Effective date of this notice: September 23, 2013
Notice of Privacy Practices
Michigan Neurosurgical Institute
This notice describes how medical information about you may be used and disclosed, and how you can gain access to this information. Please review it carefully.
Protected health information (PHI), about you, is maintained as a written and slash or a electronic of your contacts are visits for Health Care Services with our practice. Specifically, PHI is the information about you, including demographic information (i.e. name, address, phone, etc.), that may identify you end relates to your past, present or future physical or mental health condition and related Health Care Services.
Our practice is required to follow specific roles on maintaining the confidentiality of your PHI using your information disclosing or sharing this information with other Health Care professionals involved in your care and treatment. This notice describes your rights to access and control your PHI. It also describes how we follow applicable rules and use and disclose your PHI to improve your tree that, obtain payment for services you receive, manage our Health Care operations and for other purposes that are permitted or required by law.
Your rights under the privacy rule
Following is a statement of your rights, under the privacy rule, in reference to your PHI. Please feel free to discuss any questions with our staff.
You have the right to receive, and we are required to provide you with, a copy of this notice of privacy practices. We are required to follow the terms of this notice. We reserve the right to change terms of our notice at any time. Apply in your request, we will provide you with a brave eyes to notice of privacy practices if you call our office and request that the revised copy be sent to you in the mail or ask for one at the time of your next appointment. The notice will also be posted in a conspicuous location within the practice, and if such is maintained by the practice, on its website.
You have the right to authorize other use and disclosure. This means that you have the right to authorize any use or disclosure of PHI that is not specified within this notice. For example we would need your written authorization to use or disclose your PHI for marketing purposes, for most uses or disclosures of psychotherapy notes, or if we intended to sell your PHI. You may revoke an authorization, at any time, in writing, except to the extent that your healthcare provider, or our practice has taken a in-action in reliance on the use or disclosure indicated in the authorization.
You have the right to request an alternative means of confidential communication. This means you have the right to ask us to contact you about medical matters using an alternative method (i.e. e-mail, telephone), and to a destination (i.e. cell phone number, alternative address, etc.) designated by you. You must inform us in writing using a form provided by our practice, how you wish to be contacted if other than the address slash phone number that we have on file. We will follow all reasonable requests.
You have the right to inspect and copy your PHI. This means that you may inspect, and obtain a copy of your complete health record. If your health record is maintained a lik chronically, you will also have the right to request a copy in a laconic format. We have the right to charge a reasonable fee for paper or electronic copies as a stab bush by professional, state, or Federal guidelines.
You have the right to request a restriction of your PHI. This means you may ask us, in writing, not to use or disclose any part of your protected health information for the purposes of treatment, payment or Health Care operations. If we agree to the requested restriction, we will abide by it, except in emergency circumstances when the information is needed for your treatment. In certain cases we may deny your request for a restriction. You will have the right to request, in writing, that we restrict communication to your health plan regarding a specific treatment or service that you, or someone on your behalf, those paid for in full, a dash of – pocket. We are not permitted to deny the specific type of requested restriction.
You may have the right to request an amendment to your protected health information. This means you may request an amendment of your PHI for as long as we maintain this information. In certain cases, we may deny your request for an amendment.
You have the right to request a disclosure of accountability. This means that you may request a listing of disclosures that we have made, of your PH I, two entities or persons outside of our office.
You have the right to receive a privacy breach notice. You have the right to receive written notification if they practice discovers a breach of your unsecured PHI, and determines through a risk assessment that a notification is required.
If you have questions regarding your privacy rights please feel free to contact our privacy manager. Contact information is provided at below, under Privacy Complaints.
How we may use or disclose protected health information
Following are examples of uses and disclosures of your protected health information that we are permitted to make. These examples are not meant to be exhaustive, but to describe possible types of uses and disclosures.
Treatment. We may use and disclose your PH eye to provide, coordinate, or manage or Health Care and any related services. This includes the coordination or management of your healthcare with a third party that is involved in your care and treatment. For example we would disclose your PH I, as in necessity, to a pharmacy that would fill your prescription. We will also disclose PHI 2 other healthcare providers who may be involved in your care and treatment.
Special notices. We may use or disclosure PHI, as necessary, to contact you to remind you of your appointment. We may contact you by phone or other means to provide results from exams or tests and to provide information but describes or recommends treatment alternatives regarding your care. Also we may contact you to provide information about health – related benefits and services offered by our office, for fundraising activities, or with respect to a group health plan, to disclose information to the health plan sponsor. You will have the right to opt out of such special notices, and each such notice will include instructions for opting out. Payment. Your PHI will be used, as needed, to obtain payment for your Health Care Services. This may include certain activities that your Health Insurance plan may undertake before it approves or pays for the Health Care Services we recommend for you such as, making a determination of eligibility or coverage for insurance benefits.
Health Care operations. We may use or disclose, as needed, your PHI in order to support the business activities of our practice. This includes, but is not limited to business planning, and development, quality a suspect and improvement, medical review, legal services, auditing functions and patient safety activities.
Health information organization. The practice may elect to use a health information organization, or other such organization to facilitate the electronic exchange of information for the purposes of treatment, payment, or Health Care operations.
To others involved in your healthcare. Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person, that you identify, tea or PHI that directly relates to that person’s involvement in your healthcare. If you are unable to agree or object to such a disclosure, we made disclose such information as necessary if we determined that it is in your best interests based on our professional judgment. We may use or disclose PHI to notify or assist in notifying a family member, personal representative or other person that is responsible for your care, of your general condition or death. If you are not present or able to agree or object to the use or disclosure of the PHI, then your healthcare provider mate, using professional judgment, determine whether the disclosure is in your best interest. In this case, only the PHI that is necessary will be disclosed.
Other permitted and required uses and disclosures. We are also permitted to use or disclose your PHI without your written authorization for the following purposes: as required by law; for public health activities; health research purposes; legal proceedings; law enforcement purposes; coroner’s; funeral directors; organ donations; criminal activity; military activity; National Security; workers’ compensation; when an inmate in a correctional facility; and if requested by the Department of Health and Human Services in order to investigate or determine our compliance with the requirements of the privacy rule.
You have the right to complain to us, or directly to the secretary of the department of health and human services if you believe your privacy rights had been violated by us. You may file a complaint with us by noticing the privacy manager at:
Michigan Neurosurgical Institute
9400 S Saginaw St, Suite A
Grand Blanc, Michigan 48439
We will not retaliate against you for filing a complaint.
Effective date: September 23, 2013