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.
Each time you visit a healthcare provider, a record of your visit is made. Typically, these records contain your symptoms, examination and test results, diagnoses, treatment plans and billing related information. This Notice applies to all of the records of your care generated by Connecticut GI Providers.
Connecticut GI, PC is required by law to maintain the privacy of your health information and to provide you with a description of our legal duties and privacy practices regarding your health information. The current Notice will be posted in the reception area. In addition, we will also provide you with a copy of this Notice that we request you acknowledge with your signature. We are required by law to abide by the terms of this Notice and notify you if we make changes to this Notice, which may be at any time. Changes to the Notice will apply to your medical information that we already maintain as well as new information received after the
change occurs. If we change the notice, it will be posted in the reception area. You may also request that a revised Notice be sent to you in the mail or you may ask for one at your next appointment or appropriate visit. This Notice will also serve to advise you as to your rights with regards to your medical information.
YOUR RIGHTS REGARDING USES AND DISCLOSURES OF YOUR PERSONAL HEALTH
The following categories describe examples of the way we
use and disclose medical information.
For treatment: We may use medical information about
you to provide, coordinate and manage your treatment or
services. We may disclose medical information about you
to other doctors, nurses, technicians, or other personnel
who are involved in your care. We may also provide a
subsequent healthcare provider with copies of various
reports that should assist him or her in treating you.
For payment: We may use and disclose medical
information about your treatment and services to bill and
collect payment from you, your insurance company or
a third party payer. For example, we need to give your
insurance company information before it approves or pays
for the health care services we recommend for you.
For health care operations: We may use or disclose as
needed, your health information in order to support our
routine health care operations. These operations include,
but are not limited to, quality assessments, medical reviews,
training activities, licensing, marketing, legal advice, billing
and collections, accounting support, transcription services,
or arranging for other healthcare operations. We may use or
disclose your protected health information to communicate
with you by telephone or mail for reminders and follow-up
appointments or procedure scheduling.
Business Associates: There are some services provided in
our organization through contracts with business associates.
Examples include quality assurances, accounting, legal
services, billing and collection services, and transcription
services. When these services are contracted, we may
disclose your health information to our business associates
so that they can perform the job that we have asked them
to do and bill you or your third party payer for services
rendered. To protect your health information, however,
we require the business associate to appropriately safeguard
your information through a written contract. Furthermore,
Business Associates are required by law to implement, and
comply with, their own HIPAA Policies and Procedures and
How we secure your Electronic Personal Health
In accordance with the HIPAA Security Rule, there are
administrative, physical and technical safeguards in place to
ensure the confidentiality, integrity and security of your
e-PHI that is created, received, used or maintained by
Permitted and Required uses and disclosures that may be
made with your authorization or opportunity to object
Individuals involved with your care or payments for
your care: Unless you object, we may release medical
information about you to a friend or family member who is
involved in medical care or who helps to pay for your care.
In addition, we may disclose medical information about
you to an entity assisting relief effort so that your family
can be notified about your condition, status and location.
Permitted and Required Uses and Disclosures That May
be Made Without Your Authorization or opportunity to
As required by law. We may use and disclose health
information to do the following types of entities, including
but not limited to:
Food and Drug Administration
Public Health or legal authorities charged with preventing
or controlling disease, injury or disability
Law enforcement/Legal proceedings as required by law or
in response to a valid subpoena.
Worker’s Compensation Agents
Organ and tissue Donation Organizations
Military Command Authorities
Health Oversight Agencies
Funeral Directors, Coroners and Medical Directors
National Security and Intelligence Agencies
The Authority that receives reports on abuse and neglect
Your Health Information Rights
Although your health record is the physical property of
Connecticut GI, PC, you have the 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 ask that you submit your requests in writing.
Amend: If you feel that the medical information we have
about you is incorrect or incomplete, you may ask us to
amend the information by submitting a request in writing.
You have the right to request an amendment for as long as
we keep the information. We may deny your request for
an amendment and if this occurs, you will be notified of
the reason for the denial.
An accounting of disclosures: You have the right to
request an accounting of our disclosures of medical
information about you except for certain circumstances,
including disclosures for treatment, payment, health carerrr
operations or where you specifically authorized a disclosure.
Connecticut GI, PC will impose a fee for each subsequent
request for an accounting within the 12 month period. We
ask that you submit these requests in writing.