Westover Hills Gastroenterology

WESTOVER HILLS GASTROENTEROLOGY NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE READ IT CAREFULLY.

Introduction. Westover Hills Gastroenterology (WHG) is committed to protecting the privacy of our patients' health information. As part of our commitment, we have developed this Notice to inform you about WHG's privacy practices.

When you become a patient of WHG, you provide us with information about your health so that we may provide you with appropriate care. Each time you visit us, or a hospital, supplier, or other healthcare provider, another record of your visit and what was done is made. Typically, this record contains information about you and your symptoms, examinations, test results, diagnoses, treatment and a plan for future care or treatments. Your health record or medical record is the information that we use to plan your care, provide treatment, and receive payment for our services.

It is important for you to understand that your health record contains personal health information that is protected by federal and state laws. When we talk about personal health information in this Notice, we mean information collected about you, including your demographic information (name, address, age, gender, etc.) and other information that relates to your past, present or future health condition, the health care services provided to you, or payment for those services.

As a patient of WHG, you are entitled to receive notice about how we may use and disclose your personal health information in different circumstances, the choices and rights you have about how your personal health information may be used and disclosed, and our obligations to protect the privacy of your personal health information. After reading this Notice, if you have any questions about its contents or need additional information, please contact our contact person at the telephone number or address provided below.

Our responsibilities. WHG has certain responsibilities concerning your personal health information. We are required to maintain the privacy of your personal health information and to provide you with notice about our legal duties and privacy practices with respect to your personal health information. We are also required to accommodate reasonable requests that you make to communicate your personal health information by alternative means or at alternative locations. In addition, any time we use or disclose your personal health information, we must follow the terms of this Notice.

How We Use And Disclose Your Personal Health Information.

Uses and Disclosures for Treatment, Payment and Health Care Operations. WHG may use or disclose your personal health information to provide your treatment, to obtain payment for your treatment, and for our own health care operations.

Uses and Disclosures for Treatment. We may use and disclose your personal health information to plan, provide and coordinate your health care services. For example, various members of WHG's medical staff may view your personal health information as necessary to provide the best care for you or we may provide your personal health information to another health care provider who, at the request of your WHG physician, is needed to assist with providing a diagnosis treating you.
Uses and Disclosures for Payment. We may use and disclose your personal health information to obtain payment for health care services we have provided to you. For example, a bill for services provided may be sent to you or your health plan that include information that identifies you and provides information about your treatment. Additionally, we may be required to forward additional personal health information to your health plan or a government agency to substantiate the medical necessity of the care we provided in order to receive payment for our services.
Uses and Disclosures for Health Care Operations. We may use or disclose your personal health information for our health care operations. For example, we may use or disclose your personal health information to perform risk assessments and other administrative tasks to monitor the quality of care that we provide. Also, we may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

It is WHG's policy to use and disclose your personal health information to provide treatment, to obtain payment for services provided to you, and for our health care operations without obtaining a consent or authorization from you. However, for new patients of WHG whom we provide direct treatment to, we will make a good faith effort to obtain your written acknowledgment of receipt of this Notice no later than the date we first provide services to you.

Uses and Disclosures with Your Authorization. For most other uses and disclosures of your personal health information, WHG will obtain a written authorization from you prior to using or disclosing any of your personal health information (unless we are required or permitted by law to use or disclose your information as set forth below). Please know that you have the right to revoke any authorization you previously granted. If you have any questions about authorizations, or how to revoke them, please contact our contact person at the telephone number or address provided below.
Uses and Disclosures without an Authorization. WHG may use and disclose your personal health information without obtaining your authorization in the following limited situations:

