NOTICE OF PRIVACY PRACTICES OF FDL DERMATOLOGY, PLLC
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.
If you have any questions about this notice, please contact the Privacy Officer at (703)310-7400, 1005 N Glebe Rd Ste 540, Arlington, VA, 22201 - 5718 (address).
WHO WILL FOLLOW THIS NOTICE.
This notice describes the practices of FDL Dermatology, PLLC (“FDL”), its employees and staff.
OUR PLEDGE REGARDING MEDICAL INFORMATION:
We understand that health information about you and your health is personal. We are committed to protecting health information about you. We create a record of the health services you receive at FDL as well as other information we receive about you. We need this record to provide you with quality service and to comply with certain legal requirements. This notice applies to all of the records of your healthcare generated for services at FDL.
This notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of health information.
We are required by law to:
- make sure that health information that identifies you is kept private;
- give you this notice of our legal duties and privacy practices with respect to health information about you;
- to notify affected individuals of any breach of unsecured protected health information; and
- follow the terms of the notice as in effect from time to time.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU.
The following categories describe different ways that we use and disclose health information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed.
For Treatment. We may use health information about you to provide you with health services. We may also disclose health information about you to health care providers who are involved in providing treatment or services to you. For example, a physician treating you for another condition may request or may need to know results from your testing at FDL. Different individuals at FDL also may share health information about you in order to coordinate the different things, such lab work and similar care. We may make a professional judgment to determine whether it is in your best interest to disclose health information about you to people outside FDL who may be involved in your medical care, such as physicians, or family members involved in your treatment or others.
For Health Care Operations. We may use and disclose health information about you for FDL health care operations. These uses and disclosures are necessary to run FDL and make sure that all of our patients receive quality care. For example, we may use health information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine health information about many FDL patients to decide what additional services FDL should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, and technicians and other FDL personnel for review and learning purposes. We may also combine the health information we have with health information from other health care facilities to compare how we are doing and see where we can make improvements in the care and services we offer.
Business Associates: We are permitted by law to utilize Business Associates to carry out treatment, payment or health care operations functions that may involve the use and disclosure of some of your health information. For example, we may use a billing service or accounting service to handle some billing and payments functions. We may also use health care consultants to assist us in improving or upgrading services we offer to patients. However, in any such instance, unless the disclosure of health information is to another health care provider for the purpose of providing treatment to you, we will have entered into a formal agreement with the Business Associate that requires the Business Associate to maintain the confidentiality of any patient information received and generally requires the Business Associate to limit its use of such information to only the purpose for which it was disclosed by us.
Appointment Reminders. We may use and disclose health information to contact you as a reminder that you have an appointment for treatment or health care at FDL.
Treatment Alternatives. We may use and disclose health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
Health-Related Benefits and Services. We may use and disclose health information to tell you about health-related benefits or services that may be of interest to you.
Individuals Involved in Your Care or Payment for Your Care. Unless you object, we may release health information about you to a friend or family member who is involved in your health care. We may also give information to someone who helps pay for your care. We may also use and disclose information about you to notify, or to assist in notifying, a family member or friend of your location or condition, but except in emergency circumstances, you will generally be given an opportunity to object.
Research. Under certain circumstances, we may use and disclose health information about you for research purposes. For example, a research project may involve comparing the health and recovery of all patients who were exposed to certain chemicals. Where consistent with the research goals and purposes, we will use or disclose only de-identified information, so that your identity cannot be ascertained from the information disclosed.
When research cannot be conducted with such de-identified information, we will usually ask for your authorization for such use or disclosure. However, some research projects that involve information gathering may be adversely affected by requiring prior patient authorization before otherwise confidential information can be used or disclosed for research purposes. In those circumstances, research projects are subject to a specific and comprehensive approval process. This process evaluates the proposed research project and its use of health information, trying to balance research needs with patients’ rights to privacy of health information. Before we use or disclose health information for research under such circumstances, the project will have been approved by an Institutional Review Board (IRB) or a specially designated privacy board, which will be required to determine whether the nature of the research is such that it could not be conducted if prior patient authorization was required and will be required to determine that adequate protections are in place to protect patient information from unauthorized use or disclosure. However, as part of the research process we may disclose health information about you to individuals preparing to conduct the research project, for example, to help them look for patients with specific medical needs, but any such health information will not be allowed to leave our offices.
