At the Jenkins Clinic, we believe that your health information is personal. We keep records of the care and services that you receive. We are committed to keeping your health information private.
The Jenkins Clinic Notice of Privacy Practices describes the privacy practices of the Jenkins Clinic.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE READ THIS NOTICE CAREFULLY.
At the Jenkins Clinic, we believe that your health information is personal. We keep records of the care and services that you receive. We are committed to keeping your health information private, and we are also required by law to respect your confidentiality. This Notice describes the privacy practices of the Jenkins Clinic. This Notice applies to all of the health records that identify you and the care you receive at the Jenkins Clinic. If you are under 18 years of age, your parents or guardian must sign for you and handle your privacy rights for you. We are legally required to give you this Notice and to follow the terms of the Notice that is currently in effect.
HOW JENKINS CLINIC MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
When you become a patient of Jenkins Clinic we will use your health information within Jenkins Clinic and disclose your health information outside Jenkins Clinic for the reasons described in this Notice. The following categories describe some of the ways that we will use and disclose your health information:
Treatment. We use your health information to provide you with health care services. We may disclose your health information to doctors, nurses, technicians, medical or nursing students, or other persons at Jenkins Clinic who need that information to take care of you. For example, a doctor treating you for a urologic problem may need to ask another doctor if you have diabetes to manage that condition while your urologic problem is under treatment. This may involve talking to doctors and others not employed by us. We also may disclose your health information to people outside Jenkins Clinic who may be involved in your health care, such as treating doctors, home care providers, pharmacies, drug or medical device experts, and family members.
Payment. We may use and disclose your health information so that the health care you receive may be billed and paid for by you, your insurance company, or another third party. For example, we may give information about surgery you had at the Jenkins Clinic to your health plan so it will pay us or reimburse you for the surgery. We may also tell your health plan about a treatment you are going to receive so we can get prior payment approval or learn if your plan will pay for the treatment.
Health Care Operations. We may use your health information and disclose it outside Jenkins Clinic for our health care operations. These uses and disclosures help us operate Jenkins Clinic to maintain and improve patient care. For example, we may use your health information to review the care you received and to evaluate the performance of our staff in caring for you. We also may combine health information about many patients to identify new services to offer, what services are not needed, and whether certain therapies are effective. We may also disclose information to doctors, nurses, technicians, and other persons at Jenkins Clinic for learning and quality improvement purposes. We may remove information that identifies you so people outside Jenkins Clinic may study your health data without knowing who you are.
Contacting You. We may use and disclose health information to reach you about appointments and other matters. We may contact you by mail, telephone or email. For example, we may leave voice messages at the telephone number you provide us with, and we may respond to your email address.
Health-Related Services. We may use and disclose health information about you to send you mailings about health-related products and services available at Jenkins Clinic.
Philanthropic Support. We may use general demographic information about you to contact you in an effort to raise funds to support Jenkins Clinic and its operations. We also will tell you how to cancel these communications.
Medical Research. We perform medical research here. Our clinical researchers may look at your health records as part of your current care, or to prepare or perform research. They may share your health information with other Jenkins Clinic researchers. All patient research conducted at Jenkins Clinic goes through a special process required by law that reviews protections for patients involved in research, including privacy. We will not use your health information or disclose it outside Jenkins Clinic for research reasons without either getting your prior written approval or determining that your privacy is protected.
Organ and Tissue Donation. We may release health information about organ, tissue, and eye donors and transplant recipients to organizations that manage organ, tissue, and eye donation and transplantation.
Legal Matters. We will disclose health information about you outside Jenkins Clinic when required to do so by federal, state, or local law, or by the court process. We may disclose health information about you for public health reasons, like reporting births, deaths, child abuse or neglect, reactions to medications or problems with medical products. We may release health information to help control the spread of disease or to notify a person whose health or safety may be threatened. We may disclose health information to a health oversight agency for activities authorized by law, such as for audits, investigations, inspections, and licensure.
AUTHORIZATIONS FOR OTHER USES AND DISCLOSURES
As described above, Jenkins Clinic will use your health information and disclose it outside of the Jenkins Clinic for treatment, payment, health care operations, and when permitted or required by law. We will not use or disclose your health information for other reasons without your written authorization. For example, you may want us to release medical information to your employer or to your child’s school. These kinds of uses and disclosures of your health information will be made only with your written authorization. You may revoke the authorization, in writing, at any time, but we cannot take back any uses or disclosures of your health information already made with your authorization.
