Rio Grande Valley Pediatric Gastroenterology, P.A.

1400 E. Ridge Rd. Suite 7. McAllen, TX 78503

NOTICE OF PRIVACY PRACTICES

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

Rio Grande Valley Pediatric Gastroenterology, P.A. collects, uses and discloses personal health information for treatment, to obtain payment for treatment, for administrative purposes, and to evaluate the quality of care that you receive.  This Notice describes our privacy practices and your rights as they relate to your protected health information. This Notice is effective September 23, 2013 and applies to all Protected Health information. You have the right to receive a printed copy of this notice. 

UNDERSTANDING YOUR MEDICAL RECORDS/PROTECTED HEALTH INFORMATION

Each time you visit Rio Grande Valley Pediatric Gastroenterology, P.A. a record of your visit is made. Typically, this record contains information about your visit including your examination, diagnosis, test results, treatment as well as other pertinent healthcare data. This information, often referred to as your health or medical record, serves as a:

• Basis for planning your care and treatment.
• Means of communication with other health professionals involved in your care.
• Legal document outlining and describing the care you received.
• A tool that you, or another payor (your insurance company) will use to verify that services billed were actually provided.
• An education tool for medical health providers.
• A source for medical research.
• Basis for public health officials who might use this information to assess and/or improve state as well as national healthcare standards.
• A source of data for planning and / or marketing.
• A tool that we can reference to ensure the highest quality of care and patient satisfaction.

Understanding what is in your record and how your health information is used helps you to ensure its accuracy, determine what entities have access to your health information, and make an informed decision when authorizing the disclosure of this information to other individuals.

HOW WE MAY USE AND/OR DISCLOSE YOUR HEALTH INFORMATION

Treatment: We are permitted to use and disclose your medical information to those involved in your treatment.  For example, the physician in this practice is a specialist.  When we provide treatment, we may request that your primary care physician share your medical information with us.  Also, we may provide your primary care physician information about your particular condition so that he or she can appropriately treat you for other medical conditions, if any.

Payment: We are permitted to use and disclose your medical information to bill and collect payment for the services provide to you.  For example, we may complete a claim form to obtain payment from your insurer or HMO. The form will contain medical information, such as a description of the medical service provided to you, that your insurer or HMO needs to approve payment to us.  Note:  If you paid out-of-pocket in full (in other words, you have requested that we not bill your health plan) for a specific item or service, you have the right to ask that your Protected Health Information with respect to that item or service not be disclosed to a health plan for purposes of payment of health care operation and our practice will honor that request.

Health Care Operations: We are permitted to use or disclose your medical information for the purposes of health care operations, which are activities that support this practice and ensure that quality care is delivered.  For example, we may engage the services of a professional to aid this practice in its compliance programs.  This person will review billing and medical files to ensure we maintain our compliance with regulations and the law. We may use or disclose, as-needed, your protected health information in order to support the business activities of your physician’s practice. These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical students, licensing, and conducting or arranging for other business activities. For example, we may disclose your protected health information to medical school students that see patients at our office. In addition, we may use a sign-in sheet at the registration desk where you will be asked to sign your name. We may also call you by name in the waiting room when your physician is ready to see you. We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment.

Appointment Reminders, Treatment Alternatives, and Other Health-related Benefits: We may contact you by telephone, mail, or both to provide appointment reminders, information about treatment alternatives, or other health-related benefits and services that may be of interest to you. We may disclose health information to tell you about treatment alternative or health-related benefits and services that may be of interest to you.

