Learn about patient privacy at Lafayette Pain Care.
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. This notice applies to all patients at all locations. Please review it carefully.
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
If you are not able to tell us your preference (for example, if you are unconscious), we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to your health or safety.
In these cases, we never share your information unless you give us written permission:
We typically use or share your health information in the following ways:
We can use your health information and share it with other professionals who are treating you.
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
We can use and share your health information to bill and get payment from health plans or other entities.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many legal conditions before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
We can share health information about you for certain situations such as:
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see we are complying with federal privacy law.
We can use or share health information about you:
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
For more information, see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.
This notice is in effect, effective January 1, 2016, and is reviewed annually.
To protect your personal health information, we use a HIPAA consent form. We understand you have certain rights to privacy regarding your protected health information. These rights are given to you under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). We understand by signing a consent, you authorize us to use and disclose your protected health information to carry out:
You may revoke your consent in writing at any time. However, any use or disclosure that occurred prior to the date the consent was revoked is not affected.
We ask all of our patients to complete a patient authorization form while being under your physician’s care. This form specifies those other persons whom you authorize to receive limited personal health information such as disclosure of any appointments and those who are released to pick up existing prescriptions.
We reserve the right to change the terms of the HIPAA consent form and patient authorization form. You may contact us any time to obtain the most current copy of the notices. We will, however, never change your authorization without your approval.
For questions about the credit monitoring service option, please contact our Call Center at 888-849-0976.