Legault CHIROPRACTIC HEALTH CENTER
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Legault CHIROPRACTIC HEALTH CENTER
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The Legault Chiropractic Health Center's OFFICE POLICY & Including our Privacy Statement This notice describes how personal, financial and medical information about you may be used and discloses and how you can get access to this information. PRIVACY STATEMENT: At the Legault Chiropractic Health Center, you’ll find that we honor and respect all of our patients (past, present & future) and their rights to privacy. While the main purpose of this office is to improve the health and well being of all who enter our doors, through our chiropractic spinal adjustments and other services, it is also the regular policy of this office to minimize disclosure or dissemination of any personal or health information on any/all of our patients. Security of personal records is a high priority - The Legault Chiropractic Center facility handles all records in a manner that no outside person nor agent has access to private health file(s) without prior authorization, except as required by law. Yet, we do like to treat each of our patients in a happy & friendly way, sending warm wishes, congratulating and thanking them openly, calling them by name, like real people [NOT making them feel like a Number], by processing their files in as expedient a fashion as possible, while at the same time, maintaining their rights to privacy. The Health Insurance Portability and Accountability Act [nicknamed HIPAA] HIPAA is a new Federal law which has created a National Standard for privacy and protection, giving all persons the right to not have personal, financial, nor health information about them disclosed, disseminated, spread or exposed to outside persons or entities without their prior authorization. Furthermore, it requires that all facilities, who may have personal, financial &/or health information about private individuals, keep that information in a secure manner, which includes both while that information is held within the facility and during any transfer of information to any other authorized facility. [For instance, if a patient wishes to have their insurance or a personal injury / attorney case pay for any of their care costs, a health facility must send pertinent personal and health information about that patient to that insurance company &/or attorney. In doing so, some of the personal & health information must be discussed with an insurance rep over the telephone &/or must be sent via the US mail, carrier, fax, or the Internet during which time it is OUT of the hands of the doctor’s facility. It is now required that each facility and mode of transfer of personal information also maintain a high degree of security to avoid allowing personal information to be circulated to unauthorized entities or persons.] As with all laws, the HIPAA law is subject to changes and additions in the future. Changes to this “Notice of Privacy Practices” Because this law is so new and is not yet completed by the government, changes and additions are to be expected. Legault Chiropractic Health Center reserves the right to amend this “Notice of Privacy Practices” at any time in the future, and will make the new provisions effective for all information that it maintains. Amendment &/or material revisions shall be posted in our office & here to our web site “www.legaultchiro.com” within 60 days of such change. A copy of said revised Notice shall be mailed upon written request. Until such amendment is made, LEGAULT CHIROPRACTIC HEALTH CENTER is required by law to comply with this Notice. The Legault Chiropractic Health Center’s Use & Disclosure of Your Health Care Information Standards of Practice 4 We ask that patients register on a Daily Sign-In Sheet , we call everyone by their name & collect information from the questionnaire filled out by the patient, along with a photocopy of the patient’s drivers license or other photo ID &/or insurance information. We frequently discuss among the chiropractors (esp of this office) findings on patient’s exams and X-rays for a more thorough comprehension & coordination of the case. 4 Portions of patient’s files are kept in/transferred to a computer for storage, retrieval of health information for assessment, referral &/or treatment, for billing &/or payment. 4 Health care information will be disclosed to health & disability insurance companies for the purpose of payment or reimbursement of services; and to persons responsible for patient’s health care - parents, guardian, family, nurse, etc. We use the fax machine, copy services, electronic billing via the Internet or simply speak on the telephone to send/give/receive information to/from a patient’s attorney, insurance company, billing & collection agencies (if applicable) for the purpose of payment, or to a laboratory, referring physicians, MRI centers, etc... for the purpose of diagnosis, assessment, treatment, referral &/or to coordinate health care. When giving or sending any information to any outside entity, it is our practice to disclose only the ‘minimum necessary’ for the purpose it is being disclosed. 4If a patient’s care needs are the result of a worker’s comp. accident or personal injury claim, the employer/payer of that claim have the right to receive health and care information on that patient. 4 We request health/spinal information (including but not limited to X-rays, findings, and treatment) from prior health care providers (esp other DC’s) if we feel it will be beneficial to the patient’s health care in our office. We maintain all health information/files and X-rays for a minimum of six (6) years. 