Notice of Privacy Practices

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. 45 CFR § 164.520 (b)(1)(i) *.

Introduction

At Anesthesiologists Associated, Incorporated (hereinafter AAI), 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 14 April 2003, and applies to all protected health information as defined by federal regulations.

Understanding Your Health Record/Information

Each time you visit your physician or care provider, AAI will receive a record of your visit for billing purposes. 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 many health professionals who contribute to your care;
• Legal document describing the care you received;
• Means by which you or a third-party payor can verify that services billed were actually provided;
• A tool in educating health professionals;
• A source of data for medical research;
• 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, or;
• As a means to provide accurate and timely billing and payment services to the health care provider.

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

Although your health record is the physical property of your physician or care provider, the information belongs to you. You have the right to:

• Obtain a paper copy of this notice of information practices upon request;
• Inspect and copy your health record as provided for in 45 CFR § 164.524;
• Amend your health record as provided in 45 CFR § 164.526 (this may be completed only by your physician or care provider; AAI does not amend information in your health care record provided for billing purposes 45 CFR § 164.526(a)(2)(i));
• Obtain an accounting of disclosures of your health information as provided in 45 CFR § 164.528;
• Request communications of your health information by alternative means or at alternative locations;
• Request a restriction on certain uses and disclosures of your information as provided by 45 CFR § 164.522; and
• Revoke your authorization to use or disclose health information except to the extent that action has already been taken.

Our Responsibilities

• Maintain the privacy of your health information;
• Provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you;
• Abide by the terms of this notice;
• Notify you if we are unable to agree to a requested restriction; and
• 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, a revised Notice of Privacy Practices will be posted on our website with the corresponding effective date of change.

We will not use or 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 the procedures included in the authorization.

For More Information or to Report a Problem

If you have questions and would like additional information, you may contact the physician or care provider's Privacy Officer or the Privacy and Compliance Manager of AAI. The Privacy and Compliance Manager at AAI may be reached at (800) 275-8752.

If you believe your privacy rights have been violated, you can file a complaint with the practice's Privacy Officer, AAI's Privacy and Compliance Manager or with the Office for Civil Rights (OCR), U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint with either the Privacy Officer, AAI's Privacy and Compliance Manager 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. 20204

Examples of Disclosures for Treatment, Payment and Health Operations

AAI will only use the information obtained from our business associates for billing and payment processing or as required by law. Based on 45 CFR § 164.502(b) and § 164.514(d) & (f), AAI will adhere to the Minimum Necessary Rule. Information gathered and used for this purpose will be contained in a "Designated Record Set" as defined by 45 CFR § 164.501. Therefore, any information provided to outside business associates or as required by law, will be limited to the information defined in 45 CFR § 164.514(b).

We may provide your physician or a subsequent health care provider, as requested, with copies of various reports that should assist him or her in treating you once you're discharged from their immediate care.

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

This information is used only by your physician or care provider. AAI does not, in its normal course of business, need or use the protected health information for health care operations, studies or statistical analysis.

For state specific privacy laws governing the access to and disclosure of confidential health information, please refer to the separate State notices available at healthprivacy.org

Business Associates

There are some services provided in our organization through contacts with business associates. Examples include insurance companies and collection agencies, and a copy service we use when making copies of your health record. When these services are contracted, we may disclose your health information to our business associates so that they can perform the job we've asked them to do and bill you or your third-party payor for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information. A signed business associate agreement is on file with our clients, vendors, contractors and consultants which AAI does business with, with whom protected health information may be shared.

Notification

We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care and/or payment for services rendered.

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.

Research

We do not disclose information to researchers or their associates. This information will only be shared by your consent to your physician or care provider.

Marketing

We do not disclose information for marketing purposes. This information will only be shared by your consent to your physician or care provider.

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.

Special Government Functions

We may disclose health information under certain circumstances, such as:

• For certain military and veteran activities, including determination of eligibility for veterans for veteran benefits and where deemed necessary by military command authorities;
• For national security and intelligence activities;
• To help provide protective services for the president and others;
• For the health and safety of inmates and others at correctional institutions or other law enforcement custodial situations for the general safety and health related to correction facilities.

Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.