NOTICE OF PRIVACY POLICIES AND PRACTICES
FOR DeVore Dermatology
DEAR PATIENT:
THIS NOTICE DESCRIBES HOW
INFORMATION ABOUT YOU MAY BE USED
AND DISCLOSED AND HOW YOU CAN GET
ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
INTRODUCTION
At DeVore Dermatology, we are committed to
treating and using protected health
information about you responsibly. This
Notice 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. This Notice is effective April
14,
2003 and applies to all protected health
information as defined by federal regulations.
UNDERSTANDING YOUR MEDICAL RECORD/ HEALTH INFORMATION
Each time you visit DeVore Dermatology, a
record of your visit is made. Typically, this
record contains information about your visit
including your examination, diagnosis, test
results & treatment as well as other pertinent
healthcare data. This information is often
referred to as your health or medical
record, serves as a:
Basis for planning your care and
treatment
Means of communication with other
health professionals involved in your
care
Legal document outlining and
describing the care you received
A tool that you, or another payer (your
insurance company) will use to verify
that services billed were actually
provided
An education tool for medical health
providers
A source for medical research
Basis for public health officials who
might use this information to assess
and/or improve state as well as
national healthcare standards
A source of data for planning and / or
marketing
A tool that we can reference to
ensure the highest quality of care and
patient satisfaction
Understanding what is in your record and how
your health information is used helps you to
ensure it’s accuracy, determine what entities
have access to you health information, and
make an informed decision when authorizing
the disclosure of this information to other
individuals.
YOUR RIGHTS
You have certain rights under the federal
privacy standards. These include:
The right to request restrictions on
the use and disclosure of your
protected health information
The right to receive confidential
communications concerning your
medical condition and treatment
The right to inspect and copy your
protected health information
The right to amend or submit
corrections to your protected health
information
The right to receive an accounting of
how and to whom your protected
health information has been disclosed
The right to receive a printed copy of
this notice
OUR RESPONSIBILITIES
DeVore Dermatology is required to:
Maintain the privacy of your health
information
Provide you with this Notice as to our
legal duties and privacy practices with
respect to information we collect and
maintain about you
Abide by the terms of this notice
Notify you if we are unable to agree
to a requested restriction
Accommodate reasonable requests
you may have regarding
communication of health information
via alternative means and/ locations
As permitted by law, we reserve the right to
amend or modify our privacy policies and
practices. These changes in our policies and
practices may be required by changes in
federal and state laws and regulations.
Whatever the reason for these revisions, we
will provide you with a revised notice on your
next office visit. The revised policies and
practices will be applied to all protected health
information that we maintain.
We will not use or disclose your health
information without your authorization, except
as described in this notice. We will also
discontinue to use or disclose your health
information after we have received a written
revocation of the authorization according
procedures included in the authorization.
HOW WE MAY USE AND/OR DISCLOSE
YOUR HEALTH INFORMATION
We will use your health information for
treatment. Your health information may be
used by staff members or disclosed to
other health care professionals for the
purpose of evaluating your health,
diagnosing medical conditions, and
providing treatment. For example: results
of laboratory tests and procedures will be
available in your medical record to all
health professionals who may provide
treatment or who may be consulted by
staff members.
We will use your information for payment.
Your health plan may request and receive
information on dates of service, the
services provided, and the medical
condition being treated in order to pay for
the service rendered to you.
We will use your information for regular
health operations. Your health
information may be used as necessary to
support the day-to-day activities and
management of DeVore Dermatology. For
example: information on the services you
received may be used to support
budgeting and financial reporting, and
activities to evaluate and promote quality.
Business Associates.
In some instances,
we have contracted separate entities to
provide services for us. These “associates”
require your health information in order to
accomplish the tasks that we ask them to
provide. Some examples of these “business
associates” might be a billing service,
collection agency, answering services and
computer software/hardware provider.
Communication with family.
Due to the nature of our field, we will use our best
judgment when disclosing health information
to a family member, other relatives, or any
other person that is involved in your care or
that you have authorized to receive this
information. Please inform the practice when
you do not wish a family member or other to recieve this information.
