Antioch Foot and Ankle Group
9104 Middleground Road, Suite 2
Savannah, Georgia 31406
This notice describes how medical information about you may be disclosed and how you can get access to this information.
Please read it carefully.
You may be worried about keeping your health and medical information private, we understand. There are laws and ways health care providers can use and share medical information about patients. The law says that we need your permission (authorization) for certain uses, but not others.
Your personal medical information is called Protected Health Information or “PHI”. The law allows us to use your PHI without your permission for the purpose of medical Treatment, Insurance payment or for business Operations (TPO). Examples are the following:
- Treatment: Any medical staff involved in treating you can use your PHI. They can also share it with others involved in your care. For example if our office refers you to a specialist we may share your PHI with that office.
- Payment: We may use and share your PHI to collect payment for services. For example, we may give your PHI to your insurance company as requested for payment for services.
- Operations: We are continually striving to provide the highest level of service to our patients and in doing so we may from time to time use your PHI for business purposes such as, to manage our budget or evaluate the quality of our care.
As well, there are other cases where we can share your PHI without permission. Examples are the following:
- To Follow the Law: We may share PHI to follow the law, to report or solve crimes or to help law enforcement.
- To Protect Public Health: We can give PHI to people who work to stop the spread of diseases, and we must report abuse and neglect.
- To Help Coroners of Medical Examiners: We may need to give PHI to help identify a body or the cause of death.
- For Organ or Tissue Donation: We may give PHI to help agencies that match organ donors with people on waiting lists.
- To Avoid a Serious Threat to Others: We can give PHI to people working to prevent a threat to the health or safety of other people.
- Special Government Functions: We may share PHI with federal officials for national security reasons.
- Workers’ Compensation: We can release PHI to comply with laws that protect you if you are hurt or get sick on the job.
- Appointment Reminders and Other Items of Interest: We can use your PHI to contact you about an appointment. We can also contact you about other treatments, services, and programs that may interest you.
- Your Access to Your Own PHI: We may share PHI with you or someone you choose to represent you.
- Government Offices: We must give your PHI to certain federal workers when you are checking on how we follow the privacy laws.
We must have your written authorization to use your PHI for any other reasons than listed above. This notice tells you our rules for using PHI. We have to follow what we say in this notice. You may revoke this authorization to release your information, with some limitations, at any time in writing.
The law says we must keep your PHI private. It also says that we must tell you in writing:
- What the law says we can and cannot do with your PHI
- Our privacy policies regarding PHI
We have the right to change information and policies contained in this notice. A new notice must be given to you and posted in our office when changes are made.
You have certain rights under the privacy laws:
- You can ask us not to share your PHI with a person or group. Keep in mind we do not have to honor this request; we must only honor what we have set forth in this notice. No matter what, we can always share your PHI in an emergency.
- You can ask that we not contact you in certain ways or a certain places, such as work or home.
- You may ask that we fix mistakes or add new facts to your PHI. We will not honor these requests if: it wasn’t written by us, contained in other physicians records released to our office, is not something you are allowed to see, or is not correct and complete.
- You may ask for a list of the people and groups who have seen your PHI within the past (6) years. The list will not include times when you gave your written permission to release your PHI.
You must make the above requests in writing. Your request should be sent to: Antioch Medial Associates c/o Compliance Officer: Mrs. Plummer 9104 Middlegroud Road, Suite 2 Savannah, GA 31406. We must reply to you within (30) days after receipt of your request. We will respond in writing with your determination.
You may request copies of this notice by contacting our office at (912) 927-8011. Copies are also posted within our office.
You may complain to us if you believe your privacy rights have been violated. You may contact our privacy officer Mrs. Plummer at our office. You also have the right to complain to the Secretary of the Department of Health and Human Services.