This Notice of Privacy Practices describes the ways in which medical information about you may be used and disclosed, and how you can obtain access to it. Please review it carefully.
Understanding Your Health Information
Each time you visit a physician, or other health care provider, a record of your visit is made in order to manage the care you receive. We understand that the medical information that is recorded about you and your health is personal. The confidentiality of your health information is also protected under both state and federal law.
This Notice of Privacy Practices describes the ways that Arlington Physicians, P.A. may use and disclose your information and the rights that you have regarding your health information. The Notice applies to all facilities.
Although your health information is the physical property of the facility or practitioner that compiled it, the information belongs to you, and you have certain rights over that information. You have the right to:
You may exercise these rights by directing a request to the Privacy Contact listed on this Notice.
Arlington Physicians, P.A. has certain responsibilities regarding your health information, including the requirement to:
We reserve the right to change these information privacy policies and practices and to make the changes applicable to any health information that we maintain. If changes are made, the revised Notice of Privacy Practices will be made available at each facility, posted on our website, and will be supplied when requested.
When you obtain services certain uses and disclosures of your health information are necessary and permitted by law in order to treat you, to process payments for your treatment and to support the operations of the entity and other involved providers. The following categories describe ways that Texas Health entities use or disclose your information, and some representative examples are provided in each category. All of the ways your health information is used or disclosed should fall within one of these categories.
Your health information will be used for treatment
Example: Disclosures of medical information about you may be made to doctors, nurses, technicians, medical residents or others who are involved in taking care of you. This information may be disclosed to other physicians who are treating you or to other health care facilities involved in your care. Information may be shared with pharmacies, laboratories or radiology centers for the coordination of different treatments.
In addition, if you receive treatment from a Texas Health entity that participates in a health information exchange, the entity may share your health information with the health information exchange in an information system for the purposes of diagnosis and treatment. Other health care providers may access your health information through this system as part of your treatment.
Your health information will be used for payment.
Example: Health information about you may be disclosed so that services provided to you may be billed to an insurance company or a third party. Information may be provided to your health plan about treatment you are going to receive in order to obtain prior approval or to determine if your health plan will cover the treatment.
Your health information will be used for health care operations.
Example: The information in your health record may be used to evaluate and improve the quality of the care and services we provide. Students, volunteers, and trainees may have access to your health information for training and treatment purposes as they participate in continuing education, training, internships, and residency programs.
Business Associates
There are some services that we provide through contracts with third party business associates. Examples include transcription agencies and copying services. To protect your health information, Texas Health entities require these business associates to appropriately protect your information.
Continuity of Care
In order to provide for the continuity of your care your information may be shared with other health care providers such as home health agencies. Information about you may be disclosed to community services agencies in order to obtain their services on your behalf.
Unless you give notice of an objection, and in accordance with your Authorization to Verbally Release Health Information, medical information may be released to a family member or other person who is involved in your medical care or who helps pay for your care. Information about you may be disclosed to notify a family member, legally authorized representative or other person responsible for your care about your location and general condition. This may include disclosures of information about you to an organization assisting in a disaster relief effort, such as the American Red Cross, so that your family can be notified about your condition.
The following disclosures of health information may be made according to state and federal law without your written authorization or verbal agreement:
Other Allowable Uses and Disclosures without Authorization
Other uses or disclosures of your health information that may be made include:
Required Uses and Disclosures
Under the law we must make disclosures when required by the secretary of the Department of Health and Human Services to investigate or determine our compliance with federal privacy law.
Uses and Disclosures Requiring Authorization
Any other uses or disclosures of your health information not addressed in this notice or otherwise required by law will be made only with your written authorization. You may revoke such authorization at any time.
Privacy Complaints
You have the right to file a complaint if you believe your privacy rights have been violated. The complaint may be addressed to the privacy contact listed in this notice, or to the secretary of the Department of Health and Human Services. There will be no retaliation for registering a complaint.
Privacy Contact
Address any questions about this notice or how to exercise your privacy rights to the applicable privacy officer contact listed below.
Effective Date
July 16, 2007
Entity Privacy Officer Contacts
Privacy Officer
Arlington Physicians, P.A.
P.O. Box 120069
Arlington, TX 76012
You may also send a written complaint to the United States Department of Health and Human Services. We will not retaliate against you for filing a complaint with the government on us. The contact information for the United States Department of Health and Human Services is:
U.S. Department of Health and Human Services
HIPAA Complaint
7500 Security Blvd., C5-24-04
Baltimore, MD 21244