contact you at work. We will not ask you the reason
for your request. We will accommodate all reasonable requests. Your request
must specify how or where you wish to be contacted.
Right
to be Notified of a Breach: You
have the right to be notified in the event that we (or one of our Business
Associates) discover a breach of unsecured PHI.
Right
to a Paper Copy of This Notice: You
may request a copy of this notice at any time.
Changes
to This Notice
We
reserve the right to change this Notice. We reserve the right to make the
revised or changed Notice effective for PHI we already have about you as well
as any information we receive in the future. We will post a copy of the
current Notice at the front desk of the facility and on our website.
Other
Uses of Protected Health information
Other
uses and disclosures of PHI not covered by this Notice or the laws that apply
to us will be made only with your written permission. If you provide us permission
to use or disclose your PHI, you may revoke that permission, in writing, at any
time. If you revoke your permission, we will no longer use or disclose your
PHI for the reasons covered by your written authorization. We are unable to
take back any disclosures we have already made with your permission, and we are
required to retain our records of the care that we provide to you.
Incidental
Disclosure
We make
reasonable efforts to avoid incidental disclosures of your PHI. An example of
an incidental disclosure is conversations that may be overheard between you and
our team members.
Complaints
If you
believe your privacy rights have been violated, you may file a complaint with
us or with the Secretary of the Department of Health and Human Services. All
complaints must be submitted in writing. You will not be penalized for filing
a complaint.
Contact Florida Endoscopy and Surgery Center
To request a copy of records, amendment, restrictions, or confidential communications
or to request an accounting of disclosure, a paper copy of this notice, or to file
a complaint contact 352-596-4999.
Non-discrimination
Florida
Endoscopy and Surgery Center does not discriminate on the basis of race,
color, national origin, age, disability, or sex.
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