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.
Uses and disclosures
Treatment Your health information may be used by staff members or discloved to other health care professionals for the purpose of evaluationg your health, diagnosing meidcal conditions, and providing treatment. For example, results of labroatory tests and procedutes will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members.
Payment Your health information may be used to seek payment from your health plan, from other sources of coverage such as an automobile insurer, or from credit card companies that you may use to pay for services. For example, you health plan may request and receive information on dates of service, the service provided, and the medical condition being treated.
Health care operations Your health information may be used as necessary to support the day to day activities and management of. For example, information on the services you receive may be used to support budgeting and financial reporting, and activites to evaluate and promote quality.
Business Associates We are permitted by law to utilize Business Associates to carry out treatment, payment or health care operations functions that may involve the use and disclosure of some of your health information. For example, we may utilize a billing service to handle billing and payment functions.
Appointment reminders We may use and disclose medical information to contact you as a reminder that you have an appointment with this practice.
Law enforcement Your health information may be disclosed to law enforcement agencies to support goverment audits and inspections, to facilitate law enforcement investigations, and to comply with government-mandated reporting.
Public health reporting Your health information may be disclosed to public health agencies as required by law. For example, we are reuired to report certain communicable diseases to the state's public health department.
Other uses and disclosures require your authorization. Disclosure of your health information or its use for any other purpose other than those listed above require your specific written authorization. If you change your mind after authorizing a use or disclosure of your information you may submit a written revocation of the authorization. However, you decision to revoke the authorization will not affect or undo any uses or discloses of information
Individual Rights
- The right to request restrictions on the use and disclosure of your protected health information
- The right to reveive confidential communications concernining 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
Prime Care Family-Urgent Care's Duties
We are required by law to maintain the privacy of your protected health information and to provide you with a copy of this notice of privacy practices.
We are also required to abide by the privacy policies and practives that are outlined in this notice.
Other uses and disclosures require your authorization. Disclosure of your health information or its use for any other purpose other than those listed above require your specific written authorization. If you change your mind after authorizing a use or disclosure of your information you may submit a written revocation of the authorization. However, you decision to revoke the authorization will not affect or undo any uses or discloses of information
Right to Revise Privacy Practices
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. Upon request, we will provide you with the most recently revised notice on any office visit. The revised policies and practice will be applied to all protected health information we maintain.
Request to Inspect Protected Health Information
We are required by law to maintain the privacy of your protected health information and to provide you with a copy of this notice of privacy practices.
Complaints
If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns to:
Privacy Officer
Prime Care Family Care
2511 Salem Church Road
Fredericksburg, VA 22407
If you believe that your privacy rights have been violated, you should call the matter to our attention by sending a letter describing to cause of your concern to the same address.
You will not to penalized or otherwise retaliated for filing a complaint.
Contact Person
The name and address of the person you may contact for further information concerning our privacy practives is:
Privacy Officer
Prime Care Family Care
2511 Salem Church Road
Fredericksburg, VA 22407
Effective Date:
This notice is effective on or after February 1, 2005.