Business Associates. There are some services that WHG provides through contracts with its business associates. In such situations, we may disclose your personal health information to our business associates so they can perform the job we asked them to do. We require all business associates to appropriately safeguard and protect your information in accordance with applicable law.
Notification of Family, Relatives or Close Friends. We may use or disclose your personal health information to notify a family member, personal representative or another person responsible for your care, and for certain general notification purposes, provided you are informed in advance of the use or disclosure and have the opportunity to agree or object to the use or disclosure. If you are unable to agree or object, we may disclose this information as necessary if we determine that it is in your best interests based upon our professional judgment. In all cases, we will only disclose the health information that is directly relevant to that person's involvement with your health care.
Required by Law. We may use or disclose your personal health information to the extent that we are required by law to do so. Any use or disclosure will be made in full compliance with the applicable law governing the use or disclosure.
Disease, Injury or Disability. We may disclose your personal health information for public health activities to a public health authority authorized by law to collect or receive information for the purpose of controlling disease, injury or disability. We may also disclose your personal health information, at the direction of a public health authority, to an official of a foreign government agency that is collaborating with the public health authority.
Child Abuse or Neglect. We may disclose your personal health information to a public health authority or other government agency authorized by law to receive reports of child abuse or neglect.
Food and Drug Administration. We may disclose your personal health information to a person subject to the jurisdiction of the United States Food and Drug Administration (FDA) concerning a FDA-regulated product or service for which that person has responsibility concerning the quality, safety or effectiveness of the product or activity.
Communicable Diseases. We may disclose your personal health information to a person who may have been exposed to a communicable disease or otherwise be at risk of contacting or spreading a disease if authorized by law to do so for public health intervention or investigation.
Health Oversight Activities. We may disclose your personal health information to a health oversight agency charged with overseeing the health care industry. Disclosures will be made only for activities authorized by law.
Judicial and Administrative Proceedings. We may disclose your personal health information in the course of any judicial or administrative hearing in response to an order of a court or administrative tribunal, or in response to a subpoena, discovery request or other lawful process where we receive satisfactory assurance that appropriate precautions have been taken to protect your health information. In all cases, we will take reasonable steps to protect the confidentiality of your health information.
Law Enforcement. We may disclose your personal health information for a law enforcement purpose to law enforcement officials in compliance with and as limited by applicable law.
Research. We may use or disclose your personal health information without your consent or authorization for research purposes when such research has been approved by an institutional review board or privacy board that has reviewed the research to ensure the privacy of your personal health information.
Victims of Abuse, Neglect or Domestic Violence. We may disclose personal health information about an individual whom we reasonably believe to be a victim of abuse, neglect or domestic violence to a government authority (e.g., adult protective services) authorized by law to receive reports of abuse, neglect or domestic violence. Any such disclosures will only be made as required by law or when permitted by law.
Limited Government Functions. We may disclose your personal health information to certain government agencies charged with special government functions, as limited by applicable law. For example, we may disclose your health information to authorized federal officials for the conduct of national security activities, as required by law.
Organ Procurement. As allowed by law, we may disclose personal health information to organ procurement organizations for organ, eye or tissue donation purposes.
Coroners, Medical Examiners and Funeral Directors. We may disclose personal health information to a coroner or medical examiner to identify a deceased person, determine a cause of death or for other duties as authorized by law. We may also disclose personal health information to funeral directors in accordance with applicable laws.
Health and Safety. We may disclose your personal health information to prevent or lessen a serious threat to a person's or the public's health or safety. In all cases, disclosures will only be to persons reasonably able to lessen the threat and made in accordance with applicable law and standards of ethical conduct.
Workers' Compensation. We may disclose your personal health information in accordance with applicable workers' compensation laws.

Your Rights. You have the right to do the following:

Right to Receive a Copy of this Notice. Upon request, you have the right to receive a paper copy of this Notice.
Right to Receive Further Information. You have the right to contact our contact person if you want additional information about our privacy practices, your privacy rights, or disagree with a decision we made about your personal health information, or if you believe that your privacy rights have been violated. The contact person will provide you with any information that you need.
Right to Request Confidentiality in Certain Communications. You have the right to request that certain communications to you (appointment reminders, lab results, bills, explanation of benefits, etc.) be made in a confidential manner. We will accommodate any such reasonable written request made on your behalf. Please contact our contact person for information you need to request confidentiality in certain communications.
Right to Request Additional Restrictions on Uses and Disclosures of Your Health Information. You have the right to request in writing that we place additional restrictions on how we may use or disclose your personal health information. While we will consider any request for additional restrictions, we are not required to agree to your request. Please contact our contact person for information you need to request additional restrictions on how we may use and disclose your personal health information.
Right to Inspect and Copy Your Health Information. Upon written request, you have the right to access and obtain a copy of your health records maintained by us. We will charge a reasonable fee for making any copies. Please contact our contact person for additional information on how to access and copy your health records.
Right to Amend Your Health Information. You have the right to request in writing that we amend health information maintained in your health record. We will comply with your request in the event that we determine the information that would be amended is false, inaccurate or misleading. If not, you will be provided with an opportunity to add a short statement to your health record explaining why you believe the information is inaccurate. Please contact our contact person for the information you need to request an amendment of your personal health information.
Right to Request an Accounting of Disclosures. You have a right to request in writing an accounting of certain disclosures of your personal health information made by us to third parties. For each disclosure, the accounting will include the date the information was disclosed, to whom, the address of the person or entity that received the disclosure (if known), and a brief statement of the reason for the disclosure. Please contact our contact person for information you need to request an accounting of disclosures.
Right to File a Complaint. If you believe your privacy rights have been violated, in addition to filing a complaint with us, you have the right to file a written complaint with the Office for Civil Rights of the United States Department of Health and Human Services. Upon request, our contact person will provide you with the information needed to file your complaint. Under no circumstances will we retaliate against you for filing a complaint with us or the Office for Civil Rights.

Changes to Notice. We reserve the right to change our privacy practices and to alter this Notice according to those changes. In the event that our Notice changes, we will make the Notice immediately available and notify you of the change the next time you visit us.

Contact Person. Questions about our privacy practices, your rights or our obligations to protect your privacy should be addressed to the office manager Cynthia Pagan at (210)509-8888.