Privacy Policy

Health Information Notice of Privacy Practices Policy

Effective April 13, 2003

Notice of Privacy Practices (NPP) Policy

On your child’s first office visit after 4/ 13/03 you will be offered the opportunity to review this policy. At that time, you will be asked to sign a consent and authorization form stating that you have had the opportunity to review these policies and that you agree with them.

Confidentiality Policy

All employees, staff, contractors, and agents of our practice will have access to your child’s complete medical record and protected health information. All employees, staff, contractors, and agents of our practice are trained to respect the health care information of the patients of our practice. They are required to treat all medical, personal and financial information as confidential.  All employees, staff, contractors, and agents of our practice will receive confidentiality training and will sign confidentiality agreements annually.  Any person who breaches this trust will be disciplined and risks immediate termination.

Incidental Disclosure Policy

Incidental uses and disclosures are defined by HHS as disclosures that: (1) cannot be reasonably prevented; (2) are limited in nature; and (3) occur as a by-product of an otherwise permissible use or disclosure. Examples of incidental disclosures are:

  1. When a patient or other person happens to see individually identifiable health information of another patient on sign-in sheets, on patient charts, on computer screens or other places within the doctor’s office.
  2. When office staff calls out a patient’s name in a waiting room.
  3. When doctors confer in public areas.
  4. When a doctor confers with a patient in his/her office.

This office will make certain that reasonable safeguards are in place to minimize such disclosures, and, where applicable, the minimum necessary standard has been implemented.

Authorization Form Policy

Protected health information (PHI) will only be released from our practice with a properly executed authorization from the patient’s parents or his/her personal representative, except for treatment, payment, or health care operations (TPO) and as otherwise required by law.

Examples of some instances in which we are required to disclose your child’s PHI include:  Public health activities; information regarding victims of abuse, neglect, or domestic violence; health oversight activities; judicial and administrative proceedings; law enforcement purposes; organ donations purposes; research purposes under certain circumstances; national security and intelligence; correctional institutions.

Minimum Disclosure Policy Necessary

All uses, disclosures of, or requests for protected health information (PHI) will be limited to the minimum amount necessary to accomplish the stated purpose. Professional judgment will determine the amount of information to be released. The minimum necessary standard IS not intended to impede the provision of quality health care. Disclosures of PHI between providers for treatment, payment and health care operations, or pursuant to an authorization without complying with this requirement are exempt from the minimum necessary rule.

Accounting of Non-Authorized Disclosures Policy

Protected health information (PHI) may be disclosed without parent authorization “nonauthorized”) in certain circumstances. These include but are not limited to: Public health authority, the FDA, the medical examiner or coroner after a patient has died, Worker’s Compensation, as authorized by state or federal law.

This practice is not required to account for disclosures made to the individual to which the information pertains, for treatment, payment or health care operations, when authorization is given, to person’s involved in the patient’s care, for national security or intelligence, to correctional institutions or law enforcement officials, as part of a limited data set, or that occurred prior to Aptil 14, 2003.

A patient may request, in writing, an accounting of any non-authorized disclosures of his PHI. The patient is allowed one accounting per year at no charge. If a patient requests frequent disclosures, this practice may charge for this service, provided we have informed you of the approximate charge in advance and you have agreed to it.

Patient Access to the Medical Record Policy

Parents have the right to inspect and receive copies of their child’s medical records. This practice may charge for the copying of the record, as well as supplies, labor, and postage, and parents will be no titled of this cost in advance.

This practice has the right to deny a patient’s parents’ request to inspect and copy their child’s medical record.  This denial will be in writing and will explain why the request has been denied.  The parents can appeal the denial and have the right to request review by another licensed health professional designated by the practice and who was not a part of the original decision to deny.

Medical Record Amendment Policy

Any parent may request that his/her child’s medical record be changed, corrected, or amended. This request must be in writing and must include the reason for the desired change, amendment, or correction.  This practice may accept or deny this request and will inform the patient’s parent(s) in writing of the decision within 60 days. One 30-day extension is permitted if the parent(s) is notified of the reason for the delay. If the request is denied, you will be sent a written reason for denying the request. The parent(s) may file a written rebuttal to the denial.

Right to Confidential Communications Policy

Parents may request to receive confidential communications of their protected health information (PHI). Requests must be in writing. A parent may request that communications from the practice be sent to an alternate location or by an alternate means. Lakeside Pediatrics will accommodate reasonable requests for such confidential communications.

Restriction of Use or Disclosure of Protected Health Information (PHI) Policy

A patient has the right to REQUEST that the use and disclosure of his protected health information (PHI) be restricted for treatment, payment, and health care operations (TPO), as well as restricting disclosure to certain people, such as family members. THIS PRACTICE DOES NOT HAVE TO AGREE TO SUCH REQUESTS. The restriction request must be in writing, be specific as to what information is covered by the request, whether it covers use, disclosure, or both, and to whom these limitations apply. If this practice agrees to the request, it will honor the request except when overriding laws or emergencies apply. The agreement to restrict health information use and/or disclosure of treatment, payment, or health care operations may be terminated at any time, in writing, by the patient, or by the practice for health information created or received after the date of the notice.

Privacy Complaint Policy

Parents have a right to file a formal complaint if they feel the practice has not adequately protected their privacy. This complaint must be submitted in writing to Matthew Cory, M.D., Compliance and Privacy Officer, or may be submitted directly to the U.S. Department of Health and Human Services Secretary. The complaint must be submitted within 180 days of the event of concern.

Modification Policy

Lakeside Pediatrics may change or amend these policies from time to time as needed or to comply with appropriate laws and regulations.