Altos Pediatric Associates | Privacy Statement

Our Practice Our Pediatricians In the News For Parents Resources

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. We understand the importance of privacy and are committed to maintaining the confidentiality of your medical information. We make a record of the medical care we provide and may receive such records from others. We use these records to provide or enable other health care providers to provide quality medical care, to obtain payment for services provided to you as allowed by your health plan and to enable us to meet our professional and legal obligations to operate this medical practice properly. We are required by law to maintain the privacy of protected health information and to provide individuals with notice of our legal duties and privacy practices with respect to protected health information. This notice describes how we may use and disclose your medical information. It also describes your rights and our legal obligations with respect to your medical information. If you have any questions about this Notice, please contact our Privacy Officer/Office Manager listed above.

A. How this Medical Practice May Use or Disclose Health Information
This medical practice collects medical and related identifiable patient information (such as billing information, claims information, referral and health plan information) and stores it in a chart, in administrative or billing files and on a computer. This information is considered "protected health information" (PHI) under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. The law permits us to use or disclose health information for the following purposes without the patient's written authorization:

1. Treatment. We may use medical information to provide medical care. We disclose medical information to our employees and others who are involved in providing the care our patients need. For example, we may share medical information with other physicians or other health care providers who will provide services, which we do not provide. Or we may share this information with a pharmacist who needs it to dispense a prescription, or a laboratory that performs a test. We may also disclose medical information to members of patients' families or others who can help them when they are sick or injured.

2. Payment. We use and disclose medical information to obtain payment for the services we provide. For example, we give health plans the information they require before they will pay us. We may also disclose information to other health care providers to assist them in obtaining payment for services they have provided to our patients.

3. Health Care Operations. We may use and disclose medical information to operate this medical practice. For example, we may use and disclose this information to review and improve the quality of care we provide, or the competence and qualifications of our professional staff. Or we may use and disclose this information to get health plans to authorize services or referrals. We may also use and disclose this information as necessary for medical reviews, legal services and audits, including fraud and abuse detection and compliance programs and business planning and management. We may also share medical information with our "business associates" that perform administrative services for us. We have a written contract with each of these business associates that contains terms requiring them to protect the confidentiality of this medical information. Although federal law does not protect health information, which is disclosed to someone other than another healthcare provider, health plan or healthcare clearinghouse, under California law all recipients of health care information are prohibited form re-disclosing it except as specifically required or permitted by law. We may also share health information with other health care providers, health care clearinghouses or health plans that have a relationship with one of our patients, when they request this information to help them with their quality assessment and improvement activities, their efforts to improve health or reduce health care costs, their review of competence, qualifications and performance of health care professionals, their training programs, their accreditation, certification or licensing activities, or their health care fraud and abuse detection and compliance efforts. From time to time, we may share health information with our professional liability carrier for our defense or their ongoing quality review of our medical practice. We may also share medical information with all the other health care providers, health care clearinghouses and health plans who participate in the organized health care arrangements in which we participate for any health care operations activities of these organized health care arrangements. Our Privacy Official/Office Manager maintains a current list of the arrangements, which include among others all relevant hospitals, IPA's, and health plans in which this medical practice participates.

4. Appointment Reminders. We may use and disclose medical information to contact and remind our patients about appointments. If you are not at home, we may leave this information on your answering machine or in a message left with the person answering the phone.

5. Sign-in sheet. We may use and disclose medical information about our patients by having them sign in when they arrive at our office. We may also call out their names when we are ready to see them.

6. Notification and communication with family. We may disclose our patients' health information to notify or assist in notifying family members, personal representatives or other persons responsible for their care about their location, general condition or in the event of death. In the event of a disaster, we may disclose information to a relief organization so that they may coordinate these notification efforts. We may also disclose information to someone who is involved with our patient's care or helps pay for care. If our patient or guardian is able and available to agree or object, we will give the patient or guardian the opportunity to object prior to making these disclosures, although we may disclose this information in a disaster even over the patient's or guardian's objections if we believe it is necessary to respond to the emergency circumstances. If our patient or guardian is unable or unavailable to agree or object, our health professionals will use their best judgment in communication with the patient's family and others.

7. Marketing. We may contact our patients to give them information about products or services related to their treatment, case management or care coordination, or to direct or recommend other treatments or health-related benefits and services that may be of interest to them, or to provide them with small gifts. We may also encourage them to purchase a product or service we offer when we see them. We will not otherwise use or disclose our patient's medical information for marketing purposes without their written authorization.

8. Required by law. As required by law, we will use and disclose our patients' health information, but we will limit our use or disclosure to the relevant requirements of the law. When the law requires us to report abuse, neglect or domestic violence, or respond to judicial or administrative proceedings, or to law enforcement officials, we will further comply with the requirements set forth below concerning those activities.

9. Public health. We may, and are sometimes required by law, to disclose our patient's health information to public health authorities for purposed related to: preventing or controlling disease, injury or disability; reporting child, elder or dependent adult abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure. When we report suspected elder or dependent adult abuse or domestic violence, we will inform our patients or their personal representatives promptly unless in our best professional judgment, we believe the notification would place a patient at risk of serious harm or would require informing a personal representative we believe is responsible for the abuse or harm.

