Privacy Policy

HIPAA NOTICE OF PRIVACY PRACTICES

Effective Date: April 1, 2015

Generally, Alaska Weight Management & Diabetes Counseling will communicate with the medical provider who referred you (and other medical providers you designate) in the form of a visit note.  Rarely, your dietitian will discuss aspects of your nutrition visit with personnel at your medical provider’s office or with your physician.

HOW WE MAY USE AND DISCLOSE PROTECTED HEALTH INFORMATION ABOUT YOU.

For Treatment.  We may use protected health information about you to provide you with, coordinate or manage your medical treatment or services.  We may disclose protected health information about you to doctors, nurses, technicians, medical students, or other Alaska Weight Management & Diabetes Counseling personnel who are involved in taking care of you.

Alaska Weight Management & Diabetes Counseling staff may also share protected health information about you in order to coordinate the different things you need.

We may use and disclose protected health information to contact you as a reminder that you have an appointment at Alaska Weight Management & Diabetes Counseling .

For Payment for Services.  We may use and disclose protected health information about you so that the treatment and services you receive at Alaska Weight Management & Diabetes Counseling may be billed to and payment may be collected from you, an insurance company or a third party.  For example, we may need to give your health plan information about nutrition services you received at Alaska Weight Management & Diabetes Counseling so your health plan will pay us or reimburse you for the service or to obtain prior approval for coverage.

For Health Care Operations.  We may use and disclose protected health information about you for Alaska Weight Management & Diabetes Counseling health care operations, such as our quality assessment and improvement activities, case management, coordination of care, customer services and other activities.  These uses and disclosures are necessary to run the facility, reduce health care costs, and make sure that all of our patients receive quality care.

For example, we may use protected health information to review our treatment and services and to evaluate the performance of the dietitian who is providing your services.  We may also combine protected health information about many Alaska Weight Management & Diabetes Counseling patients to decide what additional services Alaska Weight Management & Diabetes Counseling should offer, what services are not needed, and whether certain new treatments are effective.  We may also disclose information to Alaska Weight Management & Diabetes Counseling personnel for review and learning purposes.

As Required By Law.  We will disclose protected health information about you when required to do so by federal, state or local law.

Health Risks.  We may disclose protected health information about you to a government authority if we reasonably believe you are a victim of abuse, neglect or domestic violence.  We will only disclose this type of information to the extent required by law, if you agree to the disclosure, or if the disclosure is allowed by law and we believe it is necessary to prevent or lessen a serious and imminent threat to you or another person.

Judicial and Administrative Proceedings. If you are involved in a lawsuit or dispute, we may disclose your information in response to a court or administrative order or 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, either by us or the requesting party, to tell you about the request or to obtain an order protecting the information requested.

Business Associates.  We may disclose information to business associates who perform services on our behalf (such as billing companies;) however, we require them to appropriately safeguard your information.

To Avert a Serious Threat to Health or Safety.  We may use and disclose protected 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.

Health Oversight Activities.  We may disclose protected health information to a health oversight agency for activities authorized by law.  These activities include audits, investigations, and inspections, as necessary for licensure and for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Law Enforcement.  We may release protected health information as required by law, or in response to an order or warrant of a court, a subpoena, or an administrative request.  We may also disclose protected health information in response to a request related to identification or location of an individual, victims of crime, decedents, or a crime on the premises.

Worker’s Compensation.  We may disclose information as necessary to comply with laws relating to worker’s compensation or other similar programs established by law.

Food and Drug Administration.  We may disclose to the FDA, or persons under the jurisdiction of the FDA, protected health information relative to adverse events with respect to drugs, foods, supplements, products and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

YOU CAN OBJECT TO CERTAIN USES AND DISCLOSURES

Unless you object, or request that only a limited amount or type of information be shared, we

may use or disclose protected health information about you in the following circumstances:

• We may share  with a family member, relative, friend or other person identified by you protected health information directly relevant to that person’s involvement in your care or payment for your care.

If you would like to object to use and disclosure of protected health information in these circumstances, please call or write to our contact person listed on page 1 of this Notice.

YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION ABOUT YOU.

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

Right to Inspect and Copy.  You have the right to inspect and copy protected health information that may be used to make decisions about your care.  Usually, this includes medical and billing records.

To inspect and copy protected health information that may be used to make decisions about you, you must submit your request in writing to Stephanie Figon.  If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request, and we will respond to your request no later than 30 days after receiving it.  There are certain situations in which we are not required to comply with your request.  In these circumstances, we will respond to you in writing, stating why we will not grant your request and describe any rights you may have to request a review of our denial.

Right to Amend.  If you feel that protected health information we have about you is incorrect or incomplete, you may ask us to amend or supplement the information.

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 protected health information about you.

To request this list or accounting of disclosures, you must submit your request in writing to Stephanie Figon.

Right to Request Restrictions.  You have the right to request a restriction or limitation on the protected health information we use or disclose about you for treatment, payment or health care operations or to persons involved in your care.  To request restrictions, you must make your request in writing to Stephanie Figon.

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.  For example, you can ask that we only contact you at work or by mail.  To request confidential communications, you must make your request in writing to Stephanie Figon.  We will accommodate all reasonable requests.

Right to a Paper Copy of This Notice.  You have the right to a paper copy of this Notice at any time by contacting Stephanie Figon.

Incidental disclosures:

If my spouse is also seeing the dietitian, I understand that strict confidentiality cannot normally be maintained when working with spouses in a cooperative effort. I, therefore, authorize disclosures made to my spouse with the understanding that care and judgment will be used to avoid any unwanted disclosures.

Use of SmartPhone Apps and Social Media:  By the nature of these, there is a small chance that other community members may recognize your identity.  Choice of username and careful use of sharing settings will minimize this issue.

OTHER USES AND DISCLOSURES

We will obtain your written authorization before using or disclosing your protected health information for purposes other than those provide for above (or as otherwise permitted or required by law).  You may revoke this authorization in writing at any time.  Upon receipt of the written revocation, we will stop using or disclosing your information, except to the extent that we have already taken action in reliance on the authorization.

YOU MAY FILE A COMPLAINT ABOUT OUR PRIVACY PRACTICES

If you believe your privacy rights have been violated, you may file a complaint with the Stephanie Figon or file a written complaint with the Secretary of the Department of Health and Human Services.  A complaint to the Secretary should be filed within 180 days of the occurrence or action that is the subject of the complaint.

If you file a complaint, we will not take any action against you or change our treatment of you in any way.