Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.  Please review it carefully.

This Notice of Privacy Practices describes how protected health information may be used or disclosed by  Midwest Dermatology Clinic to carry out treatment, payment, health care operations, and for other purposes that are permitted or required by law.  This Notice also sets out our legal obligations concerning your protected health information, and describes your rights to access and control your protected health information.

Protected health information (“PHI”) is individually identifiable health information, including demographic information, collected from you or created or received by a health care provider, a health plan, your employer (when functioning on behalf of the group health plan), or a health care clearinghouse and that relates to:  (i) your past, present, or future physical or mental health or condition; (ii) the provision of health care to you; or (iii) the past, present, or future payment for the provision of health care to you.

This Notice of Privacy Practices has been drafted to be consistent with what is known as the “HIPAA Privacy Rule”, and any of the terms not defined in this Notice should have the same meaning as they have in the HIPAA Privacy Rule. In addition, this Notice of Privacy Practices has been updated and amended for changes or additions brought about by the HIPAA Security Rule and provisions of the HITECH Act.

This Practice does not sell, rent, or lease its customer lists or mobile opt-in data to third parties for marketing purposes.

If you have any questions or want additional information about the Notice or the policies and procedures described in the Notice, please contact:

 Midwest Dermatology Clinic, PC

2323 S 171 St Suite 100

Omaha, NE 68130

402-933-0800

Effective Date

 This Notice of Privacy Practices became effective on September 2016.

Our Responsibilities

We are required by law to maintain the privacy of your protected health information.  We are obligated to provide you with a copy of this Notice of our legal duties and of our privacy practices with respect to protected health information, and we must abide by the terms of this Notice.  We reserve the right to change the provisions of our Notice and make the new provisions effective for all protected health information that we maintain.  If we make a material change to our Notice, we will mail a revised Notice to the address that we have on record for the contract holder for your member contract.

Primary Uses and Disclosures of Protected Health Information

 The following is a description of how we are most likely to use and/or disclose your protected health information.

• Payment and Health Care Operations

We have the right to use and disclose your protected health information for all activities that are included within the definitions of “treatment”, “payment” and “health care operations” as set out in 45 C.F.R. § 164.501 (this provision is a part of the HIPAA Privacy Rule).  We have not listed in this Notice all of the activities included within these definitions, so please refer to 45 C.F.R. § 164.501 for a complete list.

• Treatment – We may use your PHI to facilitate medical treatment or services. We may also disclose your PHI to doctors, nurses, technicians, medical students, or other hospital personnel who are involved in your medical care.
• Payment – We will use or disclose your PHI to pay claims for services provided to you and to obtain stop-loss reimbursements or to otherwise fulfill our responsibilities for coverage and providing benefits. For example, we may disclose your PHI when a provider requests information regarding your eligibility for coverage under our health plan, or we may use your information to determine if a treatment that you received was medically necessary.
• Healthcare Operations – We will use or disclose your PHI to support our business functions. These functions include, but are not limited to:  quality assessment and improvement, reviewing provider performance, licensing, underwriting, soliciting bids, business planning, and business development.  To the extent that we use or disclose PHI for underwriting purposes, we are prohibited from using or disclosing your individual genetic information for such purposes. For example, we may use or disclose your PHI: (i) to provide you with information about one of our disease management programs; (ii) to respond to a customer service inquiry from you; or (iii) in connection with fraud and abuse detection and compliance programs.
• Deceased Patients. Our practice may disclose PHI to family members who are/were involved in a deceased patient’s care. We may release PHI to a medical examiner or coroner to identify a deceased individual or to identify the cause of death. If necessary, we may also release information for a funeral director to perform their job.
• Certain types of uses and disclosures of PHI require an individual’s authorization under 45 CFR § 164.508(a)(2) through (a)(4). These include: 1) most uses of psychotherapy notes (if Covered Entity maintains a record of such notes); 2) uses and disclosures of PHI for marketing purposes; and 3) disclosures that constitute a sale of PHI.

Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.  Please review it carefully.

This Notice of Privacy Practices describes how protected health information may be used or disclosed by  Midwest Dermatology Clinic to carry out treatment, payment, health care operations, and for other purposes that are permitted or required by law.  This Notice also sets out our legal obligations concerning your protected health information, and describes your rights to access and control your protected health information.

Protected health information (“PHI”) is individually identifiable health information, including demographic information, collected from you or created or received by a health care provider, a health plan, your employer (when functioning on behalf of the group health plan), or a health care clearinghouse and that relates to:  (i) your past, present, or future physical or mental health or condition; (ii) the provision of health care to you; or (iii) the past, present, or future payment for the provision of health care to you.

This Notice of Privacy Practices has been drafted to be consistent with what is known as the “HIPAA Privacy Rule”, and any of the terms not defined in this Notice should have the same meaning as they have in the HIPAA Privacy Rule. In addition, this Notice of Privacy Practices has been updated and amended for changes or additions brought about by the HIPAA Security Rule and provisions of the HITECH Act.

If you have any questions or want additional information about the Notice or the policies and procedures described in the Notice, please contact:

 Midwest Dermatology Clinic, PC

2323 S 171 St Suite 100

Omaha, NE 68130

402-933-0800

Effective Date

 This Notice of Privacy Practices became effective on September 2016.

Our Responsibilities

We are required by law to maintain the privacy of your protected health information.  We are obligated to provide you with a copy of this Notice of our legal duties and of our privacy practices with respect to protected health information, and we must abide by the terms of this Notice.  We reserve the right to change the provisions of our Notice and make the new provisions effective for all protected health information that we maintain.  If we make a material change to our Notice, we will mail a revised Notice to the address that we have on record for the contract holder for your member contract.

Midwest Dermatology does not sell, rent, or lease its customer lists or mobile opt-in data to third parties for marketing purposes.

Primary Uses and Disclosures of Protected Health Information

 The following is a description of how we are most likely to use and/or disclose your protected health information.

• Payment and Health Care Operations

We have the right to use and disclose your protected health information for all activities that are included within the definitions of “treatment”, “payment” and “health care operations” as set out in 45 C.F.R. § 164.501 (this provision is a part of the HIPAA Privacy Rule).  We have not listed in this Notice all of the activities included within these definitions, so please refer to 45 C.F.R. § 164.501 for a complete list.

• Treatment – We may use your PHI to facilitate medical treatment or services. We may also disclose your PHI to doctors, nurses, technicians, medical students, or other hospital personnel who are involved in your medical care.
• Payment – We will use or disclose your PHI to pay claims for services provided to you and to obtain stop-loss reimbursements or to otherwise fulfill our responsibilities for coverage and providing benefits. For example, we may disclose your PHI when a provider requests information regarding your eligibility for coverage under our health plan, or we may use your information to determine if a treatment that you received was medically necessary.
• Healthcare Operations – We will use or disclose your PHI to support our business functions. These functions include, but are not limited to:  quality assessment and improvement, reviewing provider performance, licensing, underwriting, soliciting bids, business planning, and business development.  To the extent that we use or disclose PHI for underwriting purposes, we are prohibited from using or disclosing your individual genetic information for such purposes. For example, we may use or disclose your PHI: (i) to provide you with information about one of our disease management programs; (ii) to respond to a customer service inquiry from you; or (iii) in connection with fraud and abuse detection and compliance programs.
• Deceased Patients. Our practice may disclose PHI to family members who are/were involved in a deceased patient’s care. We may release PHI to a medical examiner or coroner to identify a deceased individual or to identify the cause of death. If necessary, we may also release information for a funeral director to perform their job.

Certain types of uses and disclosures of PHI require an individual’s authorization under 45 CFR § 164.508(a)(2) through (a)(4). These include: 1) most uses of psychotherapy notes (if Covered Entity maintains a record of such notes); 2) uses and disclosures of PHI for marketing purposes; and 3) disclosures that constitute a sale of PHI.