HIPAA Notice of Privacy Practices
Neuroscience specialty Centers and Topple Diagnostics
(NSC/TDX)
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW THIS NOTICE CAREFULLY.
Federal and state laws establish strict requirements regarding the use and disclosure of confidential and protected information. NSC/TDX is required to comply with those laws as noted throughout this notice.
OBLIGATIONS OF Neuroscience specialty Centers: NSC/TDX is required by law to:
• Maintain the privacy of your health information;
• Give you this notice of our legal duties and privacy practices regarding health information about you; and
• Follow the terms of our notice currently in effect.
HOW NSC/TDX MAY USE AND DISCLOSE HEALTH INFORMATION:
The following describes the ways NSC/TDX may use and disclose protected health information that identifies you (“Health Information”). Except for the purposes described below, NSC/TDX will use and disclose Health Information only with your written permission. You may revoke such permission at any time by writing to the Privacy Officer at the contact information below.
In all cases, including those listed below, if we have substance use disorder patient records about you, subject to 42 CFR part 2, we cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against you without (1) your consent or (2) a court order and a subpoena.
For Treatment.
NSC/TDX may use and disclose Health Information for your treatment and to provide you with treatment-related health care services. For example, NSC/TDX may disclose Health Information to doctors, nurses, technicians, or other personnel who are involved in your medical care and need the information to provide you with medical care.
For Payment.
NSC/TDX may use and disclose Health Information so that NSC/TDX or others may bill and receive payment related to your care, an insurance company, or a third party for the treatment and services you received. For example, NSC/TDX may provide your health plan information so that treatment may be paid for.
For Health Care Operations.
NSC/TDX may use and disclose Health Information for health care operations purposes. These uses and disclosures are necessary to make sure that quality care is received and to operate, manage, and administer the functions of the agency. For example, NSC/TDX may use and disclose information to make sure the medical care you receive is of the highest quality. NSC/TDX also may share information with other entities that have a relationship with you (for example, your health plan) for their health care operation activities.
Appointment Reminders, Treatment Alternatives and Health Related Benefits and Services.
NSC/TDX may use and disclose Health Information to contact you to remind you of an appointment with a physician. NSC/TDX also may use and disclose Health Information to tell you about treatment alternatives or health-related benefits and services that may be of interest to you.
Individuals Involved in Your Care or Payment for Your Care.
When appropriate, NSC/TDX may share Health Information with a person who is involved in your medical care or payment for your care, such as your family or a close friend. NSC/TDX also may notify your family about your location or general condition or disclose such information to an entity assisting in a disaster relief effort.
Research.
Under certain circumstances, NSC/TDX may use and disclose Health Information for research. For example, a research project may involve comparing the health of patients who received one treatment to those who received another, for the same condition. Before NSC/TDX uses or discloses Health Information for research, the project will go through a special approval process. Even without special approval, NSC/TDX may permit researchers to look at records to help them identify patients who may be included in their research project or for other similar purposes, as long as they do not remove or take a copy of any Health Information.
SPECIAL SITUATIONS:
As Required by Law.
NSC/TDX will disclose Health Information when required to do so by international, federal, state or local law. To Avert a Serious Threat to Health or Safety.
NSC/TDX may use and disclose Health Information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Disclosures, however, will be made only to someone who may be able to help prevent the threat.
Business Associates.
NSC/TDX may disclose Health Information to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. For example, NSC/TDX may utilize the services of a separate entity to perform information technology services. All NSC/TDX business associates are obligated to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract.
Organ and Tissue Donation.
If you are an organ donor, NSC/TDX may use or release Health Information to organizations that handle organ procurement or other entities engaged in procurement, banking or transportation of organs, eyes or tissues to facilitate organ, eye or tissue donation and transplantation.
Military and Veterans.
If you are a member of the armed forces, NSC/TDX may release Health Information as required by military command authorities. NSC/TDX also may release Health Information to the appropriate foreign military authority if you are a member of a foreign military.
