This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Understanding your health record/information
Each time you visit a hospital, physician, dentist, or other healthcare provider, which includes substance and alcohol abuse, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information often referred to as your health or substance and alcohol abuse record serves as a basis for planning your care and treatment and serves as a means of communication among the many health professionals who contribute to your care. Understanding what is in your record and how your health information is used helps you to ensure its accuracy, better understand who, what, when, where, and why others may be allowed access to your health information. This effort is being made to assist you in making informed decisions before authorizing the disclosure of your medical information to others.
Your health information rights
Unless otherwise required by law, your health record is the physical property of the healthcare practitioner or facility that compiled it. However, you have certain rights with respect to the information. You have the right to:
- Receive a copy of this Notice of Privacy Practices upon enrollment or upon request.
- Request restrictions on certain uses and disclosures of your protected health information for treatment, payment and health care operation. With this in mind, please discuss any restriction you wish to request with your substance/alcohol abuse provider. However, we reserve the right not to agree to the requested restriction if the provider believes this would not be in your best interest. Other than activity that has already occurred, you may revoke any further authorizations to use or disclosure of your health information. You may request a restriction by sending a letter to: Attn: Privacy Officer, John E. Hickey, Tuerk House, Inc. P.O. Box 31419, Baltimore, Maryland 21216
- Request to receive communications of protected health information in confidence. You may also request communications of your health information by alternative means or to alternative locations. We will advise you if any such request is not feasible for our office to accommodate.
- Inspect and obtain a copy of the protected health information contained in your medical and billing records and in any other Practice records used to make decisions about you. This can be done by appointment only. A copying charge may apply to obtain a copy of any portion of your medical record. Additionally, a fee will apply to inspect your records, if such inspection is requested. (Under federal law, however, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding.) A decision to deny access may be reviewable. Please contact our Privacy Officer if you have any questions about access to your medical record.
Request an amendment to your protected health information. However, we may deny your request for an amendment, if we determine that the protected health information or record that is the subject of the request:
- Was not created by us, unless you provide a reasonable basis to believe that the originator of the protected health information is no longer available to act on the requested amendment;
- Is not a part of your medical or billing records;
- Is not available for inspection as set forth above; or
- Is accurate and complete.
In any event, any agreed upon amendment will be included as an addition to, and not a replacement of, already existing records. If your request for amendment is denied, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.
How medical information about you may be used and disclosed
This organization may use and/or disclose your medical information for the following purposes:
Treatment: We may use and disclose protected health information in the provision, coordination, or management of your health care, including consultations between health care from one health care provider to another.
Payment: We may use and disclose protected health information to obtain reimbursement for the health care provided to you, including determinations of eligibility and coverage and other utilization review activities.
Regular Healthcare Operations: We may use and disclose protected health information to support functions of our practice related to treatment and payment, such as quality assurance activities, case management, receiving and responding to patient complaints, physician reviews, compliance programs, audits, business planning, development, management and administrative activities.
Appointment Reminders: We may use and disclose protected health information to contact you to provide appointment reminders.
Treatment Alternative: We may use and disclose protected health information to contact you to provide appointment reminders.
Health-Related Benefits and Services: We may use and disclose protected health information to tell you about health-related benefits, services, or medical education classes that may be of interest to you.
Individuals involved in Your Care or Payment for Your Care: Unless you object, we may disclose your protected health information to your family or friends or any other individual identified by you when they are involved in your care or the payment for your care. We will only disclose the protected health information directly relevant to their involvement in your care or payment. We may also disclose your protected health information to notify a person responsible for your care (or to identify such person) of your location, general condition or death.
Business Associates: There may be some services provided in our organization through contracts with Business Associates. Examples include physician services in the emergency department and radiology, certain laboratory tests, and a copy service we use when making copies of your health record. When these services are contracted, we may disclose some or all of our health information to our Business Associate so that they can perform the job we have asked them to do. To protect your health information, however, we require the Business Associate to appropriately safeguard your information.
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.
Worker’s Compensation: We may release protected health information about you for programs that provide benefits for work related injuries or illness.
Communicable Diseases: We may disclose protected health information 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.
Health Oversight Activities: We may disclose protected health information to federal or state agencies that oversee our activities.
Law Enforcement: We may disclose protected health information as required by law or in response to a valid judge ordered subpoena. For example in cases of victims of abuse or domestic violence: to identify or locate a suspect, fugitive, material witness, or missing person; related to other law enforcement purposes.
Military and Veterans: If you are a member of the armed forces, we may release protected health information about you as required by military command authorities.
Lawsuits and Disputes: We may disclose protected health 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.
Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release protected health information about you to the correctional institution or law enforcement official. An inmate does not have the right to the Notice of Privacy Practices.
Abuse or Neglect: We may disclose protected health information 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.
Corners, Medical Examiner, and Funeral Directors: We may release protected health information to a coroner or medical examiner. This may be necessary to identify a deceased person or determine the cause of death. We may also release protected health information about patients to funeral directors as necessary to carry out their duties.
Public Health Risks: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose such as controlling disease, injury or disability.
Serious Threats: As permitted by applicable law and standards of ethical conduct, we may use and disclose protected health information if we, in good faith, believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
Food and Drug Administration (FDA): As required by law, we may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.
We are required to maintain the privacy of your health information. In addition, we are required to provide you with a notice of our legal duties and privacy practices with respect to information we collect and maintain about you. We must abide by the terms of this notice. We reserve the right to change our practices and to make the new provisions effective for all the protected health information we maintain. If our information practices change, a revised notice will be mailed to the address you have supplied upon request. If we maintain a Web site that provides information about our patient services or benefits, the new notice will be posted on that Web site. Your health information will not be used or disclosed without your written authorization, except as described in this notice. Except as noted above, you may revoke your authorization in writing at any time.
For more information or to report a problem
If you have questions about this notice or would like additional information, you may contact our Privacy Officer, at the telephone or address below. If you believe that your privacy rights have been violated, you have the right to file a complaint with the Privacy Officer at Tuerk House, Inc. or with the Secretary of the Department of Health and Human Services. We will take no retaliatory action against you if you make such complaints.
The contact information for both is included below
U.S Department of Health and Human Services
Office of the Secretary
200 Independence Avenue, S.W.
Tel: (202) 619-0257
Toll Free: 1-877-696-6775
730 Ashburton Street
Baltimore, MD. 21216
Tel: (410) 233-0684 Ext. 115
Notice of privacy practices availability
This notice will be prominently posted in the office where registration occurs. You will be provided a hard copy of this notice as part of your admission process. Thereafter, additional copies are available upon request.