Privacy Practices

Internist Associates of Central New York, PC

NOTICE OF PRIVACY PRACTICES

 
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USEDAND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.


PLEASE REVIEW IT CAREFULLY. YOU WILL BE ASKED TO SIGN AN ACKNOWLEDGMENT THAT WILL BE KEPT IN YOUR MEDICAL CHART.

We understand that your health information is personal to you, and we are committed to protecting the information about you. This Notice of Privacy Practices (or "Notice") describes how we will use and disclose protected information and data that we receive or create related to your health care.


Our Duties

We are required by law to maintain the privacy of your health information, and to give you this Notice describing our legal duties and privacy practices. We are also required to follow the terms of the Notice currently in effect.


How We May Use and Disclose Health Information About You

We will not use or disclose your health information without your authorization, except in the following situations:

  • Treatment: We will use and disclose your health information while providing or coordinating your health care. For example, information obtained by one of our staff may be shared with other health care providers outside our practice to assist in treating you.
  • Payment: We will use and disclose your medical information to obtain compensation or reimbursement for providing your health care services. For example, we may send a claim to you or your health plan that includes information that identifies you, as well as your diagnosis, procedures, and supplies used.
  • Health Care Operations: We will use and disclose your health information to deal with certain administrative aspects of your health care, and to manage our business more efficiently. For example, members of our medical staff may use information in your health record to assess the quality of care and outcomes in your case and others like it. This information will then be used in an effort to improve the quality and effectiveness of the health care and services we provide.
  • Business Associates: There are some services provided in our organization through contracts with business associates. We may disclose your health information to our business associate so they can perform the job we’ve asked them to do. However, we require the business associate to take precautions to protect your health information.
  • Notification of Family: We may use or disclose information to notify or assist in notifying a family member, personal representative, or other person responsible for your care of your location and general condition.
  • Communication with Family: We may disclose to a family member, other relative, close friend or any person you identify, health information relevant to that person’s involvement in your care.
  • Research: Consistent with applicable law we may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.
  • Funeral Director, Coroner, and Medical Examiner: Consistent with applicable law we may disclose health information to funeral directors, coroners, and medical examiners to help them carry out their duties.
  • Organ Procurement Organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
  • Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events, product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.
  • Public Health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability, including child abuse and neglect.
  • Victims of Abuse, Neglect or Domestic Violence: We may disclose your health information to appropriate governmental agencies, such as adult protective or social services agencies, if we reasonably believe you are a victim of abuse, neglect, or domestic violence.
  • Health Oversight: In order to oversee the health care system, government benefits programs, entities subject to governmental regulation and civil rights laws for which health information is necessary to determine compliance, we may disclose your health information for oversight activities authorized by law, such as audits and civil, administrative, or criminal investigations.
  • Court Proceeding and Law Enforcement: We may disclose your health information in response to requests made during judicial, legal, and administrative proceedings, such as following or acting on court orders or subpoenas.
  • Threats to Public Health or Safety: We may disclose or use health information when it is our good faith belief, consistent with ethical and legal standards, that it is necessary to prevent or lessen a serious and imminent threat or is necessary to identify or apprehend an individual.
  • Specialized Government Functions: Subject to certain requirements, we may disclose or use health information for military personnel and veterans, for national security and intelligence activities, for protective services for the President and others, for medical suitability determinations for the Department of State, for correctional institutions and other law enforcement custodial situations, and for government programs providing public benefits.
  • Workers Compensation: We may disclose health information when authorized and necessary to comply with laws relating to workers compensation or other similar programs.
  • Other Uses: We may also use and disclose your personal health information for the following additional purposes:

              • to contact you to remind you of an appointment for treatment;

              • to describe or recommend treatment alternatives to you; and,

              • to furnish information about health-related benefits or services that may be of interest to you.


Prohibition on Other Uses or Disclosures

We may not make any other use or disclosure of your personal health information without your written authorization. Once given, you may revoke the authorization by writing to us. Understandably, we are unable to take back any disclosure we have already made with your permission.


Individual Rights

You have rights concerning the confidentiality of your health information. You have the right:

  • to request restrictions on the health information we may use and disclose for treatment, payment, and health care operations. We are not required to agree to these requests. To request restrictions; please send a written request to the address below.
  • to receive confidential communications of health information about you in a certain manner or at a certain location. For instance, you may request that we only contact you at work or by mail. To make such a request, you must write to us at the address below, and tell us how or where you wish to be contacted.
  • to inspect or copy your health information. You must submit your request in writing to the address below. If you request a copy of your health information we may charge you a fee for the cost of copying, mailing or other supplies. In certain circumstances, we may deny your request to inspect or copy your health information. If you are denied access to your health information, you may request that the denial be reviewed. The treating physician of record will then 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 the review.
  • to amend health information. If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. To request an amendment, you must write to us at the address below. You must also give us a reason to support your request. We may deny your request to amend your health information if it is not in writing or does not provide a reason to support your request.

             We may also deny your request if:

             § The information was not created by us, unless the person that created the information is no
                 longer available to make the amendment.

             § The information is not part of the health information kept by or for us, is not part of the
                 information you would be permitted to inspect or copy or is accurate and complete.

  • to receive an accounting of disclosures of your health information. You must submit a request in writing to the address below. Not all health information is subject to this request. Your request must state a time period, no longer than 6 years and may not include dates before April 14, 2003. The first accounting you request within a 12-month period is free. For additional accountings, we may charge you the cost of providing the accounting. Upon request, we will estimate for you the cost and you may choose to withdraw or modify your request before charges are incurred.
  •  to receive a paper copy of this Notice upon request, you must submit a request for a paper notice in writing to the address below. All requests to restrict use of your health information for treatment, payment, and health care operations, to inspect and copy health information, to amend your health information, or to receive an accounting of disclosures of health information must be made in writing.

 
Complaints

If you believe that your privacy rights have been violated, a complaint may be made by calling our Privacy Officer at (315) 701-2550 or writing to the address listed below. You may also submit a complaint to the Secretary of the Department of Health and Human Services. We will not retaliate against you for filing a complaint.


Contact

Please contact our Administrative Offices for all questions, requests or for further information related to the privacy of your health information at:

Internist Associates of CNY, PC
Attn: Privacy Officer
739 Irving Ave. Suite 200
Syracuse, NY 13210


Changes to This Notice

We reserve the right to change our privacy practices and to apply the revised practices to health information about you that we already have. Any revision to our privacy practices will be described in a revised Notice that will be posted prominently in our facility.


Request for Signature

You will be asked to sign a document or label acknowledging that you have received this notice. A larger font edition of this notice is available upon request in the office. Your signature will remain with your medical chart.