Alan S. Rahm, M.D.
618 Beaver Street
Sewickley, PA 15143
NOTICE OF PRIVACY PRACTICES UNDER HIPAA
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU
MAY BE USED, DISCLOSED, AND SAFEGUARDED, AND HOW YOU CAN
GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
What is this Notice and why is it important?
As of April, 2003, a new federal law (HIPAA) went into effect, modified on March 26, 2013, with changes that became effective September 23, 2013. This law requires that health care practitioners create a notice of privacy practices for you to read. This notice tells you how I, Alan S. Rahm, M.D., will protect your medical information, how I may use or disclose this information, and describes your rights. If you have any questions about this notice, please contact me directly at (412) 741-3300.
Understanding Your Health Information
During each appointment, I record clinical information and store it in your chart. Typically, this record includes a description of your symptoms, your recent stressors, your medical problems, a mental status exam, any relevant lab test results, diagnoses, treatment, and a plan for future care. This information, often referred to as your medical record, serves as a:
o Basis for planning your care and treatment
o Means of communication among the health professionals who contribute to your care
o Legal document of the care you receive
o Means by which you or a third party payer ( e.g. health insurance company ) can verify that services you received were appropriately billed
o A tool with which I can assess and work to improve the care I provide
Your Health Information Rights
You have the following rights related to your medical record:
o Obtain a copy of this notice
o Provide authorization to use your health information. Before I use or disclose your health information, other than as described below, I will obtain your written authorization, which you may revoke at any time to stop future use or disclosure
o Access your health information. You may request a copy of your medical record from me at any time. There will be a charge for copying based on the length of time involved in making the copy.
o Change your health information. If you believe the information in your record is inaccurate or incomplete, you may request that I correct or add information.
o Request confidential communications. You may request that when I communicate with you about your health information, I do so in a specific way (e.g. at a certain mailing address or phone number). I will make every reasonable effort to comply with your request.
o Accounting of disclosures. You may request a list of disclosures of your health information that I have made for reasons other than treatment, payment, or health care operations
o Be notified following a breach of protected health information
o Prevent me from providing certain protected health information to your health plan where you are paying out of pocket in full for your health service
o I am required by law to protect the privacy of your health information, to provide this notice about my privacy practices, and to abide by the terms of this notice
o I reserve the right to change my policies and procedures for protecting health information. When I make a significant change in how I use or disclose your health information, I will also change this notice
o Except for the purposes related to your treatment, to collect payment for my services, to perform necessary business functions, or when otherwise permitted or required by law, I will not use or disclose your health information without your authorization. You have the right to revoke your authorization at any time.
When Can I Legally Disclose Your Health Information Without Your Specific Consent?
o In order to facilitate your medical treatment. For example, if I needed to speak with your primary care physician or your psychotherapist, or they needed to speak with me, regarding your care, in those situations I would disclose information about your diagnosis, your medications, and so on. Please note that we cannot generally disclose other detailed and personal information concerning your treatment without your specific written consent.
o In order to collect payment for health care services that I provide. For example, in order to be paid by your medical insurance I have my biller send a bill to your insurance company. The information on the bill may include information that identifies you, as well as your diagnosis, and type of treatment. In other cases, I fill out prior authorization forms which include some information about you, including your history, treatment and diagnosis.
0 In Order to Facilitate Routine Office Operations: For example: Occasionally, I dictate notes from visits, usually for letters to other clinicians. In that case your health information will be disclosed to the transcriptionist.
Will I Disclose Your Health Information to Family and Friends?
While the new law allows such disclosures without your specific consent (as long as it contributes to your treatment), my office policy is that I will never share your clinical information with your family without a signed authorization from you. The BIG EXCEPTION to this is if I believe you pose an immediate danger to yourself or someone else. In that case, I will do whatever is necessary, even if that means breaching confidentiality. Also, the Department of Health and Human Services permits disclosure of your covered information after you are deceased, to your family members and others who were involved in your care or payment for care, unless you have clearly expressed a preference that these individuals not be given this information.
How Long Does the Period of Protected Health Information Last?
It does not last beyond 50 years after you are deceased. This does not mean that your records will be kept that long. This rule does not supersede or interfere with other laws that might provide for a longer period of protection.
Less Common Situations in Which I Might Disclose Your Health Information
o Workers Compensation: I may disclose your health information to comply with laws relating to Workers Compensation or other similar programs
o Law Enforcement: I may disclose your health information for law enforcement for purposes as required by law or in response to a valid subpoena, or court or administrative order. This includes any information requested by the Department of Social Services related to cases of neglect or abuse of children
o Business Associates: I hire a billing company to send out bills to insurance companies. Some of the contractors of this company have access to a small portion of your health information in order to allow them to do their jobs, but they are obligated to the same rules to protect your privacy.
For More Information or To Report a Problem
If you have questions, would like additional information, or want to request an updated copy of this notice, you may contact me, Alan S. Rahm, M.D., at any time at (412) 741-3300. If you feel your privacy rights have been violated in any way, please let me know and I will take appropriate action. You may also send a written complaint to the Secretary of Health and Human Services by writing to Office for Civil Rights, U.S. Department of Health and Human Services, 150 S. Independence Mall West, Suite 372, Public Ledger Building, Philadelphia, PA, 19106-9111; by calling (215) 861-4441 (Main Line), 800-368-1019 (Hotline), (215) 861-4431 (FAX), or (215) 861-4440 (TDD), or by sending an email to the Office for Civil Rights OCR at [email protected]. I cannot and will not make you waive your right to file a complaint as a condition of receiving care from me or penalize you for filing a complaint.