Workers’ Compensation.
NSC/TDX may release Health Information for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Public Health Risks.
NSC/TDX may disclose Health Information for public health activities. These activities generally include disclosures to prevent or control disease, injury or disability; report births and deaths; report child abuse or neglect; report reactions to medications or problems with products; notify people of recalls of products they may be using; a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and the appropriate government authority if it is believed a patient has been the victim of abuse, neglect or domestic violence. NSC/TDX will only make this disclosure if you agree or when required or authorized by law.
Health Oversight Activities.
NSC/TDX 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.
DataBreach Notification Purposes.
NSC/TDX may use or disclose your Health Information to provide legally required notices of unauthorized access to or disclosure of your Health Information.
Lawsuits and Disputes.
If you are involved in a lawsuit or a dispute, NSC/TDX may disclose Health Information in response to a court or administrative order. NSC/TDX also may disclose Health Information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
Law Enforcement.
NSC/TDX may release Health Information if asked by a law enforcement official if the information is: (1) in response to a court order,subpoena, warrant,summons or similar process; (2) limited information to identify or locate a suspect,fugitive,material witness, or missing person; (3) about the victim of a crime even if, under certain very limited circumstances, we are unable to obtain the person’s agreement; (4) about a death we believe may be the result of criminal conduct;(5) about criminal conduct on our premises; and (6) in an emergency 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.
NSC/TDX may release Health Information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. NSC/TDX also may release Health Information to funeral directors as necessary for their duties. National Security and Intelligence Activities.
NSC/TDX may release Health Information to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Protective Services for the President and Others.
NSC/TDX may disclose Health Information to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or to conduct special investigations.
Inmates or Individuals in Custody.
If you are an inmate of a correctional institution or under the custody of a law enforcement official, NSC/TDX may release Health Information to the correctional institution or law enforcement official. This release would be if necessary:(1)for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) the safety and security of the correctional institution.
USES AND DISCLOSURES THAT REQUIRE NSC/TDX TO PROVIDE YOU AN OPPORTUNITY TO OBJECT AND OPT OUT:
Individuals Involved in Your Care or Payment for Your Care.
Unless you object, NSC/TDX may disclose to a member of your family, a relative, a close friend or any other person you identify, your Health Information that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such a disclosure, NSC/TDX may disclose such information as necessary if it is determined that it is in your best interest based on the professional judgment of NSC/TDX.
Disaster Relief.
NSC/TDX may disclose your Health Information to disaster relief organizations that seek your Health Information to coordinate your care or notify family and friends of your location or condition in a disaster. NSC/TDX will provide you with an opportunity to agree or object to such a disclosure whenever it is practical to do so.
YOUR WRITTEN AUTHORIZATION IS REQUIRED FOR OTHER USES AND DISCLOSURES:
The following uses and disclosures of your Health Information will be made only with your written authorization:
1. Uses and disclosures of Health Information for marketing purposes; and
2. Disclosures that constitute a sale of your Health Information.
Other uses and disclosures of Health Information not covered by this Notice or the laws that apply to NSC/TDX will be made only with your written authorization. If you do provide NSC/TDX with an authorization, you may revoke it at any time by submitting a written revocation to the Privacy Officer. Upon receipt, NSC/TDX will no longer disclose Health Information under the authorization. However, disclosures made in reliance upon your authorization before you evoked it will not be affected by the revocation.
YOUR RIGHTS:
You have the following rights regarding Health Information NSC/TDX has about you:
Right to Inspect and Copy.
You have a right to inspect and copy Health Information that may be used to make decisions about your care or payment for your care. This includes medical and billing records, other than psychotherapy notes. To inspect and copy this Health Information, you must make your request, in writing, to the below referenced Privacy Officer. NSC/TDX has up to 30 days to make your Health Information available to you and NSC/TDX may charge you a reasonable fee for the costs of copying, mailing or other supplies associated with your request. NSC/TDX may not charge you a fee if you need the information for a claim for benefits under the Social Security Act or any other state of federal needs-based benefit program. NSC/TDX may deny your request in certain limited circumstances. If NSC/TDX does deny your request, you have the right to have the denial reviewed by a licensed healthcare professional who was not directly involved in the denial of your request, and NSC/TDX will comply with the outcome of the review.