10. Health oversight activities. We may, and are sometimes required by law, disclose our patients' health information to health oversight agencies during the course of audits, investigations, inspections, licensure and other proceedings, subject to the limitations imposed by federal and California law.

11. Judicial and administrative proceedings. We may, and are sometimes required by law, disclose our patients' health information in the course of any administrative or judicial proceeding to the extent expressly authorized by a court or administrative order. We may also disclose information about our patients in response to a subpoena, discovery request or other lawful process if reasonable efforts have been made to notify them of the request and they have not objected, or if their objections have been resolved by a court or administrative order.

12. Law enforcement. We may, and are sometimes required by law, disclose our patients' health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order, warrant, grand jury subpoena and other law enforcement purposes.

13. Coroners. We may, and are often required by law, disclose our patients' health information to coroners in connection with their investigations of deaths.

14. Organ or tissue donation. We may disclose our patients' health information to organizations involved in procuring, banking or transplanting organs and tissues.

15. Public safety. We may, and are sometimes required by law, disclose our patients' health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.

16. Specialized government functions. We may disclose our patients' health information for military or national security purposes or to correctional institutions or law enforcement officers that have the patient in their lawful custody.

17. Change of ownership. In the event that this medical practice is sold or merged with another organization, your health information/record will become the property of the new owner, although you will maintain the right to request that copies of your health information be transferred to another physician or medical group.

18. Research. We may disclose your health information to researchers conducting research with respect to which your written authorization is not required as approved by an Institutional Review Board or privacy board, in compliance with governing law.

B. When This Medical Practice May Not Use or Disclose Health Information
Except as described in our Notice of Privacy Practices, this medical practice will not use or disclose health information which identifies individual patients without their written authorization. If a patient authorized this medical practice to use or disclose health information for another purpose, the patient may revoke the authorization in writing at any time.

C. Our Patients' Health Information Rights

1. Right to Request Special Privacy Protections. Our patients have the right to request restrictions on certain uses and disclosures of their health information, by a written request specifying what information they want to limit and what limitations on our use or disclosure of that information they wish to have imposed. We reserve the right to accept or reject these requests, and will notify each patient of our decision.

2. Right to Request Confidential Communications. Our patients have the right to request that they receive their health information in a specific way or at a specific location. For example, they may ask that we send information to a particular e-mail account or to their work address. We will comply with all reasonable requests submitted in writing which specify how or where they wish to receive these communications.

3. Right to Inspect and Copy. Our patients have the right to inspect and copy their health information, with limited exceptions. To access their medical information, they must submit a written request detailing what information they want access to and whether they want to inspect it or get a copy of it. We will respond to every written request within the time required by California and federal law. We will charge a reasonable fee, as allowed by California and federal law. We may deny their request under limited circumstances. If we deny their request to access their child's records or the records of an incapacitated adult they are representing because we believe allowing access would be reasonably likely to cause substantial harm to the patient, they will have a right to appeal our decision. If we deny our patient's request to access his or her psychotherapy notes, the patient will have the right to have them transferred to another mental health professional.

4. Right to Amend or Supplement. Our patients have a right to request that we amend their health information, which they believe is incorrect or incomplete. Our patients must make a request to amend in writing, and include the reasons they believe the information is inaccurate or incomplete. We are not required to change their health information, and if we refuse, we will provide them with information about this medical practice's denial and how they can disagree with the denial. We may deny their request if we do not have the information, if we did not create the information (unless the person or entity that created the information is no longer available to make the amendment), if they would not be permitted to inspect or copy the information at issue, or if the information is accurate and complete as is. Our patients also have the right to request that we add to their record a statement of up to 250 words concerning any statement or item they believe to be incomplete or incorrect.

5. Right to an Accounting of Disclosures. Our patients have a right to receive an accounting of disclosures of their health information made by this medical practice, except that this medical practice does not have to account for the disclosures provided to them or pursuant to their written authorization, or as described in paragraphs 1(treatment), 2(payment), 3(health care operations), 6(notification and communication with family) and 16(specialized government functions of Section A above), or disclosures for purposes of research or public health which exclude direct patient identifiers, or which are incident to a use or disclosure otherwise permitted or authorized by law, or the disclosures to a health oversight agency or law enforcement official to the extent this medical practice has received notice from that agency or official that providing this accounting would be reasonable likely to impede their activities.

6. Right to a Paper Copy of Notice of Privacy Practices. Our patients have a right to a paper copy of this Notice of Privacy Practices.

D. Changes to this Notice of Privacy Practices
We reserve the right to amend this Notice of Privacy Practices at any time in the future. Until such amendment is made, we are required by law to comply with this Notice. After an amendment is made, the revised Notice of Privacy Protections will apply to all protected health information that we maintain, regardless of when it was created or received. We will keep a copy of the current notice posted in our reception/patient waiting area, and will offer you a copy at each appointment.

E. Complaints
Complaints about this Notice of Privacy Practices or how this medical practice handles your health information should be directed to our Privacy Officer/Office Manager listed at the top of this Notice of Privacy Practices. If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to:

Department of Health and Human Services/Office of Civil Rights/Hubert H. Humphrey Bldg.
200 Independence Ave, S.W. Room 509F HHH Building Washington, DC 20201 You will not be penalized for filing a complaint.