NOTICE OF PRIVACY PRACTICES

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

Jeffers Chiropractic and Sports Injuries is required by law to maintain the privacy and confidentiality of your protected health information and to provide our patients with notice of our legal duties and privacy practices with respect to your protected health information.

Disclosure of Your Health Care Information

Treatment:            We may disclose your health care information to other healthcare professionals within our practice for the purpose of treatment, payment or healthcare operations. (Consultation with other health care providers, substitute provider in Dr. Jeffer’s absence.)

Payment:            We may disclose your health information to your insurance provider for the purpose of payment or health care operations (Billing statements contain medical information, including diagnosis, date of injury or condition, and codes which describe the health care services rendered).

Special Situations

Workers’ Compensation:              We may disclose your health information as necessary to comply with Sate 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 or your death.

Public Health:            As required by law, we may disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability, reporting child abuse or domestic violence, reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure.

Judicial and Administrative Proceedings:            We may disclose your health information in the course of any administrative or judicial proceeding.

Law Enforcement:                        We may disclose your health information to a law enforcement official for purposes such as complying with a court order or subpoena, and other law enforcement purposes.

Deceased Persons:            We may disclose your health information to coroners or medical examinations.

Research:            We may disclose your health information to researchers conducting research that has been approved by an Institutional Review Board.

Specialized Government Agencies:            We may disclose your health information for military, national security, prisoner and government benefits purposes.

Marketing:            We may contact you to remind you of appointments times or missed appointments.  No personal health information will be disclosed in any message or recording.  We may contact you with educational or marketing materials by mail.

Change of Ownership:            In the event that Jeffers Chiropractic and Sports Injuries is sold or merged with another organization, your health information will become the property of the new owner.

Your Health Information Rights:

• You have the right to request restrictions on certain uses and disclosures of your health information.  Please be advised, however, that Jeffers Chiropractic and Sports Injuries is not required to agree to the restriction that you requested.
• 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.
• You have the right to inspect and copy your health information.  There may be a charge for copies of your records.
• You have a right to request that Jeffers Chiropractic and Sports Injuries amend your protected health information.  Please be advised, however, that Jeffers Chiropractic and Sports Injuries is not required to agree to this request.  If your request is denied, you will be provided with a written explanation of our denial.
• You have a right to receive an accounting of disclosures of your protected health information.
• You have a right to a paper copy of this Notice of Privacy Practices at any time upon request.

Changes to this Notice of Privacy Practices:

Jeffers Chiropractic and Sports Injuries 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.  Until such amendment is made, Jeffers Chiropractic and Sports Injuries is required by law to comply with this notice.

OTHER USES AND DISCLOSURES OF HEALTH INFORMATION

We will not use or disclose your health information for any purpose other than those identified in the previous sections without your specific, written Authorization. We must obtain your Authorization separate from any Consent we may have obtained from you. If you give us Authorization to use or disclose health information about you, you may revoke that Authorization, in writing, at any time. If you revoke your Authorization, we will no longer use or disclose information about you for the reasons covered by your written Authorization, but we cannot take back any uses or disclosures already made with your permission.