Disclosures That Can Be Made Without Your Authorization: There are situations in which we are permitted by law to disclose or use your medical information without your written authorization or an opportunity to object.  These situations include:

• Public Health Reporting, Abuse or Neglect, and Health Oversight
• Legal Proceedings and Law Enforcement
• Workers’ Compensation
• Avert a Serious Threat to Health or Safety (Medical emergency to individual or public)
• Inmates or Individual Custody
• Military, National Security, and Intelligence Activity, Protection of the President
• Research, Organ Donation, Coroners, Medical Examiners, and Funeral Directors
• Required by Law
• Data Breach Notification Purposes (to provide legally required notices of unauthorized access)

Uses and Disclosures Where You Have an Opportunity to Object and Opt Out: In other situations 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, in writing, to stop future uses and disclosures.  However, any revocation will not apply to disclosures or uses already made or taken in reliance on that authorization. These situations include:

• Individuals Involved in Your Care or Payment for Your Care 
• For Disaster Relief: We can provide an opportunity to agree or object to a disclosure of your location and condition in a disaster.
  • Fundraising Activities

Written Authorization is Required for the Following Uses and Discloses: The following uses and disclosures of your Protected Health Information will be made only with your written authorization:

1. Most uses and disclosures of psychotherapy notes.
2. Uses and disclosures of Protected Health Information for marketing purposes
3. Disclosures that constitute a sale of your Protected Health Information

For Other Uses and Disclosures. Disclosure of your Protected Health Information or its use for any purpose other than those listed above may or may not require your specific written authorization. If you change your mind after authorizing a use or disclosure of your information, you may submit a written revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision.

OUR RESPONSIBILITIES 

Rio Grande Valley Pediatric Gastroenterology is required by law to:

• Protect the privacy of your medical information
• Provide you with this notice of our privacy practices with respect to protected health information,
• Abide by the terms of the notice of privacy practices in effect
• Notify you if we are unable to agree to a requested restriction
• Accommodate reasonable requests you have regarding communication of health information via alternative means and locations.

As permitted by law, we may change our policies and this notice at any time and have those revised policies apply to all the protected health information we maintain.  If or when we change our notice, we will post the new notice in the office where it can be seen.

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

YOUR RIGHTS UNDER FEDERAL PRIVACY REGULATIONS

The United States Department of Health and Human Services created regulations intended to protect patient privacy as required by the Health Insurance Portability and Accountability Act (HIPAA).  Those regulations create several privileges that patients may exercise.  We will not retaliate against a patient that exercises their HIPAA rights. These include:

• Right to request restriction on the use and disclosure of your protected health information.
• Right to receive confidential communication concerning your medical condition and treatment.
• Right to inspect and copy your protected health information.
• Right to an electronic copy of your medical record(s) for a fee at our disclosure, received within a period up to 15 days.
  • Right to a summary or explanation of your medical record(s).
  • Right to amend or submit correction to your protected health information.
• Right to receive an accounting of how and to whom your protected health information has been disclosed.
  • Right to receive notice of a breach.
  • Right to receive printed copy of this notice.

Requested Restrictions: You may request that we restrict or limit how your protected health information is used or disclosed for treatment, payment, or healthcare operations. We do not have to agree to this restriction, but if we do agree, we will comply with your request except under emergency circumstances. To request a restriction, submit the following in writing:

(a)   The information to be restricted

(b)   what kind of restriction you are requesting (i.e. on the use of information, disclosure of information or both), and

(c)   to whom the limits apply. 

Please send the request to the address and person listed below. You may also request that we limit disclosure to family members, other relatives, or close personal friends that may or may not be involved in your care. 

Receiving Confidential Communications by Alternative Means: You may request that we send communications of protected health information by alternative means or to an alternative location.  This request must be made in writing to the person listed below.  We are required to accommodate only reasonable requests.  Please specify in your correspondence exactly how you want us to communicate with you and, if you are directing us to send it to a particular place, the contact/address information.

FOR MORE INFORMATION OR TO REPORT A PROBLEM

Questions and Contact Person for Requests: If you have any questions or want to make a request pursuant to the rights described above, please contact:

Mrs. Licia M. Cerrate-Reinoso

1400 E. Ridge Rd. Suite 7

McAllen, TX 78503

Phone:  (956) 928-0400

Complaints: You may also send a written complaint to the United States Department of Health and Human Services.  We will not retaliate against you for filing a complaint with the government or us. The contact information for the United States Department of Health and Human Services is:

U.S. Department of Health and Human Services

HIPAA Complaint

7500 Security Blvd., C5-24-04

Baltimore, MD 21244