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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. YOU HAVE THE RIGHT TO OBTAIN A PAPER COPY OF THIS NOTICE UPON REQUEST.

Introduction

At Oak Ridge Gastroenterology Associates, PC (ORGA) and Endoscopy Center of Oak Ridge, LLC (ECOR), we are committed to treating and using protected health information about you responsibly. This Notice of Privacy Practices describes the personal information we collect, and how and when we use or disclose that information. It also describes your rights as they relate to your protected health information. This Notice is effective April 14, 2003, and applies to all protected health information as defined by federal regulations.

Understanding Your Health Record/Information

Each time you visit ORGA and/or ECOR, 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 medical record, serves as a:

Basis for planning your care and treatment,

  • Means of communication among the health professionals who contribute to your care,
  • Legal document describing the care you received,
  • Means by which you or a third-party payer can verify that services billed were actually provided,
  • A source of information for public health officials charged with improving the health of this state and the nation,
  • A source of data for our planning and marketing,
  • A tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.

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 access your health information, and make more informed decisions when authorizing disclosure to others.

Your Health Information Rights

You have the following rights with regard to your health information. Please contact the Privacy Officer to obtain the appropriate form for exercising these rights.

• You may request restrictions on certain uses and disclosures of your health information. We are not required to agree to such restrictions, but if we do agree, we must abide by those restrictions.In most cases, you have the right to inspect and/or request a copy of your health record. There will be a charge for the copies. If you believe that the information in your record is incorrect, or if important information is missing, you have the right to request that we correct the existing information or add the missing information. You may request a list of instances where we have disclosed your information for reasons other than treatment, payment or health care operations. You may ask us to communicate with you confidentially by, for example, sending notices to a special address or not leaving messages on your answering machine to remind you of appointments. You may revoke your authorization to use or disclose health information except to the extent that action has already been taken.

Our Responsibilities

ORGA and ECOR are required to:

  • Maintain the privacy of your health information,
  • Abide by the terms of this notice,
  • Notify you if we are unable to agree to a requested restriction, and
  • Provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you,

• Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will give you a revised notice on your next visit to our office.

For More Information or to Report a Problem

If you have questions and would like additional information, you may contact the ORGA/ECOR Privacy Officer, Karen Payne at (865) 483-4366.

If you believe your privacy rights have been violated, you can file a complaint with the Privacy Officer, or with the Office for Civil Rights, U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint with either the Privacy Officer or the Office for Civil Rights. The address for the OCR is listed below:

Office for Civil Rights

U.S. Department of Health and Human Services 200 Independence Avenue, S. W.
Room 509F, HHH Building
Washington, D. C. 20201

Examples of Disclosures for Treatment, Payment and Health Operations

We will use your health information for treatment.

For example: Information obtained by a nurse, physician, or other member of your health care team 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 the members of your health care team. Members of your health care team will then record the actions they took and their observations. In that way, the physician will know how you are responding to treatment.

We will also provide your physician or a subsequent health care provider with copies of various reports that should assist him or her in treating you.

We will use your health information for payment.

For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

We will use your health information for regular health operations.

For example: Members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess 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 the healthcare and service we provide.

Business associates: There are some services provided in our organization through contacts with business associates. Examples include a copy service we use when making copies of your health record and a records storage company that we use to store your medical record, if you have not been seen in this office for three years. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we've asked them to do. To protect your health information, however, we require the business associate to appropriately safeguard your information.

Notification: We may use or disclose information to notify or assist in notifying you, a family member, personal representative, or another person responsible for your care. Examples include calling a spouse, other family member or person designated by you, with results of your tests, if you are not personally available to take the call. We may leave a message on an answering machine if you or the person you designate are not available to take the call.

Communication with family: Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person's involvement in your care or payment related to your care.

Funeral directors: We may disclose health information to funeral d i rectors consistent with applicable law to carry out their duties.

Marketing: We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may leave information about upcoming appointments on your answering machine if you or a family member are not available to take the call.

Food and Drug Administration (FDA): 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.

Workers compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

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.

Law enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.

In any situation other than those required by law, or uses for treatment, payment and health care operations, we will ask for your written authorization- before using or disclosing any identifiable health information about you. If you choose to sign an authorization to disclose information, you can later revoke that authorization to stop any future uses and disclosures except to the extent that action has already been taken.