As Required By Law. We will disclose health information about you when required to do so by federal, state or local law.
To Avert a Serious Threat to Health or Safety. We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person, consistent with applicable law. Any disclosure, however, would only be to someone able to help prevent or lessen the threat.
SPECIAL SITUATIONS
Organ and Tissue Donation. If you are an organ donor, we may release health information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
Military and Veterans. If you are a member of the armed forces, we may release health information about you as required by military command authorities. We may also release health information about foreign military personnel to the appropriate foreign military authority.
Workers' Compensation. Where required or permitted by state law, we may release health information about you for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Public Health Risks. Where required or permitted by state and federal law, we may disclose health information about you for public health activities. These activities generally include the following:
- to prevent or control disease, injury or disability;
- to report births and deaths;
- to report child abuse or neglect;
- to report reactions to medications or problems with products;
- to notify people of recalls of products they may be using;
- to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
Health Oversight Activities. We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
Law Enforcement. We may release health information if asked to do so by a law enforcement official:
- In response to a court order, subpoena, warrant, summons or similar process;
- To identify or locate a suspect, fugitive, material witness, or missing person;
- About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person's agreement;
- About a death we believe may be the result of criminal conduct;
- About criminal conduct at our offices; and
- In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
Coroners, Medical Examiners and Funeral Directors. We may release health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release health information about patients of FDL to funeral directors as necessary to carry out their duties.
National Security and Intelligence Activities. We may release health information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Protective Services for the President and Others. We may disclose health information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU.
You have the following rights regarding health information we maintain about you:
Right to Inspect and Copy. You have the right to inspect or obtain copies of your health information that may be used to make decisions about your care. Usually, this includes health and billing records.
To inspect and copy health information that may be used to make decisions about you, you must submit your request in writing to the Privacy Officer at the address set forth above. If you request a copy of the information, there will be a charge for labor, supplies and for postage.
We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to health information, you may request that the denial be reviewed by another licensed health care professional. We will comply with the outcome of the review.
Right to Amend. If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for FDL.
To request an amendment, your request must be made in writing and submitted to the Privacy Officer at the address set forth above. In addition, you must provide a reason that supports your request.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
- Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
- Is not part of the health information kept by or for FDL;
- Is not part of the information which you would be permitted to inspect and copy; or
- Is accurate and complete.
You will be informed of the decision regarding any request for amendment of your health information and, if we deny your request for amendment, we will provide you with information regarding your right to respond to that decision.
Right to an Accounting of Disclosures. You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of health information about you. In most cases, this list will not include disclosures made for purposes of treatment, payment, or health care operations and disclosures that were made in response to a specific authorization from you.
To request this list or accounting of disclosures, you must submit your request in writing to the Privacy Officer at the address set forth above. Your request must state a time period which may not be longer than six years. The first list you request within a 12 month period will be free. For additional lists, there will be a charge per page and for postage.
Right to Request Restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or health care operations. For example, you could ask that we not use or disclose information about a surgery you had.
We are not required to agree to your request, other than a request that we not disclose information to a health plan for payment or health care operations where the request relates only to a health care item or service for which we have been paid in full. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
To request restrictions, you must make your request in writing to the Privacy Officer at the address set forth above. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
Right to Request Confidential Communications. You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
To request confidential communications, you must make your request in writing to the Privacy Officer at the address set forth above. We will not ask you the reason for your request. Your request must specify how or where you wish to be contacted.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
To obtain a paper copy of this notice, contact the Privacy Officer.