NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION
Effective Date: March 1, 2024
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our Commitment to Your Privacy
Key Decisions MD is committed to protecting the privacy of your health information. This Notice of Privacy Practices describes how we may use and disclose your Protected Health Information (PHI) to carry out treatment, payment, or healthcare operations and for other purposes permitted or required by law. It also describes your rights regarding your health information.
We are required by law to:
- Maintain the privacy of your Protected Health Information
- Provide you with this Notice of our legal duties and privacy practices
- Follow the terms of this Notice
- Notify you of any breach of your unsecured PHI
What is Protected Health Information (PHI)?
PHI is information about you, including demographic information, that may identify you and relates to your past, present, or future physical or mental health condition and related healthcare services.
How We May Use and Disclose Your Health Information
WITHOUT YOUR AUTHORIZATION, we may use and disclose your PHI for:
1. Treatment We may use and disclose your PHI to provide, coordinate, or manage your healthcare and related services.
- Example: Sharing your medical information with specialists or other healthcare providers involved in your care.
2. Payment We may use and disclose your PHI to obtain payment for services we provide to you.
- Example: Submitting claims to your health insurance company or verifying insurance coverage.
3. Healthcare Operations We may use and disclose your PHI for our business operations, quality improvement, and administrative purposes.
- Example: Reviewing the quality of care provided, training staff, or conducting business planning.
4. As Required by Law We may disclose PHI when required by federal, state, or local law.
5. Public Health Activities We may disclose PHI for public health purposes, including:
- Disease or injury reporting
- FDA-regulated product monitoring
- Notifying persons exposed to communicable diseases
6. Health Oversight Activities We may disclose PHI to health oversight agencies for activities authorized by law, such as audits, investigations, and inspections.
7. Judicial and Administrative Proceedings We may disclose PHI in response to a court order, subpoena, or other lawful process.
8. Law Enforcement We may disclose PHI for law enforcement purposes in limited circumstances, such as:
- In response to a warrant or subpoena
- To identify or locate a suspect or fugitive
- Regarding victims of crime under certain conditions
9. Coroners, Medical Examiners, and Funeral Directors We may disclose PHI to coroners, medical examiners, or funeral directors as necessary to carry out their duties.
10. Organ and Tissue Donation We may disclose PHI to organizations involved in organ, eye, or tissue procurement, banking, or transplantation.
11. Research We may use or disclose PHI for research purposes when approved by an institutional review board or privacy board that has reviewed the research proposal.
12. To Avert a Serious Threat to Health or Safety We may use or disclose PHI when necessary to prevent a serious threat to your health or safety, or the health or safety of others.
13. Specialized Government Functions We may disclose PHI for military, national security, intelligence, protective services, or correctional institution purposes as authorized by law.
14. Workers’ Compensation We may disclose PHI as authorized by workers’ compensation or similar programs.
WITH YOUR AUTHORIZATION:
For uses and disclosures not described above, we will obtain your written authorization before using or disclosing your PHI. You may revoke your authorization in writing at any time. We will not use or disclose your PHI for marketing purposes or sell your PHI without your written authorization.
Your Rights Regarding Your Health Information
You have the following rights regarding your PHI:
1. Right to Inspect and Copy You have the right to inspect and obtain a copy of your PHI contained in your medical and billing records. To request access, submit a written request to our Privacy Officer. We may charge a reasonable fee for copying and mailing costs.
2. Right to Amend If you believe your PHI is incorrect or incomplete, you may request that we amend it. Your request must be in writing and must explain why the information should be amended. We may deny your request under certain circumstances.
3. Right to an Accounting of Disclosures You have the right to request an “accounting of disclosures,” which is a list of certain disclosures we have made of your PHI. The request must be in writing and must state the time period desired (not longer than six years).
4. Right to Request Restrictions You have the right to request restrictions on certain uses and disclosures of your PHI. We are not required to agree to your request except in one situation: if you pay out-of-pocket in full for a service and request that we not submit the claim to your health insurance, we must agree unless we are required by law to make the disclosure.
5. 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 may request that we contact you only at work or by mail.
6. Right to a Paper Copy of This Notice You have the right to obtain a paper copy of this Notice upon request, even if you have agreed to receive the Notice electronically.
7. Right to Notification of a Breach You have the right to be notified in the event of a breach of your unsecured PHI.
How to Exercise Your Rights
To exercise any of your rights described above, please submit a written request to:
Privacy Officer
Key Decisions MD
7 Central Ave
Glen Burnie, MD 21061
Email: info@keydecisionsmd.com
Phone: +1 410-344-2852
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights.
To file a complaint with us:
Contact our Privacy Officer at the address above.
To file a complaint with the federal government:
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Online: https://www.hhs.gov/ocr/privacy/hipaa/complaints/
You will not be penalized or retaliated against for filing a complaint.
Changes to This Notice
We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for PHI we already have about you as well as any information we receive in the future. We will post a copy of the current Notice on our website and in our office. The Notice will contain the effective date on the first page.
Contact Information
If you have questions about this Notice or need more information, please contact:
Privacy Officer
Key Decisions MD
7 Central Ave
Glen Burnie, MD 21061
Email: info@keydecisionsmd.com
Phone: +1 410-344-2852
