How We May Use or Disclose Your Protected health information

Preface

We understand that your protected health information is personal and confidential. This Notice of Privacy Practices (“Notice”) describes how TAMG uses and discloses your protected health information.

In order to properly treat you and receive payment for the services we provide, we need to obtain personal information from you. It includes such information such as your full name and address, insurance company or health plan, family medical history, current medical history, current medical condition, the type or care and treatment you receive, among other items.

We will use and disclose this and other protected health information we collect in the ways described below.

To make it easy for you to understand how we will use and disclose your protected health information, we have put the different uses and disclosures of your protected health information into categories and have provided examples. We have not listed every use or disclosure within the categories, but all permitted uses and disclosures will fall within one of the following categories.

We may use and disclose your protected health information without your consent or authorization for treatment, payment, and health care operations, and for the following other reasons.

Treatment

We may use protected health information about you to provide you with medical treatment and services. We may disclose protected health information about you to individuals and facilities who are involved in taking care of you in order to provide care and services (such as prescriptions and lab tests) to you. We may also disclose protected health information to members of your family or others who can help you when you are sick or injured, or following your death.

Payment

We may use and disclose protected health information about you to obtain payment for the services we provide. We may tell your insurance company or health plan or plan sponsor about a treatment you are going to receive to get approval for payment or to determine whether your insurer or health plan will cover the treatment. We use your information to create a bill and disclose your information when we send the bill to your insurance company or health plan or plan sponsor, to you, or to a third party. The entity or individual paying the bill may request more information to determine whether the bill is covered by your insurance or health plan or plan sponsor. We may also disclose information to other health care providers to assist them in obtaining payment for services they have provided to you.

Health Care Operations

We may use and disclose your protected health information to operate our medical practice. For example, we may use and disclose this information to review and improve the quality of care we provide, and to review and improve the competence and qualifications of our staff. Or, for example, we may use and disclose this information to get your health plan to authorize services or referrals. We may also use and disclose your protected health information as necessary for medical reviews, legal services and audits, including fraud and abuse detection and compliance programs and business planning and management. We may also share your protected health information with our "business associates," such as our billing service, that perform administrative services for us. We have a written contract with each of these business associates that contains terms requiring them and their subcontractors to protect the confidentiality and security of your protected health information. Although federal law does not protect health information which is disclosed to someone other than another healthcare provider, health plan, healthcare clearinghouse or one of their business associates, California law prohibits all recipients of healthcare information from further disclosing it except as specifically required or permitted by law. We may also share your information with other health care providers, health care clearinghouses or health plans that have a relationship with you, when they request this information to help them with their quality assessment and improvement activities, their patient-safety activities, their population-based efforts to improve health or reduce health care costs, protocol development, case management or care coordination activities, their review of competence, qualifications and performance of health care professionals, their training programs, their accreditation, certification or licensing activities, their activities related to contracts of health insurance or health benefits, or their health care fraud and abuse detection and compliance efforts.

Business Associates

Some of the services provided within and to our organization are performed by third parties referred to as “Business Associates” by the Health Insurance Portability and Accountability Act (“HIPAA”). Some examples of business associates include billing companies, management consultants, quality assurance reviewers, and attorneys. We may disclose your protected health information to our business associates so that they can perform the job we’ve asked them to do. As required by HIPAA, to protect your protected health information, we enter into contracts with our business associates to required them to keep your information confidential to the same extent that we are obligated to keep it confidential.

Appointment Reminders

We may use and disclose your protected health information to contact you in order to remind you of appointments.

Individuals Involved in Your Care or In Payment For Your Care

Unless you tell us in advance not to do so, we may disclose protected health information about you to a friend or family member or personal representative or another person responsible for your medical care for the payment for it. In the event of a disaster, we may disclose information to a relief organization so that they may coordinate notification efforts – we may do so even over your objection if we believe it is necessary to respond to emergency circumstances. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.

Treatment Alternatives

We may use and disclose your protected health information to provide you with information about treatment alternatives and other health related benefits and services.

