(Effective Date: September 12, 2012)
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.
Legal duty and commitment to privacy
I (Caitlin) am committed to maintaining the privacy of your protected health information (“PHI”). I am required by law to maintain the privacy of your PHI, provide you with this Notice of Privacy Practices and notice of legal duties regarding your PHI. I am also required to follow the practices described in the Notice of Privacy Practices currently in effect.
If you have any questions or complaints, please contact Caitlin Russell, MS, RDN, LD, CLT using the contact form above.
Uses and Disclosures of Health Information For Treatment, Payment or Health Care Operations (“TPO”)
I may use or disclose PHI about you for TPO as follows:
- For treatment purposes (such as sharing information about your care with members of my staff to assist in your treatment or care, or with the physician or hospital that referred you, as part of efforts to coordinate your follow-up care)
- For payment purposes (such as verifying your insurance coverage or providing information needed for your health insurance plan to cover and pay for the claim for services that we provide to you, although Caitlin does not currently accept insurance.)
- For health care operations (such as administrative activities, activities to enhance the care that I provide to my patients and their satisfaction with my services, and activities to help make sure that I comply with applicable law).
I may also disclose your PHI for treatment activities of other health care providers, for payment activities of other health care providers, payors or health care clearinghouses, or for the health care operations of one of those entities if we and that entity each have (or had) a relationship with you and the PHI relates to that relationship.
Other Uses and Disclosures Without Your Written Authorization
I may use or disclose PHI about you without your authorization for several other purposes required or permitted by law. Subject to certain requirements, I may use or disclose your PHI without your authorization as follows:
- To inform you about treatment options or alternatives, or health related benefits or services that we think may be of interest to you;
- To provide you with appointment reminders, such as voice mail messages, postcards or letters;
- For public health activities (such as reporting information to agencies authorized by law to collect information for purposes of preventing or controlling diseases, injuries or disabilities; preparing reports to the FDA; maintaining vital health records such as for births and deaths, etc);
- To our business associates that perform certain key functions or processes for us. Business Associates must provide written assurance that they will safeguard and protect the privacy of your health information;
- To your personal representatives (if applicable);
- For face to face communications that we make with you regarding products or services;
- To help prevent or control communicable diseases;
- For reporting abuse, neglect, or domestic violence;
- For health oversight activities authorized by law (such as civil or criminal investigations, audits, licensure and disciplinary proceedings, etc.);
- For judicial and administrative proceedings (such as in response to court orders or discovery requests) if we are permitted to do so by law;
- For law enforcement or to military command authorities as required by law if you are or were a member of the armed forces;
- To funeral directors, coroners and medical examiners;
- For purposes of organ, eye or tissue donation;
- To avoid serious threat of harm to your health and safety or health and safety of someone else;
- For specialized government functions (e.g. military operations, national security);
- For auditing purposes;
- For research purposes, but only if we are sure that your privacy will be protected;
- If we are directed to do so by a court order;
- For workers’ compensation purposes or similar programs as permitted or required by law.
I may also contact you about appointment reminders or treatment alternatives.
In any other situation, I will ask for your written authorization before using or disclosing any of your PHI. If you sign an authorization to use or disclose information, you can later revoke that authorization to stop further uses and disclosures.
In most cases, you have the right to look at or obtain a copy of PHI that I can maintain about you. I may charge a fee for costs related to your request. I may, under certain circumstances, deny your request but if I do, I can obtain a review of that denial by another licensed health care professional that I designate.
You also have the right to receive an “accounting”, which lists certain instances when I have disclosed PHI about your for reasons other than treatment, payment, or health care operations. The request can cover a time period no longer than 6 years from the date of disclosure. Your first request in a 12-month period is free. After that, I may charge for costs related to additional requests.
If you believe that information in your record is incorrect, or if important information is missing, you also have the right to request that I correct the existing information or add the missing information. I have the right to deny such a request under certain circumstances.
You have the right to request that your health information be communicated to you in a confidential manner such as asking that I contact you at work rather than at home or vice versa.
You may request that I restrict how I use or disclose information about you for treatment, payment, or health care operations or to persons involved in your care (except when specifically authorized by you, when required by law, or in emergency circumstances). I will consider your request for such restrictions, but am only bound by them if we agree to them.
To exercise any of the rights described above, please make a request in writing to Caitlin Russell using the Contact form at the top of this page.
Changes in Notice of Privacy Practices
I may change the privacy practices at any time and the new terms shall apply to all PHI about you that I have at the time of the change and to all PHI about you that I maintain in the future. If I make any material changes, I will change the Notice of Privacy Practices. The changes will not take effect until they are reflected in a revised Notice of Privacy Practices. You can request a copy of the Notice of Privacy Practices at any time. If this Notice of Privacy Practices was sent to you electronically, you have the right to obtain a paper copy upon request. For more information about these privacy practices, contact Caitlin Russell MS, RDN, CLT.
If you are concerned that I have violated your privacy rights, you may contact me. You also have the right to file a complaint with the Office of Civil Rights. I am happy to answer any questions you have about your rights and how to contact the Office of Civil Rights.
Thank you for your cooperation and understanding in this matter.
-Caitlin Russell MS, RDN, CLT