Privacy
Protecting the Confidentiality of Our Patients' Personal
Medical Information
Patient Rights
Our Patients have the right to:
-
Access or inspect your medical record
-
Obtain a copy of your medical record
-
Access and copying for as long as information is retained
-
Request an amendment to your medical record
-
Request a list of when and where their confidential information was
released since April 2001
-
Request Dr. Baker to restrict the use and disclosure of your information
(can request restriction in use of information for treatment, payment, or
healthcare operation purposes, however, we can choose if we will honor the
request).
-
Request to receive communication by alternative means after completing our
patient consent form
-
File a complaint to the following if you believe your privacy rights were
violated: 1) Baker Medical Arts Privacy Officer, 2)
The Secretary of the Department of Health and Human Services, Mike
Leavitt, 200 Independence Ave, S.W. Washington, D.C. 20201 (202) 619-0257,
Toll Free: 1-877-696-6775, Email:
HHS.mail@hhs.gov
-
Receive a notice of our practice privacy Practices (brochure)
Patient Consent to Receive Mail and/or Telephone Messages
Our Commitment To You
Dr. Baker
recognizes the sensitive nature of your health information, and takes every
precaution to protect your privacy. You can be certain it will be used
only within our strict guidelines.
Dr. Baker
prepared this to explain what types of information we collect, and under
what circumstances we may share this information.
Please read
through all the details of our privacy act. Dr. Baker wants you to
understand that we use information for the following reasons:
1)
Provide you with the healthcare service you've requested.
2) File your healthcare claim with your insurance company
3) Make your visits or procedures more convenient and efficient for
you.
Dr. Baker has
never allowed us to provide account or personal health information to any
other companies for the purpose of independent telemarketing or direct mail
marketing of any types of products or services.
Patient Information Collected
When you
register we ask you to provide us with information needed to accurately file
your insurance claim. The following information is requested:
1) Name
and Address
2) Telephone number, home, work, cell, Email address
3) Social Security number
4) Race
5) Date of Birth
6) Sex
7) Marital Status
8) Guarantor demographic information
9) Insurance carrier name and address
10) Insurance ID and group number
11) Employer
12) Patients' history and physical
13) Current medications
Information Provided
The information collected is used for only one purpose
- to help us deliver the healthcare services requested, accurately and
efficiently.
Access to Information
Our Practice;
Our employees are permitted access to the information
they need to perform their jobs. Strict policies are in place
regarding unauthorized disclosure or use of personal health information by
employees.
Outside Providers;
Dr. Baker has arrangements with companies whose
services are essential for our own services to operate properly. For
example: surgical, pathology, laboratory, pharmacy, and management.
Other companies prepare our financial statements, enable online claims
submission, and make banking transactions.
These firms perform their functions under the direction
of the practice and, as permitted by law, Dr. Baker shares patient
information necessary to perform these functions with them.
As with all our business partners, these companies are
required to safeguard your information and use it only for authorized
purposes.
Government;
Certain federal and state laws may require us to share
information about you. Example: legal matters, may require us to
provide information to a court or other party. Only the specific
information required by law, subpoena, or court order will be shared.
HIPAA;
These new privacy regulations are part of the Health
Insurance Portability and Accountability Act (HIPAA) passed by congress in
1996. The privacy rules became effective in April 2001.
Dr. Baker has always
protected the privacy of her patients.
|
new_small1.JPG)