We may also disclose your protected health information to outside entities, without your consent or authorization, in the following circumstances:

As Required by Law

We will use and disclose your protected health information as required by law; however, we will limit our use or disclosure to the relevant requirements of the law. When the law requires us to report abuse, neglect or domestic violence, or respond to judicial or administrative proceedings, or to law enforcement officials, we will further comply with the requirement set forth below concerning those activities.

Public Health Purposes

We may, and are sometimes required by law, to disclose your protected health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability; reporting child, elder or dependent adult abuse or neglect; reporting domestic violence; reporting problems with products and reactions to medications to the Food and Drug Administration; and reporting disease or infection exposure. When we report suspected elder or dependent adult abuse or domestic violence, we will inform you or your personal representative promptly unless in our best professional judgment, we believe the notification would place you at risk of serious harm or would require informing a personal representative we believe is responsible for the abuse or harm.

Health Oversight Activities

We may, and are sometimes required by law, to disclose your protected health information to health oversight agencies during the course of audits, investigations, inspections, licensure and other proceedings, subject to the limitations imposed by federal and California law.

Public Safety

We may, and are sometimes required by law, to disclose your protected health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.

Judicial and Administrative Proceedings

We may, and are sometimes required by law, to disclose your protected health information in the course of an administrative or judicial proceeding to the extent expressly authorized by a court or administrative order. We may also disclose information about you in response to a subpoena, discovery request or other lawful process if reasonable efforts have been made to notify you of the request and you have not objected, or if your objections have been resolved by a court or administrative order.

Law Enforcement

We may, and are sometimes required by law, to disclose your protected health information to a law enforcement official for purposes such as identifying of locating a suspect, fugitive, material witness or missing person, complying with a court order, warrant, grand jury subpoena and other law enforcement purposes.

Coroners and Funeral Directors

We may, and are often required by law, to disclose your protected health information to coroners in connection with their investigations of deaths. We may also disclose your protected health information to a funeral director, as authorized by law, in order to permit the funeral director to carry out his or her duties. That information may be disclosed in reasonable anticipation of death.

Organ or Tissue Donation

We may disclose your protected health information to organizations involved in procuring, banking or transplanting organs and tissues.

Specialized Government Functions

Workers Compensation

We may use and disclose your protected health information as necessary to comply with worker's compensation and other similar laws/programs.

Change of Ownership

In the event that our medical practice is sold or merged with another organization, your protected health information/record will become the property of the new owner, although you will maintain the right to request that copies of your protected health information be transferred to another physician or medical group.

Breach Notification

In the case of a breach of unsecured protected health information, we will notify you as required by law. If you have provided us with a current email address, we may use email to communicate information related to the breach. In some circumstances our business associate may provide the notification. We may also provide notification by other methods as appropriate.

Inmates

Use of Electronic Records

We may use an electronic health record. Your records may be disclosed in electronic form for treatment, payment, and healthcare operations, and as permitted by law.

Psychotherapy Notes

Except as specifically permitted by law, we will not use or disclose your psychotherapy notes without a written authorization.

Marketing

We will not use or disclose your protected health information for marketing purposes, other than face-to-face communications with you or promotional gifts of nominal value, without your written authorization.

Sale of Information

We will not sell your protected health information without your written authorization, including notification of the payment we will receive.

Except as described in this Notice of Privacy Practices, TAMG will, consistent with its legal obligations, not use or disclose protected health information which identifies you without your written authorization.

Where a disclosure is made under your written authorization, you have the right to revoke the authorization at any time. Revocation of an authorization must be in writing. The revocation is effective as of the date you provide it to TAMG and does not affect any prior disclosures made under the authorization.

If a state or federal law provides additional restrictions or protections to your information, we will comply with the most stringent requirement.

Right to Request Special Privacy Protections

You have the right to request restrictions on certain uses and disclosures of your protected health information. To do so, you must send us a written request specifying what information you want to limit, and what limitations on our use or disclosure of that information you wish to have imposed. If you tell us not to disclose information to your commercial health plan concerning health care items or services for which you paid for in full out-of-pocket, we will abide by your request, unless we must disclose the information for treatment or legal reasons. We reserve the right to accept or reject any other request, and will notify you of our decision.

