How We May Use and Disclose Health Information About You

The following categories describe different ways that we may use and disclose your health information. For many of these categories, we provide an example to explain what we mean. Not every use or disclosure in a category will be listed.

For Treatment. We may use or disclose health information about you to provide health care or to facilitate medical treatment or services by other providers. For example, we might disclose information about you with other physicians who are treating you.

For Payment. We may use and disclose health information about you to bill and receive payment for the treatment and services you receive from the Practice.

For Practice Operations. We may use and disclose health information about you for the Practice’s operations. For example, we may use health information about you to improve your care, send you appointment reminders, or obtain business support services.

To Business Associates. We may contract with individuals or entities known as Business Associates to perform various functions or to provide certain types of services. In order to perform these functions or to provide these services, they may receive or use your health information, but only after they agree in writing to implement safeguards to protect your health information. For example, we may disclosure your health information to a Business Associate to process bills or provide our electronic health records systems. Business Associates are required to comply with HIPAA also.

As Required By Law. We will disclose health information about you when required to do so by
federal, state or local law. For example, we may disclose medical information when required by a public health disclosure law or a court order in a litigation proceeding such as a malpractice action.

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. Any disclosure, however, would only be to someone able to help prevent the threat.

Workers’ Compensation. We may release health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or
illness, or disability determination.

Public Health Risks. 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 reactions to medications or problems with products

• to notify people of recalls of products they may be using

• to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition

• to comply with OSHA and other workplace safety laws

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.

Clinical Research Activities. We may use or disclose your health information in a permitted manner for clinical research purposes. We may use your health information to determine your eligibility for a research study, and we, or our Business Associates acting on our behalf, may contact you to discuss participation in such clinical research studies. We may also use and disclose your health information to medical researchers who request it for approved medical research projects, but only as permitted by law. If a research project requires your specific authorization, we will obtain your written permission first.

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 or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request so you can consent to the disclosure 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

• 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, medical examiner or funeral director. This may be necessary, for example, to identify a deceased person or determine the cause of death.

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Your Rights Regarding Your Health Information

You have the following rights regarding health information we maintain about you:

Right to Inspect and Copy. You have the right to inspect and copy health information that may be used to make decisions about your care. Requests must be made in writing to our Privacy Officer. We may charge a reasonable, cost-based fee for copies. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to your health information, you may request that the denial be reviewed.

Right to Amend. If you feel that the health information we have about you is incorrect or incomplete, you may ask us to amend the information. To request an amendment, your request must be made in writing to the Practice’s Privacy Officer. You should 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:

• is accurate and complete

• is not part of the health information kept by the Practice

• was not created by us, unless the person or entity that created the information is no longer available to make the amendment

Right to an Accounting of Disclosures. You may request a list of certain disclosures of your information made in the past six years, excluding those for treatment, payment, and operations. To request this accounting of disclosures, you must submit your request in writing to the Practice’s Privacy Officer. We will provide one list annually free of charge.

Right to Request Confidential Communications. You have the right to request that we communicate with you about health matters in a certain way. We will accommodate all reasonable requests. For example, you may ask that we only contact you at your mobile telephone number or by mail.

Right to Request Restrictions. You may request restrictions on certain uses and disclosures. While we are not required to agree, we will comply with your request to restrict disclosure to your health plan if you paid for the service in full out-of-pocket. If a restriction is agreed to by the Practice, you may terminate it at any time by written request. To request a restriction, you must make your request in writing to the Practice’s Privacy Officer.

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.

Right to File a Complaint. If you feel we have violated your rights, you can file a complaint with the Practice by contacting the Practice’s Privacy Officer. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to
200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting
www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a
complaint.

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Your Choices Regarding Certain Health Information
 

For certain health information, you can tell us your choices about what we share. If you have a
clear preference for how we share your information in the situations described below, talk to us.
 

In the following cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care

• Share information in a disaster relief situation

 

We never share your information for the purposes below, unless you give us written permission:

• Marketing purposes

• Sale of your information

 

Changes to This Notice
We reserve the right to change the terms of this notice and to make the new notice effective for all health information we maintain. The updated notice will be available in our office and on our website, and you may request a copy at any time.
 

Contact Information
Patient requests to the Practice’s Privacy Officer should be sent to:
Greater Hartford Nephrology, LLC
Attention: Privacy Officer, Dr. Sharad Sathyan
35 Jolly Drive, Suite 203
Bloomfield, CT 06002

If you have any questions about this notice, please contact the Practice’s Privacy Officer, Dr. Sharad Sathyan at 860-769-9866 or privacyofficer@ghneph.com.