NOTICE OF PRIVACY PRACTICES
THIS NOTICE
DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW
YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
THE PRIVACY OF YOUR HEALTH INFORMATION
IS IMPORTANT TO US.
We reserve the right to
change our privacy practices and the terms of this Notice at any time, provided
such changes are permitted by applicable law.
We reserve the right to make the changes in our privacy practices and
the new terms of our Notice effective for all health information that we
maintain, including health information we created or received before we made
the changes. Before we make a
significant change in our privacy practices, we will change this Notice and
make the new Notice available upon request.
You may request a copy of
our Notice at any time. For more
information about our privacy practices, or for additional copies of this
Notice, please contact us using the information listed at the end of this
Notice.
Treatment: We may use or disclose your health
information to a physician or other healthcare provider providing treatment to
you.
Payment:
We may use and disclose your health information to obtain payment for
services we provide to you.
Healthcare Operations: We may use and disclose your health
information in connection with our healthcare operations. Healthcare operations include quality
assessment and improvement activities, reviewing the competence or
qualifications of healthcare professionals, evaluating practitioner and
provider performance, conducting training programs, accreditation,
certification, licensing or credentialing activities.
Your Authorization: In addition
to our use of your health information for treatment, payment or healthcare
operations, you may give us written authorization to use your health
information or to disclose it to anyone for any purpose. If you give us an authorization, you may
revoke it in writing at any time. Your
revocation will not affect any use or disclosures permitted by your
authorization while it was in effect.
Unless you give us a written authorization, we cannot use or disclose
your health information for any reason except those described in this Notice.
To Your Family and Friends: We must
disclose your health information to you, as described in the Patient Rights
section of this Notice. We may disclose
your health information to a family member, friend or other person to the
extent necessary to help with your healthcare or with payment for your
healthcare, but only if you agree that we may do so.
Persons Involved In Care: We may use
or disclose health information to notify, or assist in the notification of
(including identifying or locating) a family member, your personal
representative or another person responsible for your care, of your location,
your general condition, or death. If
you are present, then prior to use or disclosure of your health information, we
will provide you with an opportunity to object to such uses or
disclosures. In the event of your
incapacity or emergency circumstances, we will disclose health information
based on a determination using our professional judgment disclosing only health
information that is directly relevant to the person’s involvement in your
healthcare. We will also use our
professional judgment and our experience with common practice to make
reasonable inferences of your best interest in allowing a person to pick up
filled prescriptions, medical supplies, x-rays, or other similar forms of
health information. We may also request
and release information to other healthcare providers you have previously seen
for treatment.
Marketing
Health-Related Services: We will not
use your health information for marketing communications without your written
authorization.
Required by
Law: We may use or disclose your
health information when we are required to do so by law.
Abuse or
Neglect: We may disclose your health information to appropriate
authorities if we reasonably believe that you are a possible victim of abuse,
neglect, or domestic violence or the possible victim of other crimes. We may disclose your health information to
the extent necessary to avert a serious threat to your health or safety or the
health or safety of others.
National Security: We may
disclose to military authorities the health information of Armed Forces
personnel under certain circumstances.
We may disclose to authorized federal officials health information
required for lawful intelligence, counterintelligence, and other national
security activities. We may disclose to
correctional institution or law enforcement official having lawful custody of
protected health information of inmate or patient under certain circumstances.
Appointment Reminders:
We may use or disclose your health information to provide you with
appointment reminders (such as voicemail messages, telephone answering
machines, postcards, or letters).
Disclosure Accounting: You have
the right to receive a list of instances in which we or our business associates
disclosed your health information for purposes, other than treatment, payment,
healthcare operations and certain other activities, for the last 6 years, but
not before April 14, 2003. If you request this accounting more than
once in a 12-month period, we may charge you a reasonable, cost-based fee for
responding to these additional requests.
Restriction: You have
the right to request that we place additional restrictions on our use or
disclosure of your health information.
We are not required to agree to these additional restrictions, but if we
do, we will abide by our agreement (except in an emergency).
Alternative Communication: You have
the right to request that we communicate with you about your health information
by alternative means or to alternative locations. {You must make your request in writing.} Your request must specify the alternative means or location,
and provide satisfactory explanation how payments will be handled under the
alternative means or location you request.
Amendment: You have
the right to request that we amend your health information. (Your
request must be in writing, and it must explain why the information should be
amended.) We may deny your
request under certain circumstances.
Electronic
Notice: If you
receive this Notice on our Web site or by electronic mail (e-mail), you are
entitled to receive this Notice in written form.
QUESTIONS AND COMPLAINTS
If you want more information about our privacy practices or have questions
or concerns, please contact us.
If you are concerned that we
may have violated your privacy rights, or you disagree with a decision we made
about access to your health information or in response to a request you made to
amend or restrict the use or disclosure of your health information or to have
us communicate with you by alternative means or at alternative locations, you
may complain to us using the contact information listed at the end of this
Notice. You also may submit a written
complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file
your complaint with the U.S. Department of Health and Human Services upon
request.
We support your right to the
privacy of your health information. We
will not retaliate in any way if you choose to file a complaint with us or with
the U.S. Department of Health and Human Services.
Contact
Officer: Mrs. Geralyn Bateman
Telephone: 504-
887-8205 Fax: 504-887-1115
Address: 2540
Severn Ave., Ste 402, Metairie, LA
70002