Notice of Health Information/Privacy Practices

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

Introduction

At Marin Endocrine we are committed to collecting and managing Protected Health Information (also referred to as PHI) responsibly.  This Notice of Health Information Practices describes the personal information we collect, and how we use or disclose that information.  It also describes your rights as they relate to your PHI.  This notice is effective April 01, 2003 and applies to all PHI as defined by federal regulations.

Understanding Your Health Record/Information

Each time you visit Marin Endocrine; a record of your visit is made.  Typically, this record contains your history, symptoms, examination notes, laboratory and diagnoses as well as a plan for future care or treatment.  This information is refered to as your health or medical record and serves as a:

  • Basis of planning your care and treatment
  • Means of communication among the other health care providers who contribute to your care
  • Legal document describing the care you receive
  • Means by which you or a third party payer can verify that services billed were actually provided.
  • A tool in educating health professionals
  • A source of data for medical research
  • A source of information for public health officials charges with improving the health of this state and the nation
  • A tool with which we can access and continually work to improve the care we render and the outcomes we receive

Understanding your health record and how this information is used helps you to: ensure its accuracy, better understand who, what, when, where, and why others may access you PHI and make more informed decisions when authorizing disclosure to others.

Your Health Information Rights

Although your health record is the physical property of Marin Endocrine, the information belongs to you and you have the right to:

  • Obtain a paper copy of this notice of information practices upon request
  • Inspect your health record
  • Possibly amend your health record
  • Obtain an accounting of disclosures or communications of your PHI
  • Request a restriction on certain uses and disclosures of your PHI
  • Revoke your authorization to use or disclose your PHI except to the extent that action has already been taken.

Our Responsibilities

Marin Endocrine is required to:

  • Maintain the privacy of your PHI
  • Provide you with notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
  • Abide by the terms of this notice
  • Notify you if we are unable to agree to a requested restriction
  • Accommodate reasonable requests to communicate health information by alternative means with proper notification

We reserve the right to change our practices and to make the new provisions effective for all PHI we maintain.  Should our information practices change, we will mail a revised notice to the address you have supplied us, or if you agree we will email the revised notice to you.

We will not use or disclose your PHI without your authorization, except as described in this notice.  We will also cease to use or disclose your PHI after we have received a written revocation of the authorization according to the procedures included in this authorization.

Examples of Disclosures for Treatment, Payment and Health Operations

Appointment Reminders:

For example: We may contact you or leave a message on a designated phone number to remind you of your appointment.

We will use your PHI for treatment.

For example:  Information obtained by a nurse, physician or other member of our staff will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his or her expectations of your health care team.  Members of the health care team will document their observations and any findings.  In that way the physician will know how you are responding to treatment.

We also provide the subsequent health care providers with copies of various reports that should assist in your treatment.

We will use your health information for payment or your reimbursement.

For example: A bill may be sent to you or a third party payer.  The information on our bill may include information that identifies you, as well as your diagnoses, procedure and supplies used.

We will use your health information for regular health operations.

For example: Members of our staff may use information in your health record to access the care and outcomes in your case and others like it.  This information will then be used in an effort to continually improve the quality and effectiveness of care we provide.

Business associates:  There are some services provided in our office through contacts with outside associates.  Examples include physician services in the emergency department, laboratory or radiology.  When these tests are ordered we may disclose your health information so they can perform the job we have requested of them and to bill your third party payer for services rendered.  Transcription of medical records will have access to your medical records to perform a job we have asked of them.  To protect your health information we require any transcription services to sign a confidentiality agreement verifying they will appropriately safeguard your information.

Notification: We may use or disclose information to notify or assist a family member, personal representative or another person responsible for your care and general condition.

Communication with family:  Health professionals, using their best judgment may disclose to a family member, other relative or any other person you identify health information that is relevant to that person's involvement in your care and well being

Funeral Directors: We may disclose health information to funeral directors consistent with applicable law or carry out their duties.

Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to supplements, medications to enable product recalls, repairs or replacements.

Law Enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.  Federal law makes provisions for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.

If you have questions and would like additional information you may contact the Office Manager at 415-461-1780.

If you believe your privacy has been violated you can file a complaint with the Office Manager or with the Office of Civil Rights, US Dept of Health and Human Services.  There will be no retaliation for filing a complaint with either the Office Manager or the Office for Civil Rights.  The address for the OCR is listed below:

    Office for Civil Rights
    US Dept of Health and Human Services
    200 Independence Ave, S.W.
    Room 509F, HHH Building
    Washington, DC 20201

We are dedicated to protecting your medical records as well as providing appropriate communication to your physician and necessary ancillary personnel.