South Atlantic Medical Group - Privacy Practices

Privacy Practices

Click here to Download in PDF Format

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.

Who Will Follow This Notice

This Notice describes our medical group's practices and that of:

Any health care professional authorized to enter information into your medical chart.

All departments and units of the medical group.

Any member of a volunteer group we allow to help you while you are at the medical group.

All employees, staff, and other medical group personnel.

All these entities, sites, and locations follow the terms of this Notice. In addition, these entities, sites and locations may share medical information with each other for treatment, payment or medical group operations purposes described in this Notice.

Our Pledge Regarding Medical Information

We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at the medical group. We need this record to provide you with quality care and to comply with certain legal requirements. This Notice applies to all of the records of your care generated by the medical group, whether made by medical group personnel or your personal doctor.

This Notice will tell you about the ways in which we may use and disclose medical information about you. It also describes your rights and certain obligations we have regarding the use and disclosure of medical information.

We are required by law to:

make sure that medical information that identifies you is kept private;

make available to you this Notice of our legal duties and privacy practices with respect to medical information about you; and

follow the terms of the Notice that is currently in effect. This Notice may change, in the manner described below under "CHANGES TO THIS NOTICE".

How We May Use And Disclose Medical Information About You

The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures, we provide examples, but not every use or disclosure in a category is listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

	For Treatment. We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students, or other medical group personnel who are involved in taking care of you at the medical group. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. In addition, the doctor may need to tell the dietitian if you have diabetes so that we can arrange for appropriate meals. Different departments of the medical group also may share medical information about you among themselves, in order to coordinate the different things you need, such as prescriptions, lab work and x-rays. We also may disclose medical information about you to people outside the medical group who may be involved in your medical care after you leave the medical group, such as family members, clergy or others we use to provide services that are part of your care.
	For Payment. We may use and disclose medical information about you so that the treatment and services you receive at the medical group may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about surgery you received at the medical group so your health plan will pay us or reimburse you for the surgery. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
	For Health Care Operations. We may use and disclose medical information about you for medical group operations. These uses and disclosures are necessary to run the medical group and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine medical information about many medical group patients to decide what additional services the medical group should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, medical students, and other medical group personnel for review and learning purposes. We may also combine the medical information we have with medical information from other medical groups to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that identifies you from this set of medical information, so others may use it to study health care and health care delivery without learning who the specific patients are.
	Appointment Reminders. We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care at the medical group.
	Treatment Alternatives. We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
	Health-Related Benefits and Services. We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.
	Hospital Directory. If you are hospitalized, the hospital routinely includes certain limited information about you in the Hospital directory while you are a patient at the hospital. This may include your name, your location in the hospital, your general condition (such as "fair" or "critical,"), and your religious affiliation. The hospital may release that directory information, except for your religious affiliation, to any person who asks for you by name. Your religious affiliation and the other directory information may be given to a member of the clergy, such as a priest or rabbi, even if they don't ask for you by name. This is so your family, friends, and clergy can visit you in the hospital and generally know how you are doing. You may instruct us not to disclose, or to limit disclosure of, your directory information, in the manner described below under "Right to Request Restrictions..
	Individuals Involved in Your Care or Payment for Your Care. We may release medical information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort, so that your family can be notified about your condition, status, and location.
	Research. Under certain circumstances, we may use and disclose medical information about you for research purposes. For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another, for the same condition. All research projects, however, are subject to a special approval process. This process evaluates a proposed research project and its use of medical information, trying to balance the research needs with patients' need for privacy of their medical information. Before we use or disclose medical information for research being conducted, the project will have been approved through this research approval process. However, we may disclose medical information about you to people preparing to conduct a research project, for example, to help them look for patients with specific medical needs, so long as the medical information they review does not leave the medical group. We will almost always ask for your specific permission (on an authorization form) if the researcher will have access to your name, address or other information that reveals who you are, or will be involved in your care at the medical group.
	As Required By Law. We will disclose medical information about you when required to do so by federal, state, or local law.
	To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
	Special Situations. We may also use and disclose medical information about you in the situations described under "SPECIAL SITUATIONS" below.

Other Uses Of Medical Information

Other uses and disclosures of medical information not covered by this Notice or the laws that apply to us will be made only with your written authorization. A form for those authorizations, both those that you request and those that we request, is available from our Medical Records office at your South Atlantic Medical Group location. If you give us an authorization, you may later revoke that permission in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. In that case, however, we will be unable to take back any disclosures we have already made with your permission, and we will still be required to retain our records of the care that we provided to you.

