Notice of GB Family Care Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATON. PLEASE REVIEW IT CAREFULLY.
This notice describes how GB Family Care may use your Medical Information. This notice also describes the rights you have concerning your Medical Information. Medical Information includes the contents of your medical record, your billing record, and other records we use to make decisions about your care or payment for your care.
HOW DOES GB FAMILY CARE USE AND DISCLOSE YOUR MEDICAL INFORMATION?
Treatment: Treatment includes the medical services and supplies provided to you. We will use and disclose your medical information to others who need it to treat you, such as doctors, nurses, clinical students, technicians, and others involved in your care. We may use or disclose your Medical Information to notify you of an upcoming appointment, to inform you about possible treatment options or alternatives, or to tell you about health-related services available to you.
Payment: GB Family Care will use and disclose your medical information to be paid for the services you receive. For example, your health plan or health insurance company may need to see parts of your medical record before paying for your treatment.
Business Operations: GB Family Care may use your Medical Information to improve the care and service we provide and to run our business. For example, we may use your Medical Information to assist in quality improvement activities, billing audits, or accounting or legal services to determine whether GB Family Care did a good job.
Family Members and Others Involved in Your Care: GB Family Care may disclose your medical Information to your family members or friends who are involved in your care, or to someone who helps to pay for your care. GB Family Care may leave information regarding your upcoming office visits and appointments as messages at your home or on an answering machine.
Required by Law: Federal, state, or local laws sometimes require us to disclose your Medical Information. For instance, we are required to report child abuse or neglect and must provide information to law enforcement officials in domestic violence cases. We are also required to report information to the Arizona Workers’ Compensation Program regarding work-related injuries.
Public Health: Arizona law requires us to report births, deaths, and communicable diseases to the State of Arizona. We also may need to report patient problems with medications or medical products to the FDA. We may also need to report problems to suppliers so that patients may be notified about product recalls.
Public Safety: In some circumstances, we may need to disclose Medical Information to law enforcement officials. For example, we may disclose Medical Information in response to a search warrant or a grand jury subpoena, or to assist law enforcement officials in identifying or locating a missing person, to report deaths that may have resulted from criminal conduct, and to report criminal conduct at the Hospital.
Health Oversight Activities: We may disclose Medical Information to a government agency that oversees GB Family Care or its personnel, such as the Arizona Department of Health Services, the federal agencies that oversee Medicare, the Arizona Medical Board or the Board of Nursing. These agencies need Medical Information to monitor GB Family Care’s compliance with state and federal laws.
Coroners, Medical Examiners and Funeral Directors: We may disclose Medical Information concerning deceased patients to coroners, medical examiners and funeral directors to assist them in carrying out their duties.
Organ and Tissue Donation: We may disclose Medical Information to organizations that handle organ, eye or tissue donation or transplantation if you have previously agreed to organ donation.
Military, Veterans, National Security and Other Government Purposes: We may disclose Medical Information about members of the armed forces, as required by military command authorities or to the Department of Veterans Affairs. If requested to do so, we will also provide information to federal officials for intelligence and national security purposes or for presidential Protective Services.
Judicial Proceedings: We may be ordered to disclose information by a court or in response to a subpoena. You will receive advance notice about this disclosure in most situations so that you will have a chance to object to sharing your Medical Information.
Information with Additional Protection: Certain types of medical information have additional protection under Arizona law. In some circumstances GB Family Care will require your consent to disclose information about communicable disease and HIV/AIDS, drug and alcohol abuse treatment, genetic testing, and mental health treatment.
WHAT ARE YOUR RIGHTS?
To Request Your Medical Information: You have the right to look at and obtain a copy of your Medical Information. To request a copy of your Medical Information, contact the Medical Records Department at our office. Before we send you the copies, we will notify you of any cost to copy the information. You can look at your record at no charge in the Medical Records Department at GB Family Care.
To Request Amendment of Medical Information: If you believe that your Medical Information is wrong or incomplete, you may ask us to change it. Your written request must include the change requested and the reason for the request.
To Request Restrictions on How GB Family Care Uses or Discloses Your Medical Information: You have the right to ask us not to use or disclosure your Medical Information as described in this notice. We are not required to agree to your request, but if we do agree, we will follow that agreement. If you want to request a restriction, write to the Medical Records Department at GB Family Care and describe your request in detail.
To Request Confidential Communications: You have the right to ask us to communicate with you in a way that you feel is more private. For example, you may ask us not to call your home, but to communicate only by mail. To do this, notify GB Family Care.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice and to make the new provisions effective for all medical information we maintain. If we change these practices, we will publish a revised Notice of Privacy Practices on GBFamilyCare.com.
DO YOU HAVE CONCERNS OR COMPLAINTS?
Please tell us about any problems or concerns you have with your privacy rights or how GB Family Care uses or discloses your Medical Information. Contact GB Family Care at (602) 427-7289.
DO YOU HAVE QUESTIONS?
GB Family Care is required by law to protect the privacy of medical information, to give you this Notice and to follow the terms of the Notice currently in effect. If you have any questions about this Notice, or have further questions about how GB Family Care may use and disclose your Medical Information, please contact us at (602) 427-7289.
Last Updated: November 28, 2012