CPC Privacy Policy
This notice describes how the Center for Primary Care (CPC) may use
and disclose medical information about you and how you can get access to
this information. Please review it carefully.
The following categories describe different ways that we use and disclose
medical information. For each category of uses or disclosures, we will
elaborate on the meaning and provide more specific examples, if you request.
Not every use or disclosure in a category will be listed. However, all of
the ways we are permitted to use and disclose information will fall within
one of the categories.
For Payment. We may use and disclose medical information about you so
that the treatment and services you receive at the practice may be billed to
and payment may be collected from you, an insurance company, or a third
party. For example: we may disclose your record to an insurance company, so
that we can get paid for treating you.
For Treatment. We may use medical information about you to provide
you with medical treatment or services. We may disclose medical information
about you to doctors, nurses, technicians, medical students, or other
personnel who are involved in taking care of you at the practice or the
hospital. For example, we may disclose medical information about you to
people outside the practice who may be involved in your medical care, such
as family members, clergy, or other persons who are part of your care.
For Healthcare Operations. We may use and disclose medical
information about you for healthcare operations. These uses and disclosures
are necessary to run the practice and ensure that all of our patients
receive quality care. We also may disclose information to doctors, nurses,
technicians, medical students, and other practice personnel for review and
learning purposes. For example, we may review your record to assist our
quality improvement efforts.
Who Will Follow This Notice. This notice describes CPC’s policies and
procedures and that of any healthcare professional authorized to enter
information into your medical chart, any member of a volunteer group that we
allow to help you, as well as all employees, staff, and other practice
personnel.
Policy Regarding the Protection of Personal Information. We create a
record of the care and services you receive at CPC. We need this record in
order to provide you with quality care and to comply with certain legal
requirements. This notice applies to all of the records of your care
generated by CPC, whether made by our personnel or by your personal doctor.
The law requires us to: make sure that medical information that identifies
you is kept private; give you this notice of our legal duties and privacy
practices with respect to medical information about you; and follow the
terms of the notice that is currently in effect. Other ways we may use or
disclose your protected healthcare information include: appointment
reminders; as required by law; for health-related benefits and services; to
individuals involved in your care or payment for your care; research; to
avert a serious threat to health or safety; and for treatment alternatives.
Other uses and disclosures of your personal information could include
disclosure to or for: coroners, medical examiners, and funeral directors;
health-oversight activities; inmates; law enforcement; lawsuits and
disputes; military and veterans; national security and intelligence
activities; organ and tissue donation; protective services for the President
and others; public health risks; and worker’s compensation.
Notice of Individual Rights
You have the following rights regarding medical information CPC maintains
about you:
Right to an Accounting of Disclosures. You have the right to request
an “accounting of disclosures.” This is a list of the disclosures we made of
medical information about you. To request this list or accounting of
disclosures, you must submit your request in writing to the Privacy Officer.
Right to Amend. If you feel that medical information we have about
you is incorrect or incomplete, you may ask us to amend the information. You
have the right to request an amendment for as long as the information is
kept by or for CPC. Requests for amendments must be made in writing and
submitted to the Privacy Officer and you must provide a reason that supports
your request. We may deny your request for an amendment.
Right to Inspect and Copy. You have the right to inspect and copy
medical information that may be used to make decisions about your care. We
may deny your request to inspect and copy in certain very limited
circumstances.
Right to a Paper Copy of this Notice. You have the right to a paper
copy of this notice. You may request a copy of this notice from CPC at any
time.
Right to Request Confidential Communications. You have the right to
request that we communicate with you about medical matters in a certain way
or at a certain location. You must make your request in writing, and you
must specify how or where you wish to be contacted.
Right to Request Restrictions. You have the right to request a
restriction or limitation on the medical information we use or disclose
about you for treatment, payment, or health care operations. You also have
the right to request a limit on the medical information we disclose about
you to someone who is involved in your care or the payment for your care,
such as a family member or friend. We are not required to agree to your
request. If we do agree, we will comply with your request unless the
information is needed to provide you emergency treatment. To request
restrictions, you must make your request in writing to the Privacy Officer.
Changes to This Notice. We reserve the right to change this notice.
We will post a copy of the current notice in CPC’s waiting rooms.
Complaints. If you believe your privacy rights have been violated,
you can contact CPC (Center for Primary Care, Attn: Privacy Officer, 363
North Belair Road, Evans, GA 30809) or the Office for Civil Rights (Office
for Civil Rights, U.S. Department of Health and Human Services, 200
Independence Avenue, S.W., Room 509F, HHH Building, Washington, DC 20201.
All complaints must be submitted in writing. You will not be penalized for
filing a complaint.
Other Uses of Medical Information. Other uses and disclosures of
medical information not covered by this notice or the laws that apply to use
will be made only with your written authorization. If you provide us
permission to use or disclose medical information about you, you may revoke
that permission, in writing, at any time.
If you have any questions
about this notice or would like to receive a more detailed explanation,
please contact CPC’s Privacy Officer, Melody Collins, at (706) 650-7799 ext
242














