NOTICE OF PRIVACY PRACTICES
MARTHE A. GABEY, MD, PC
333 HOOSICK ST TROY, NY 12180
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review this information carefully.
We Are Required by Law to:
Maintain the privacy of protected health information; give you this notice of our legal duties and privacy practices regarding health information about you and follow terms of our notice that is currently in effect.
Use and Disclosure of your medical information:
We will not use or disclose your medical information for any purpose not listed below without your written permission. You may revoke such permission at any time by writing to us.
For Treatment:
We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, or other people or health care providers who are taking care of you.
For Payment:
We may use and disclose your health information to others so they will pay us or reimburse you for your treatment. For example, a bill might be sent to you, your insurance company, or a third party payer. The bill may contain information that identifies you, your diagnosis, and treatment or supplies used in course of treatment.
Health Care Operations:
We may use and disclose your health information for health care operation purposes. These are necessary to make sure that all of our patients receive quality care, and to operate and manage our office. We may also share information with other entities that have a relationship with you; for example, (your health plan) for their health care operation activities. We may use and disclose health information to contact you and to remind you that you have an appointment with us. We also may use and disclose health information to tell you about health-related benefits and services that may be of interest to you.
Individuals Involved In Your Care or Payment for your care:
When appropriate, We may share health information with a person who is involved in your medical care or payment of your care, such as your family or a close friend. We also may notify your family about your location or general condition or disclose such information to an entity assisting in a disaster relief effort.
Additional Uses and Disclosures:
In addition to using and disclosing your medical information for treatment, payment and health care operations, we are also allowed by law to use and disclose your health information without your authorization for the following purposes:
As required by law:
We will disclose health information when required to do so by international, federal, state, or local law.
Health Oversight Activities:
We may use and disclose your health information to health oversight agencies for activities authorized by law necessary for the government to monitor the health care system, government benefit programs, compliance with government regulatory programs, and compliance with civil rights laws.
Workers Compensation:
We may disclose your health information to workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Military:
If you are a member of the armed forces, we may release your health information as required by military command authorities. If you are a member of a foreign military, we may release your health information to the appropriate foreign military authority.
Law Enforcement:
We may disclose your health information, within limitations, to law enforcement officials for several different purposes: To comply with a court order, warrant, subpoena, summons, or other similar process: To identify or locate a suspect, fugitive, material witness, or missing person; about the victim of a crime, if unable to obtain victim’s agreement; about a death we suspect may have resulted from criminal conduct: about criminal conduct we believe in good faith to have occurred on our premises; and to report a crime, the location, and the identity, description, and location of the individual who committed the crime, in an emergency situation.
Public Health activities:
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 including child abuse or neglect. We may also disclose your medical information to report adverse events associated with product defects or problems, to enable product recalls, repairs or replacements, to track products, or to conduct activities by the Food and Drug Administration. We may, when authorized by law, notify a person who may have been exposed to a communicable disease or otherwise be at risk of contracting or spreading disease or condition.
Victims of Abuse, Neglect, or Domestic Violence:
We may disclose your health information to the appropriate government authority if we believe a patient has been a victim of abuse, neglect, or domestic violence. We will only make this disclosure when required or authorized by law.
Inmates:
If you are an inmate of a correctional institution or under the custody of law enforcement official, we may disclose your health information to assist them in providing your health care, protecting your health and safety or the health and safety of others, or for the safety of the correctional institution.
Serious Threat to Health or Safety:
If there is a serious threat to your health or safety or the health and safety of the public or another person, we may disclose your health information to someone able to help prevent the threat.
Business Associates:
We may disclose your health information to our business associates that provide us with services if the information is necessary for such functions of services, for example, billing or transcription services. All of our business associates are obligated to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract.
Research In Limited Circumstances:
We may disclose your health information for research purposes in limited circumstances where the research has been approved by a review board that has reviewed the research proposal and established protocols to ensure the privacy of medical information. For example, a research project may involve comparing the health of patient who received one treatment to those who have received another for the same condition.
Lawsuits and Disputes:
If you are involved in a lawsuit or dispute, we may disclose your health information in response to a court or administrative order. We also may disclose health information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.