Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Effective Date: April 14, 2003

The Health Insurance Portability & Accountability Act of 1996 (HIPAA) is a federal law that requires that all medical records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper, or orally, are kept confidential. HIPAA requires us to maintain the privacy of your protected health information (PHI), to provide you with notice of our legal duties and privacy practices with respect to protected health information and to advise you of your legal rights under HIPAA. We have prepared this Notice of Privacy Practices to provide you with this information.

Permitted Uses and Disclosures. We may use and disclose your protected health information without your consent or authorization for a variety of activities, which are listed below. We have provided some examples of the activities, but not all the activities in every category are listed.

• For Treatment: Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. If you receive Screening Services from us, an example of "treatment" would be a physical examination by a certified nurse practitioner. If you receive Home Care Support from us, an example would be supportive home care after you have completed your initial treatment. If you receive Wellness Community services from us, an example would be weekly support groups.
• For Payment. Payment includes activities like obtaining reimbursement for services. For example, if reimbursement is applicable to services we provide to you, we may bill you, an insurance company or a third party payor. Payment also includes confirmation of coverage, and billing or collection activities.
• For Health Care Operations. Health care operations include the business aspects of running the Columbus Cancer Clinic, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis, and customer service. Examples of "health care operations" include: sharing information with office personnel for record keeping on paper and computer and sharing information about you with other cancer specialists to assure that we are providing you with the very best care.
• Treatment Alternatives and Health Related Benefits. We may contact you about treatment alternatives or other health-related benefits and services that we believe may be of interest to you.
• Appointments and Reminders. We may mail an appointment reminder to you or leave a message on an answering machine, voice mail or with someone who answers the phone. We may call your name in the waiting room or ask you to put your name on a sign-in sheet.
• Fundraising. You may be contacted for fundraising activities done by us or on our behalf. We may collect information about our clients to present to our board to focus our fundraising efforts. If we use photographs or protected health information for fundraising we will do so only with your authorization.
• To Family and Close Friends Involved in Your Care. We may disclose your protected health information to a family member or a close friend involved in your care if that person accompanies you to an appointment or if we determine that it is in your best interest in order for us to provide you with the very best care. If you do not want us to discuss your health care with your family and close friends, please tell us and we will honor your request unless we determine that it is not in your best interests for us to do so.
• As Required by Law or by a Federal, State or Local Agency. We will disclose your protected health information when we are required to do so by law or by a federal, state, or local agency. Examples of legally required disclosures of your protected health information are: public health activities, such as preventing or controlling disease; health oversight activities, such as audits and reports for government benefit programs; quality assurance for mammography services; judicial or administrative proceedings, such as in response to a court order or subpoena; law enforcement, such as preventing serious harm or a crime, reporting a death or locating a missing person, to a jail or correctional facility about an inmate; military activities; national security and intelligence; organ donations after death; workers’ compensation; and reporting victims of crimes, abuse, neglect and domestic violence. If we are legally required to disclose information about you, we will disclose only the amount necessary for the legal purpose.
• Research. We may disclose your information for certain research projects where the research proposal has been approved by an established, authorized review board and the researchers have established procedures to ensure the privacy of your PHI.
• De-Identified Information. We may also use and disclose de-identified health information by removing all references to individually identifiable information.