Right to Request Confidential Communications

You have the right to request that you receive your protected health information in a specific way or at a specific location. For example, you may ask that we send information to a particular email account or to your work address. We will comply with all reasonable requests submitted in writing which specify how or where you wish to receive these communications.

Right to Inspect and Copy

Subject to limited exceptions, you have the right to inspect and copy your protected health information. To access your protected health information, you must submit a written request detailing what information you want access to, whether you want to inspect it or get a copy of it, and if you want a copy, your preferred form and format. We will provide copies in your requested form and format if it is readily producible, or we will provide you with an alternative format you find acceptable, or if we can’t agree and we maintain the record in an electronic format, your choice of a readable electronic or hardcopy format. We will also send a copy to any other person you designate in writing. We will charge a reasonable fee which covers our costs for labor, supplies, postage, and if requested and agreed to in advance, the cost of preparing an explanation or summary, as allowed by federal and California law. We may deny your request under limited circumstances. If we deny your request to access your child's records or the records of an incapacitated adult you are representing because we believe allowing access would be reasonably likely to cause substantial harm to the patient, you will have a right to appeal our decision. If we deny your request to access your psychotherapy notes, you will have the right to have them transferred to a mental health professional.

Right to Amend or Supplement

You have a right to request that we amend your health information that you believe is incorrect or incomplete. You must make a request to amend in writing, and include the reasons you believe the information is inaccurate or incomplete. We are not required to change your health information, and will provide you with information about our denial and how you can disagree with the denial. We may deny your request if we do not have the information, if we did not create the information (unless the person or entity that created the information is no longer available to make the amendment), if you would not be permitted to inspect or copy the information at issue, or if the information is accurate and complete as is. If we deny your request, you may submit a written statement of your disagreement with that decision, and we may, in turn, prepare a written rebuttal. You also have the right to request that we add to your record a statement of up to 250 words concerning anything in the record you believe to be incomplete or incorrect. All information related to any request to amend or supplement will be maintained and disclosed in conjunction with any subsequent disclosure of the disputed information.

Right to an Accounting of Disclosures

You have a right to receive an accounting of disclosures of your protected health information made by us, except that we do not have to account for the disclosures provided to you or pursuant to your written authorization, or as described above under the headings treatment, payment, health care operations, and other certain disclosures. You may receive one free accounting during a twelve month period. If you request more than one accounting in a twelve month period, you will be charged a fee.

Right to Notice

You have a right to notice of our legal duties and privacy practices with respect to your protected health information, including the right to a paper copy of this Notice of Privacy Practices, even if you have previously requested one be sent to you by email.

If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, contact our Privacy Officer listed at the bottom of this Notice of Privacy Practices.

We are required by law to maintain the privacy of protected health information and to provide individuals with this Notice of our legal duties and privacy practice regarding health information.

We are required to notify you if there is a breach of your unsecured protected health information.

We are required to abide by the terms of the current Notice of Privacy Practices.

Changes to this Notice of Privacy Practices

We reserve the right to change our privacy practices and the terms of this Notice of Privacy Practices at any time. Until such a change is made, we are required by law to comply with this Notice. After a change is made, the revised Notice of Privacy Protections will apply to all protected health information that we maintain, regardless of when it was created or received. We will post the current notice on our website and a copy may be requested from our Privacy Officer at the phone number or address listed below.

If you believe your privacy rights have been violated or you disagree with a decision made by us about your protected health information, you may contact our Privacy Officer, Molly Chung, M.D at 310-517-4759 or at the following address:

Molly Chung, M.D., Privacy Officer

Torrance Anesthesia Medical Group

c/o PO BOX 60790

Pasadena, CA 91116-6790

If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to the U.S. Department of Health & Human Service Office of Civil Rights.

Under no circumstances will we penalize or retaliate against you in any manner for filing a complaint.

If you have questions about this notice or want more information, please contact our Privacy Officer, Molly Chung, M.D, at 310-517-4759.