Notice of Privacy

Board-Certified Plastic Surgeon Serving Manchester, Nashua, and Nearby Areas of New Hampshire

INTRODUCTION:

This Notice of Privacy Practices describes the medical and personal information we collect, and how and when we use or disclose that information. It also describes your rights as they relate to your protected health information.

We maintain protocols to ensure the security and confidentiality of your personal information. We have physical security in our buildings, passwords to protect databases, compliance audits, and virus/intrusion detection software. Within our practice, access to your information is limited to those who need it to perform their jobs.

UNDERSTANDING YOUR HEALTH RECORD

Each time you visit Dr. Feins’ office, a record of your visit is made. Typically, this record contains the reason for your visit, your symptoms, examination and test results, photographs, diagnoses, treatments, and a plan for your future care and treatment. This information, often referred to as your health or medical record, serves as a:

  • Basis for planning your care and treatment,
  • Means of communicating among the many health professionals who contribute to your care,
  • Legal documents describing the care or treatments you received,
  • Means by which you or a third-party payer can verify that services billed were actually provided,
  • Tool in educating health professionals,
  • Source of data for medical research,
  • Source of information for public health officials charged to improve the health of the state and nation,
  • Source of data for our planning and marketing, and
  • Tool by which we can assess and continually work to improve the care we render and outcomes we achieve.

Understanding what is in your record and how your health information is used helps you to: ensure its accuracy; better understand who, what, when, where, and why others may access your health information; and make more informed decisions when authorizing disclosure to others.

YOUR HEALTH INFORMATION RIGHTS:

Although your health record is the physical property of Robert S. Feins, M.D., Prof. Ass’n., the information belongs to you. You have the right to:

  • Obtain a paper copy of this Notice of Privacy Practices upon request,
  • Inspect and obtain a copy of your health record as provided by 45 CFR 164.524 (reasonable copy fees apply in accordance with state law),
  • Amend your health record as provided by 45 CFR 164.526,
  • Obtain an accounting of disclosures of your health information as provided by 45 CFR 164.528,
  • Request confidential communications of your health information as provided by 45 CFR 164.522(b), and
  • Request a restriction on certain uses and disclosures of your information as provided by 45 CFR 164.522(a) (however, we are not required by law to agree to a requested restriction).

OUR RESPONSIBILITIES

Our practice is required to:

  • Maintain the privacy of your health information,
  • Provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you,
  • Abide by the terms of this notice,
  • Notify you if we are unable to agree to a requested restriction, and
  • Accommodate reasonable requests you may have to communicate your health information.

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. We will keep a posted copy of the most current notice in our facility containing the effective date in the lower, right-hand corner. In addition, each time you visit our facility for treatment, you may obtain a copy of the current notice in effect upon request.

We will not use or disclosure your health information in manner other than described in the section regarding Examples Of Disclosures For Treatment, Payment, And Health Operations, without your written authorization, which you may revoke as provided by 45 CFR 164.508(b)(5), except to the extent that action has already been taken.

FOR MORE INFORMATION OR TO REPORT A PROBLEM

If you have questions and would like additional information, you may contact our practice’s Privacy Officer, at 603-647-4430.

If you believe your privacy rights have been violated, you can either file a complaint with the Privacy Officer, or the Office of Civil Rights, U.S. Department of Health and Human Services (OCR). There will be no retaliation for filing a complaint with either our practice or the OCR. The address for the OCR is as follows:

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, DC 20201

Although your health record is the physical property of Robert S. Feins, M.D., Prof. Ass’n., the information belongs to you. You have the right to:

  • Obtain a paper copy of this Notice of Privacy Practices upon request,
  • Inspect and obtain a copy of your health record as provided by 45 CFR 164.524 (reasonable copy fees apply in accordance with state law),
  • Amend your health record as provided by 45 CFR 164.526,
  • Obtain an accounting of disclosures of your health information as provided by 45 CFR 164.528,
  • Request confidential communications of your health information as provided by 45 CFR 164.522(b), and
  • Request a restriction on certain uses and disclosures of your information as provided by 45 CFR 164.522(a) (however, we are not required by law to agree to a requested restriction).

EXAMPLES OF DISCLOSURES FOR TREATMENT, PAYMENT, AND HEALTH OPERATIONS

To Provide Treatment

We will use your PROTECTED HEALTH INFORMATION within our office to provide you with the best care possible. This may include administrative and clinical office procedures designed to optimize scheduling and coordination of care between physicians and/or staff members.

In addition, we may share your protected health information with physicians, referring specialists, clinical laboratories, pharmacies or other health care personnel providing you treatment.

To Obtain Payment

A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information
that identifies you, as well as your diagnosis, procedures, and supplies used. We may include your health information with an invoice used to collect payment for treatment you received in our office. We may do this with insurance forms filed for you in the mail or sent electronically. We will be sure to only work with companies with a similar commitment to the security of your health information.

To Conduct Health Care Operations

Members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team
may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and services we provided.

Your health information may be used during performance evaluations of our staff. Some of our best teaching opportunities use clinical situations experienced by patients receiving care at our office. As a result, health information may be included in training programs for students, interns, associates, and business and clinical employees. It is also possible your protected health information will be disclosed during audits by insurance companies or government appointment agencies as part of their quality assurance and compliance reviews. Your protected health information may be reviewed during the routine process of certification, licensing or credentialing activities.

In Patient Reminders

Because we believe regular care is very important to your health, we may contact you or a family member at the phone number you have provided us to remind you that you have a scheduled appointment or that it is time for you to contact us and make an appointment. Additionally, we may contact you to follow up on your care.

Marketing

We may contact you to provide information about treatment alternatives, treatment options or other health-related benefits and services that may be of interest to you or your family.

These communications are an important part of our philosophy of partnering with our patients to be sure they received the best care modern plastic surgery can provide. These may include postcards, folding postcards, letters, telephone reminders or electronic reminders, such as email (unless you tell us that you do not want to receive these reminders).

Business Associates

There are some services provided in our organization through contacts with business associates. Examples include physician services in the emergency department and radiology, certain laboratory tests, and a transcription service we use to transfer dictated patient care into the medical record. Due to the nature of business associates’ services, they must receive your health information in order to perform the jobs we’ve asked them to do. To protect your health information, however, when these services are contracted we require the business associate to appropriately safeguard your information.

Research

We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

Fundraising

We may contact you as part of a fund-raising effort.

Food and Drug Administration

We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs or replacement.

Workers Compensation

We may disclose health information to the extent authorized by and necessary to comply with laws relating to workers compensation or other similar programs established by law.

Public Health

As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Directory

Unless you notify us that you object, we will use your name, location in the facility, and general condition for our directory purposes. This information may be provided to members of your family and to other people who ask for you by name.

Notification

We may use or disclose information to notify or assist in notifying a family member or personal representative (or other person responsible for your care) of your location and general condition.

Family, Friend, and Caregivers

Health professionals, using their best judgment, may disclose to a family member, other relative, or close personal friend (or any other person you identify) health information relevant to that persons involvement in your care or payment related to your care.

We may share information with those you tell us will be helping with your home hygiene, treatment, medications, or payment. We will be sure to ask your permission first. In the case of an emergency, where you are unable to tell us what you want, we will use our judgment when sharing your protected health information only when it will be important to those participating in providing your care.

Law Enforcement

We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.

Federal Law makes provision for your health information to be released to an appropriate health oversight agency, public health authority, or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers, or the public.