Right to an Electronic Copy of Electronic Medical Records.
If your Health Information is maintained in an electronic format (known as an electronic medical record or an electronic health record), you have the right to request that an electronic copy of your record be given to you or transmitted to another individual or entity. NSC/TDX will make every effort to provide access to your Health Information in the form or format you request if it is readily producible in such form or format. If the Health Information is not readily producible in the form or format you request, your record will be provided in either our standard electronic format. If you do not want this form or format, a readable hard copy form will be provided. NSC/TDX may charge you a reasonable, cost-based fee for the labor associated with transmitting the electronic medical record.
Right to Get Notice of a Breach.
You have the right to be notified upon a breach of any of your unsecured Protected Health Information.
Right to Amend.
If you feel that Health Information NSC/TDX has is incorrect or incomplete, you may request NSC/TDX to amend the information. You have the right to request an amendment for as long as the information is kept by or for our office. To request an amendment, you must make your request, in writing, to the below referenced Privacy Officer.
Right to an Accounting of Disclosures.
You have the right to request a list of certain disclosures NSC/TDX made of Health Information for purposes other than treatment, payment and health care operations or for which you provided written authorization. To request an accounting of disclosures, you must make your request, in writing, to the Privacy Officer.
Right to Request Restrictions.
You have the right to request a restriction or limitation on the Health Information NSC/TDX uses or disclosed for treatment, payment, or health care operations. You also have the right to request a limit on the Health Information NSC/TDX discloses to someone involved in your care or the payment for your care, like a family member or friend. For example, you could ask that NSC/TDX not share information about a particular diagnosis or treatment with your spouse. To request a restriction, you must make your request, in writing, to the Privacy Officer. NSC/TDX is not required to agree to your request unless you are requesting NSC/TDX restrict the use and disclosure of your Health Information to a health plan for payment or health care operation purposes and such information you wish to restrict pertains solely to a health care item or service for which you have paid “out-of-pocket” in full. If NSC/TDX agrees, we will comply with your request unless the information is needed to provide you with emergency treatment.
Right to Request Confidential Communications.
You have the right to request that NSC/TDX communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that NSC/TDX only contact you by mail or at work. To request confidential communications, you must make your request, in writing, to the Privacy Officer. Your request must specify how or where you wish to be contacted. NSC/TDX will accommodate reasonable requests.
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 at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. To obtain a paper copy of this notice, please contact the Privacy Officer or ask while in the office.
CHANGES TO THIS NOTICE:
NSC/TDX reserves the right to change this notice and make the new notice apply to Health Information already obtained as well as any information received in the future. NSC/TDX will post a copy of the current notice at our office and on the website at https://NSCenters.com The notice will contain the effective date on the first page, in the top right-hand corner.
COMPLAINTS:
If you have any questions about this notice, please contact:
Brent Jones, CEO
Neuroscience Specialty Center
2200 Century Parkway NE, Ste 260
Atlanta, GA 30345
404-946-9327
If you believe your privacy rights have been violated, you may file a complaint in writing by contacting the above-referenced Privacy Officer. Please include your name, phone number, account number and a description of the complaint. You will not be penalized for filing a complaint. You may also file with the U.S. Department of Health andHuman Services, Office for Civil Rights (OCR). For more information on HIPAA privacy requirements, HIPAA electronic transactions, and code sets regulations and the proposed HIPAA security rules, please visit U.S. Department of Health and Human Services web site at: https://www.hhs.gov/hipaa/index.html.
If you have questions about your health or your health care services, you should contact your health care provider (physician, pharmacy, hospital or other medical provider).