YOUR RIGHTS REGARDING HEALTH INFORMATION
Right to Accounting. You may request an accounting, which is a listing of the entities or persons (other than yourself) to whom the Jenkins Clinic has disclosed your health information without your written authorization. The accounting would not include disclosures for treatment, payment, health care operations, and certain other disclosures exempted by law. Your request for an accounting of disclosures must be in writing, signed, and dated, and it must identify the time period of the disclosures about which you want the accounting. We will not list disclosures made earlier than 6 years before your request. Your request should indicate the form in which you want the list (for example, on paper or electronically). You must submit your written request to the Privacy Office, Jenkins Clinic, Inc., 1800 Howell Mill Road, Suite 500, Atlanta, GA 30318. We will respond to you within 60 days. We will give you the first listing within any 12-month period free, but we will charge you for all other accountings requested within the same 12 months.
Right to Amend. If you feel that health information we have about you is incorrect or incomplete, you have the right to ask us to amend your medical records. Your request for an amendment must be submitted to the Privacy Office, Jenkins Clinic, Inc., 1800 Howell Mill Road, Suite 500, Atlanta, GA 30318. Jenkins Clinic will respond to you within 60 days. We may deny your request. If we do, we will tell you why and explain your options.
Right to Inspect and Obtain Copy. You have the right to inspect and obtain a copy of your completed health records unless your doctor believes that disclosure of that information to you could harm you. You may not see or get a copy of information gathered for a legal proceeding or certain research records while the research is ongoing. Your request to inspect or obtain a copy of the records must be submitted in writing, signed and dated, to the Privacy Office, Jenkins Clinic, Inc., 1800 Howell Mill Road, Suite 500, Atlanta, GA 30318. (Requests for billing records should be sent to the billing departments.) We may charge a fee for processing your request. If Jenkins Clinic denies your request to inspect or obtain a copy of the records, you may appeal the denial to the President of the Jenkins Clinic.
Right to Request Restrictions. You have the right to ask us to restrict the uses or disclosures we make of your health information for treatment, payment, or health care operations, but we do not have to agree. You also may ask us to limit the health information that we use or disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. Again, we do not have to agree. A request for a restriction must be signed and dated. The request should also describe the information you want restricted, say whether you want to limit the use or the disclosure of the information or both, and tell us who should not receive the restricted information. You must submit your request in writing to the Privacy Office, Jenkins Clinic, Inc., 1800 Howell Mill Road, Suite 500, Atlanta, GA 30318. We will tell you if we agree with your request or not. If we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment.
NOTICE OF PRIVACY PRACTICES
Effective March 1, 2009
© Jenkins Clinic, Inc. 2009
Right to Request Confidential Communications. You have the right to request that we communicate with you about your health in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. Your request for confidential communications must be in writing, signed, and dated, and it must specify how or where you wish to be contacted. You need not tell us the reason for your request, and we will not ask. You must send your written request to the Privacy Office, The Jenkins Clinic, Inc., 1800 Howell Mill Road, Suite 500, Atlanta, Georgia 30318. We will accommodate all reasonable requests.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy of this Notice. You may obtain a paper copy of this Notice at any of our facilities or by calling the Jenkins Clinic at 404-240-9700. You may view this Notice at our Web site, www.jenkinsclinic.org.
If you believe your privacy rights have been violated, you may file a complaint with Jenkins Clinic or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with Jenkins Clinic, you must submit your complaint in writing to Jenkins Clinic, Inc., 1800 Howell Mill Road, Suite 500, Atlanta, Georgia 30318. You will not be penalized for filing a complaint.
CHANGES TO THIS NOTICE
Jenkins Clinic may change this Notice at any time. Any change in the Notice could apply to medical information we already have about you, as well as any information we receive in the future. We will post a copy of the current Notice at each of our facilities and on our Web site, www.jenkinsclinic.org. The effective date of the Notice is on the first page in the top right corner.
If you have questions about this Notice, you may telephone 404-240-9700 or write to Jenkins Clinic, Inc., 1800 Howell Mill Road, Suite 500, Atlanta, Georgia 30318.