The terms of this notice apply to all records containing your IIHI that are created or retained by our practice. We reserve the right to revise or amend this Notice of Privacy Practices. Any revision or amendment to this notice will be in effect for all of your records that our practice has created or maintained in the past, and for any of your records that we may create or maintain in the future. Our practice will post a copy of our most current Notice in our offices in a visible location at all times, and you may request a copy of our most current Notice at any time.
1. Treatment. Our practice may use your IIHI to treat you. For example, we may ask you to have laboratory tests (such as blood or urine tests), and we may use the results to help us reach a diagnosis. We might use IIHI in order to write a prescription for your, or we might disclose your IIHI to a pharmacy when we order a prescription for you. Many of the people who work for our practice – including, but not limited to, our doctors and nurses – may use or disclose your IIHI to others who may assist in your care, such as your spouse, children or parents.
3. Health Care Operations. Our practice may use and disclose your IIHI to operate our business. As examples of the ways in which we may use and disclose your information for our operations, our practice may use your IIHI to evaluate the quality of care you received from use, or to conduct cost-management and business planning activities for our practice.
7. Release of Information to Family/Friends. Our practice may release your IIHI to a friend or family member that is involved in your care, or who assists in taking care of you. For example, a parent or guardian may ask that a babysitter take their child to one of our offices for treatment. In this example, the babysitter may have access to this child’s medical information.
8. Disclosures Required By Law. Our practice will use and disclose your IIHI when required to do so by federal, state or local law.
3. Lawsuits and Similar Proceedings. Our practice may use and disclose your IIHI in response to a court or administrative order, if you are involved in a lawsuit or similar proceeding. We also may disclose your UHI in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.
7. Military. Our practice may disclose your IIHI to the appropriate authorities if you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate authorities.
10. Workers’ Compensation. Our practice may release your IIHI for workers’ compensation and similar programs.
1. Confidential Communications. You have the right to request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than work. In order to request a type of confidential communication, you must make a written request to James C. Rholl, MD 1032 Fleming Street, Hendersonville, NC 28791 specifying the requested method of contact, or the location where you wish to be contacted. For your convenience, a form for this purpose may be obtained, at no charge to you, from the front desk of our practice office closest to you. Our practice will accommodate reasonable requests. You do not need to give a reason for your request.
For your convenience, a form for this purpose may be obtained, at no charge to you, from the front desk of our practice office closest to you. The form is not required. However, it would be helpful in filling your request.
3. Inspection and Copies. You have the right to inspect and obtain a copy of the IIHI that may be used to make decisions about you, including patient medical records and billing records. You must submit your request in writing to James C. Rholl, MD 1032 Fleming Street, Hendersonville, NC 28791 in order to inspect and/or obtain a copy of your IIHI. For your convenience, a form for this purpose may be obtained, at no charge to you, from the front desk of our practice office closest to you. Our practice may charge a fee for the costs of copying, mailing, labor and supplies associated with your request. Our practice may deny your request to inspect and/or copy in certain limited circumstances; however, you may request a review of our denial. Another licensed health care professional chosen by us will conduct reviews.
4. Amendment. You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing and submitted to James C. Rholl, MD 1032 Fleming Street, Hendersonville, NC 28791. For your convenience, a form for this purpose may be obtained, at no charge to you, from the front desk of our practice office closest to you. You must provide us with a reason that supports your request for amendment. Our practice will deny your request if you fail to submit your request (and the reason supporting your request) in writing. Also, we may deny your request if you ask us to amend information that is in our opinion: (a) accurate and complete; (b) not part of the IIHI kept by or for the practice; or (c) not created by our practice, unless the individual or entity that created the information is not available to amend the information.
5. Accounting of Disclosures. All of our patients have the right to request an “accounting of disclosures.” An “accounting of disclosures” is a list of certain non-routine disclosures our practice has made of your IIHI for non-treatment or operations purposes. Use of your IIHI as part of the routine patient care in our practice is not required to be documented. For example, the doctor sharing information with the nurse; or the billing department using your information to file your insurance claim. In order to obtain an accounting of disclosures, you must submit your request in writing to James C. Rholl, MD 1032 Fleming Street, Hendersonville, NC 28791. For your convenience, a form for this purpose may be obtained, at no charge to you, from the front desk of our practice office closest to you. All requests for an “accounting of disclosures” must state a time period, which may not be longer than six (6) years from the date of disclosure and may not include dates before April 14, 2003. The first list you request within a 12-month period is free of charge, but our practice may charge you for additional requests, and you may withdraw your request before you incur any costs.
6. Right to a Paper Copy of This Notice. You are entitled to receive a paper copy of our notice of privacy practices. You may ask us to give you a copy of this notice at any time. To obtain a paper copy of this notice please ask for one at the front desk of the practice office nearest you, or contact James C. Rholl, MD 1032 Fleming Street, Hendersonville, NC 28791.
7. Right to File a Complaint. If you believe your privacy rights have been violated, you may file a complaint with our practice, with the Secretary of the Department of Health and Human Services, or with the Office of Civil Rights. To file a complaint with our practice, contact James C. Rholl, MD 1032 Fleming Street, Hendersonville, NC 28791. All complaints must be submitted in writing. For your convenience, a form for this purpose may be obtained, at no charge to you, from the front desk of our practice office closest to you. You will not be penalized for filing a complaint.
8. Right to Provide and Authorization for Other Uses and Disclosures. Our practice will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. Any authorization you provide to us regarding the use and disclosure of your IIHI may be revoked at any time in writing. For your convenience, a form for this purpose may be obtained, at no charge to you, from the front desk of our practice office closest to you. After you revoke your authorization, we will no longer use or disclose your IIHI for the reasons described in the authorization. Please note: we are required to retain records of your care.