For Example: Information obtained by a nurse, physician, or other member of our staff will be recorded in your record and used to determine the course of treatment that should work best for you. In that way, the physician will know how you are responding to the treatment.
Copies of various reports may be provided to your Private physician or subsequent healthcare provider to assist him or her in treating you once you are discharged from Doctor’s Walk-In Clinic.
We will use your health information for payment.
For example: A bill may be sent to your insurance or a third party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.
We will use your health information for regular health operations.
For example: Members of our medical staff, or quality improvement team may use information in your medical record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the health care and services we provide.
Business Associates: There are some services provided in our organization through contracts with business associates. Examples include physician services in medical record storage and billing companies. 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. To protect your health information, however, we require the business associate to appropriately safeguard your information.
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, your location and general condition.
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.
Access to Protected Health Information:
Marketing: We may contact you to provide appointment reminders or information about treatment alternatives, any questions you may have concerning your care and treatment or other health related benefits and services that may be of interest to you.
Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, supplement products and product defects or post marketing surveillance information to enable product recalls, repairs or replacement.
Workers’ Compensation: We may disclose health information to the extent necessary to comply with laws relating to workers’ compensation or other similar programs established by law.
Employer: If you are being seen for an employment physical and/or tests, Doctor’s Walk-In Clinic may disclose your health information to your employer as determined by you and your employer.
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.
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.
At DOCTOR’S WALK-IN CLINIC, we are committed to responsibly treating and protecting your health information. This Notice of Health Information Practices describes the personal information we collect, 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 April 14, 2003, and applies to all protected health information as defined by federal regulations.
Each time you visit DOCTOR’S WALK-IN CLINIC, a record of your visit is made. Typically this record contains your symptoms, examination and test results, diagnoses, treatment and a plan for future care or treatment, as indicated. This information, often referred to as your health or medical record, serves as a:
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.
Although your health record is the physical property of DOCTOR’S WALK-IN CLINIC, the information belongs to you. You have the right to:
DOCTOR’S WALK-IN CLINIC is required to:
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, you may obtain a copy at any of our facilities or on our website at www.dwic.org.
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.
If you have questions and would like additional information, you may contact the practice’s Privacy Officer, Kathy Miller at 813-289-8014, extension 134.
If you believe your privacy rights have been violated, you can file a complaint with the practice’s Privacy Officer or with the Office for Civil Rights, U.S. Dept. of Health and Human Services. There will be no retaliation for filing a complaint with either the Privacy Officer or the Office of Civil Rights. The addresses for the Privacy Officer and the OCR are listed below:
DOCTOR’S WALK-IN CLINIC ATTN: Kathy Miller P.O. Box 22997 Tampa, Florida 33622-9977 Office for Civil Rights U.S. Dept. of Health & Human Services 200 Independence Avenue, S.W. Room 509F, HHH Building Washington, D.C. 20201