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Notice of Privacy Practices

Notice of Privacy Practices

At The Parkinson's Institute, we are committed to protecting your health information. The Privacy Regulations created as a result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) require us to maintain the confidentiality and security of your health information. This Notice of Privacy Practices describes the personal information we collect, and how and when we use or disclose that information. It also describes your rights as they relate to your Protected Health Information (PHI). This revised Notice is effective April 15, 2014 and remains in effect until we replace it. It applies to all PHI as defined by federal regulations.

Understanding Your Health Record/Information

Protected health information is the information we create and obtain in providing our services to you. Such information includes documentation of your symptoms, examination and test results, diagnoses, treatment, and plans for continued care. It also includes billing documents for those services. Our office is permitted by federal privacy laws to use and disclosure your health information for the purposes of treatment, payment, and health care operations.

You have a right to:

  1. Consent to use your PHI for Treatment, Payment, or healthcare Operations (TPO)
  2. Request a restriction on certain uses and disclosures of your information. Additionally, you have the right to request that we restrict our disclosure of your PHI to only certain individuals involved in your care, such as family members and friends. We are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you.
  3. Appoint another person to consent to or authorize disclosure of your PHI.
  4. Obtain a copy of this notice upon request.
  5. Inspect and copy your health record for a reasonable, cost-based fee. Submit requests in writing to the Privacy Officer. The request will be processed within 30 days.
  6. Amend your health record if you believe that it is incorrect or incomplete. Submit requests in writing to the Privacy Officer, with a reason that supports the request. The physician must make the amendment within 60 days. If the physician denies the request, you may write an objection to the denial, and require that all communications be documented and attached to future disclosures of PHI.
  7. Ask us not to share your PHI if you pay for a service or health care item out-of-pocket in full. We will say “yes” unless a law requires us to share that information.
  8. Receive an accounting of certain disclosures we have made of your health information if you provide a written request to our office. An accounting will not include internal uses of information for treatment, payment, or operations, disclosures made to you or made at your request, or disclosures made to family members or friends in the course of providing care.
  9. Revoke your authorization to use or disclose health information except to the extent that action has already been taken.
  10. Request how and where we contact you regarding your health information.

Our Responsibilities

The Parkinson's Institute is required by law to: 1) Maintain the privacy of your health information, 2) Provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you, 3) Abide by the terms of this notice, which is now in effect, 4) Notify you if we are unable to agree to a requested restriction, 5) Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations, and 6) Notify you promptly if a breach occurs that may have compromised the privacy or security of your information.

We will not use or disclose your health information without your authorization, except as described in this notice. We will also discontinue using or disclosing your health information after we have received a written revocation of the authorization according to the procedures included in the authorization.

For More Information or to Report a Problem

If have questions and would like additional information, you may contact The Parkinson's Institute's Privacy Officer, Karen Merchant, at (408) 734-2800. If you believe your privacy rights have been violated, you can file a complaint with the practice's Privacy Officer or with the Office for Civil Rights, U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint with either the Privacy Officer or the Office for Civil Rights. The address for the OCR is listed below:

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201
Email: OCRComplaint@hhs.gov

Examples of Disclosures for Treatment, Payment and Health Operations

We will use your health information for treatment.

For example: Information obtained by a physician, nurse or other member of your health care team will be recorded in your record and used to determine the course of treatment that should work best for you. We may also provide your other health care providers with copies of reports to assist them in treating you.

We will use your health information for payment.

For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, visit details, and procedures or supplies used during the visit.

We will use your health information for our regular health operations.

Health care operations are any of the following activities: (a) Quality assessment and improvement activities, including care coordination; (b) Competency assurance activities, including provider or health plan performance evaluation, credentialing, and accreditation; (c) Conducting or arranging for medical reviews, audits, or legal services, including fraud and abuse detection and compliance programs; and (d) Specified insurance functions, such as underwriting, risk rating, and reinsuring risk. We may also share your medical information with our "business associates," such as our billing service, that perform administrative services for us. We have a written contract with each of these business associates that contains terms requiring them and their subcontractors to protect the confidentiality and security of your PHI.

Notification:

Unless you object we may use or disclose your protected health information to notify, or assist in notifying, a family member, personal representative, or other person responsible for your care, about your location, and about your general condition, or your death.

Using our best judgment, we may disclose to a family member, other relative, close personal friend, or any other person you identify, health information relevant to that person's involvement in your care or in payment for such care if you do not object or in an emergency.

Research:

We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

Funeral directors:

We may disclose health information to funeral directors consistent with applicable law to carry out their duties. Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Marketing and Fundraising:

We may contact you to provide appointment reminders, information about treatment alternatives, or information about other health-related benefits and services that may be of interest to you. We may contact you to ask for your help with different fund raising campaigns. Please notify us if you do not wish to receive such communications and we will not use or disclose your information for these purposes.

Workers compensation:

We may disclose your health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

Public health:

As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability, including child abuse and neglect. We may use and disclose your protected health information to assist in disaster relief efforts.

Food and Drug Administration (FDA):

We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Victims of Abuse, Neglect, or Domestic Violence:

We may disclose PHI to appropriate authorities if we believe that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes. We may share your PHI if it is necessary to prevent a serious threat to your health or safety or the health or safety of others.

Law enforcement:

We will share information about you with law enforcement official or health oversight agencies if state or federal laws require it. We will share information with the Department of Health and Human Services if they want to verify that we’re complying with the federal privacy law.

Specialized Government Functions:

Subject to certain requirements, we may use or disclose PHI for military personnel and veterans, to federal officials for national security and intelligence activities, for protective services for the President and others, for medical suitability determinations for the Department of State, for correctional institutions and other law enforcement custodial situations, and for government programs providing public benefits.

675 Almanor Avenue | Sunnyvale, CA 94085
408.734.2800 main | 408.734.8455 fax (Main) | 408.734.9208 fax (Clinic Secure)