Special Situations

Organ and Tissue Donation. If you are an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

Military and Veterans. If you are a member of the armed forces, we may release medical information about you as required by military command authorities or, some cases if needed to determine benefits, to the Department of Veterans Affairs. We may also release medical information about foreign military personnel to the appropriate foreign military authority.

Workers' Compensation. We may release medical information about you for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Public Health Risks. We may disclose medical information about you for public health activities. These activities generally include the following:

to prevent or control disease, injury or disability;

to report births and deaths;

to report child abuse or neglect;

to report elder abuse or neglect;

to report reactions to medications or problems with products;

to notify people of recalls of products they may be using;

to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;

to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.

Health Oversight Activities. We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Law Enforcement. We may release medical information if asked to do so by a law enforcement official:

In response to a court order, subpoena, warrant, summons or similar process;

To identify or locate a suspect, fugitive, material witness, or missing person;

About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person's agreement;

About a death we believe may be the result of criminal conduct;

About criminal conduct at the medical group; and

In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.

Coroners, Medical Examiners and Funeral Directors. We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients of the medical group to funeral directors as necessary to carry out their duties.

National Security, Intelligence, and Federal Protective Service Activities. We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law, and to authorized federal officials where required to provide protection to the President of the United States, other authorized persons or foreign heads of state or conduct special investigations.

Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official where necessary for the institution to provide you with health care; to protect your health and safety or the health and safety of others; or for the safety and security of the correctional institution.

Your Rights Regarding Medical Information About You

You have the following rights regarding medical information we maintain about you:

	Right to Inspect and Copy. You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes. You must submit any request to inspect and copy your medical information to our Medical Records office at your South Atlantic Medical Group location. (A form for that request is available from that office.) If you request a copy of your information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. We may deny your request in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by the medical group will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of that review.
	Right to Amend. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the medical group. You must submit any request for an amendment our Medical Records office at your South Atlantic Medical Group location, in writing. (A form for that request is available from that office.) Your written request must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that: o Was not created by us, unless the person or entity that created the information is no longer available to make the amendment; o Is not part of the medical information kept by or for the medical group; o Is not part of the information which you are permitted to inspect and copy; or o Is accurate and complete.
	Right to an Accounting of Disclosures. You have the right to request an "accounting of disclosures." This is a list of the disclosures we have made of medical information about you, with some exceptions. The exceptions are governed by federal health privacy law, and include (1) routine disclosures for treatment, payment and operations conducted pursuant to your signed consent form, (2) disclosures to you, and (3) disclosures made from the medical group directory, as described above. You must submit any request for an accounting of disclosures to our Medical Records office at your South Atlantic Medical Group location, in writing. (A form for that request is available from that office.) Your written request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003, when current federal health privacy laws became effective for our medical group. Your request should indicate whether you want the report on paper or electronically. The first report you request within a 12-month period will be free. For additional reports, we may charge you for the costs of providing the report. We will notify you of the cost involved, and you may choose to withdraw or modify your request at that time before any costs are incurred.
	Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had. Please note that we are not required to agree to your request. However, if we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. You must submit any request for restrictions to our Medical Records office at your South Atlantic Medical Group location, in writing. (A form for that request is available from that office.) Your written request must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
	Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. You must submit any request for confidential communications restrictions to our Medical Records office at your South Atlantic Medical Group location, in writing. (A form for that request is available from that office.) Your written request must tell us how or where you wish to be contacted. We will not ask you the reason for your request. We will accommodate all reasonable requests.
	Right to a Paper Copy of This Notice. You may ask us to give you a paper copy of this Notice at any time, even if you have agreed to receive this Notice electronically, by contacting [our Medical Records office] at the location noted on the first page of this Notice.

Changes To This Notice

We reserve the right to change this Notice. When we do, we may make the changed Notice effective for medical information we already have about you then, as well as any information we receive in the future. We will post a copy of the current Notice in our Admitting and Registration Office(s) and in our Medical Records Department. Each Notice will contain on the first page, in the top right-hand corner, its effective date. Also, each time you register at or are admitted to the medical group for treatment or health care services as an inpatient or outpatient, we will offer you a copy of the current Notice in effect.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with the medical group or with the Secretary of the Department of Health and Human Services. To file a complaint with the medical group, our Medical Records office at your South Atlantic Medical Group location. All complaints must be submitted in writing. YOU WILL NOT BE PENALIZED FOR FILING A COMPLAINT.

If you have any questions about this Notice, please contact our Medical Records office at:

Administrative Service South Atlantic Medical Group - Los Angeles/Commerce
5504 Whittier Boulevard
Los Angeles, CA 90022-4104
323-725-0167