4 Although we do not presently take part in any research or statistical programs, if in the future we decide to participate, only ‘De-identified’ health information will be disclosed [all names, addresses, phone #s, and other identifying numbers, etc that might identity the patient shall be removed before any general information is disclosed] . 4 Everyone in the Legault Chiropractic Health Center has agreed & signed affidavits swearing to hold all personal /health information in a secure and confidential manner. This includes the associate businesses that we may deal with. Security of personal records is a high priority - The Legault Chiropractic Center facility handles all records in a manner that no outside person nor agent has access to private health file(s) without prior authorization, except as required by law. It is customary that fees for services be paid in full on the day of that service, unless prior arrangements have been made. (Example: insurance/personal injury/ attorney.) NOTE: Patients who wish to have their health care be paid / reimbursed by a health insurance company or through an attorney, must allow this office to make a copy their drivers license or other government photo ID & must be willing to authorize that pertinent information from their personal and health file be made available to said entity. In the event that a patient does not wish that the Legault Chiropractic Health Center make a copy of drivers license &/or govern. photo ID or send any personal or health information to said outside entities, then those patients must keep their care charges paid in full on the day of service. Additional Uses & Disclosures of Your Health Care Information PERMITTED or REQUIRED by LAW Payment -We may disclose your health information to your insurance provider for the purpose of payment or health care operations. Example: “As a courtesy to our patients , we will wait for the insurance company to pay for your services if we have been assured by your company that they will send payment. After which we submit an itemized billing statement to your insurance carrier for the purpose of payment to LEGAULT CHIROPRACTIC HEALTH CENTER for health care services rendered. [NOTE: We can not & do not waive the collection of any “co-pay” in accordance with your insurance coverage. Each patient is personally responsible to pay their co-pay on each visit /at the time of service.] OR if you have paid for your health care services, in full, personally at the time of service, we will, as a courtesy, provide an itemized billing to your insurance carrier for the purpose of reimbursement to you. In either case, the billing statement contains medical information, including diagnosis, date of injury or condition, dates of care and codes which describe the health care services received.” Workers’ Compensation -We may/must disclose your health information, as necessary, to comply with State Workers’ Compensation Laws. Emergencies- We may disclose your health information to notify or assist in notifying a family member, or another person responsible for your care about your medical condition or in the event of an emergency. Legal -In spite of the Privacy Laws, there are also many laws that require that certain personal and health information be reported/delivered to courts, law enforcement offices, public health offices and other similar agencies. The law also requires disclosure to specialized government agencies (such as for military, national security, prisoner and government benefits purposes). In the unlikely event that a file is requested in these circumstances, the Legault Chiropractic Health Center must comply with the law. Note again that in all of these cases, only the minimum necessary information is sent. PATIENT’S RIGHTS ----Your Health Information Rights Ø You have the right to request restrictions on certain uses and disclosures of your health information. Please be advised, however, that LEGAULT CHIROPRACTIC HEALTH CENTER is not required to agree to the restriction that you requested. [# SEE BELOW] Ø You have the right to have your health information received or communicated through an alternative method or sent to an alternative location other than the usual method of communication or delivery, upon your request. Ø You have the right to inspect and/or receive a copy of your health information, but there will be a fee for the copies. NOTE: when a large number of pages &/or x-rays are to be copied, we send your file/x-rays to a copy company for this purpose. Ø You have a right to request that Legault Chiropractic Health Center amend your protected health information. Please be advised, however, that Legault Chiropractic Health Center is not required to agree to amend your protected health information. If your request to amend your health information is denied, you will be provided with an explanation of our denial reason(s) and information about how you can disagree with the denial.Ø You have a right to receive an accounting of disclosures of your protected health information made by Legault Chiropractic Health Center. You have a right to a paper copy of this Notice of Privacy Practices, as well as future revisions, at any time upon request. If you have questions about any part of this notice or if you want more information about your privacy rights, please contact: one of our Privacy Officers — DR. JACQUELINE VALCOURT, D.C., DR. VIRGINIA LEGAULT D.C. &/or MARGIE SANTANA by calling this office at 954-966-2211. If NONE of these Privacy Officers are available when you call, you may make an appointment for a private conference(in person or by telephone) within 2 working days. HIPAA - 1st Edition- 4/09/2003
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Last modified: 05/01/10
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