This Notice describes how medical information about you may be used and disclosed, and how you can access this information. Please read carefully.
Our Responsibility:
The confidentiality of your personal health information is extremely important to us. Your Health information includes records that we create and obtain when we provide you with care. It also includes bills, insurance claims, and other payment information that we maintain related to your care and treatment. This notice describes how we handle your health information and your rights regarding this information. We are required to maintain the policy of your health information as required by law; provide you with this Notice of our duties and privacy practices regarding the health information about you that we collect and maintain; and follow the terms of our Notice currently in effect.
Contact Information:
After reviewing this Notice, if you need further information or want to contact us for any reason regarding the handling of your health information, please direct any communications to the privacy officer at (513) 516-9293.
Uses and Disclosure of Information:
Under federal law, we may use and disclose personal health information without authorization for treatment, payment, and health care operations. Participants in this organized healthcare arrangement also share health information with each other, as necessary to carry out treatment, payment, or healthcare operations related to the organized healthcare management. We may share the minimum amount of personal health information necessary with business associates who perform services on our behalf.
Other Uses and Disclosures:
- As required by the Food & Drug Administration
- As required during an investigation by law enforcement agencies
- Health oversight activities
- In response to Legal proceedings
- Other covered entities’ payment activities
- Other covered entities’ healthcare operations activities to the extent permitted under HIPAA
- Other healthcare providers’ treatment activities
- Other public health activities
- To prevent a serious threat to public health or safety.
- To Workers’ Compensation or similar programs for processing claims
- Uses and disclosures required by law
- Uses and disclosures required by law or unemancipated minors
- Uses and disclosures in domestic violence or neglect situations
Any other Use or Disclosure:
Before using or disclosing your personal health information for any other purpose not identified above, we will obtain your written authorization. Unless action has already been taken in compliance with the authorization, you have the right to revoke such authorization by submitting your written request to us.
Your Health Information Rights:
- Request that we restrict certain uses and disclosures of your health information; we are not, however, required to agree to a requested restriction.
- Request that we communicate with you by alternative means, such as making records available for pickup or mailing them to you at an alternative address, such as a P.O. Box. We will accommodate reasonable requests for such confidential communications.
- Request to review, or to receive a copy of, the health information about you that is maintained in our files and the files of our business associates. We reserve the right to charge a fee for the cost of copying, mailing, or other supplies associated with your request. If we are unable to satisfy your request, we will tell you in writing the reason for the denial and your right, if any, to request a review of the decision.
- Request that we amend the health information that is maintained in our files and the files of our business associates. Your request must explain why you believe our records require amendment. If we cannot satisfy your request, we will tell you in writing the reason for the denial and how you may contest the decision, including your right to submit a statement disagreeing with the decision. We will add this statement to your records.
- Request a list of our disclosures of your health information. This list, known as an “accounting” of disclosures, will not include certain disclosures, such as those made for treatment, payment, or health care operations. We will provide you with accounting services free of charge; however, if you request more than one accounting service in any twelve-month period, we may impose a reasonable, cost-based fee, as permitted by Ohio law. Your request should indicate the period you are interested in. We will be unable to provide you with accounting for any disclosures made before.
- Request a paper copy of this Notice; to exercise any of your rights described above, you must submit a written request to our office. If you have questions about your rights, please get in touch with our designated representative, who is available by phone or email during normal business hours.
Request Information or File a Complaint:
If you believe your privacy rights have been violated, you may file a written complaint by mailing it or delivering it to the office HIPAA Privacy Officer or you may complain to the Secretary of Health and Human Services (HHS) by writing to the Office of Civil Rights, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Room 509F, HHH Building, Washington, D.C. 20201; by calling 1-800-368- 1019; or by an email to OCRprivacy@hhs.gov. We cannot and will not require you to waive your right to file a complaint as a condition of receiving care from us, nor will we penalize you for filing a complaint.
Revision to this Notice:
We reserve the right to amend the terms of this Notice. If this Notice is revised, the amended terms shall apply to all health information that we maintain, including information about you collected or obtained before the effective date of the revised Notice. If the revisions reflect a material change to the use and disclosure of your information, your rights regarding such information, our legal duties, or other privacy matters described in the Notice, post it in the waiting area of our office, make copies available to our patients and others, and post it on our website.