River Valley Gastroenterology
NOTICE OF PRIVACY PRACTICES
www.rivervalleygastroenterology.com

River Valley Gastroenterology Privacy Officer: 479-444-3566

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.

River Valley Gastroenterology understands the importance of maintaining your privacy.  We are committed to maintaining the confidentiality of your medical information and records, also known as PHI (Protected Health Information).  A record is created of your medical care that is rendered, and we may also receive records of your PHI from others.  Your medical record is property of River Valley Gastroenterology, but the information in the medical record belongs to you.  This notice describes how we may use or disclose your medical information.  It also describes your rights and our legal obligations with respect to your PHI. Please contact our Privacy Officer if you have any questions regarding this Notice of Privacy Practices at the number above. 

1- Access, Use and Disclosure of Your Medical Information / Protected Health Information

Treatment:

We will use and disclose your PHI to render, coordinate and manage your medical needs and provide all necessary treatment.  Your PHI may be shared with other providers, our office personnel, hospitals, medical imaging / radiology departments, labs, pathology labs, pharmacies who are actively involved in your care.  Your PHI may be accomplished by electronic methods for the purpose of providing a collaborative and comprehensive approach to your care.  Your care may involve the use of telemedicine. If telemedicine is used, your PHI will be electronically submitted via a secure encrypted network that is not used by the public. 

Payment:

Our facility will use and disclose your PHI as necessary to obtain payment for medical services rendered to you.  Information may be provided to your insurance carrier (determining eligibility, coverage, peer / utilization review) as needed to obtain prior approval for ordered services before rendering to be able to receive reimbursement.  

Healthcare Operations:

We may use or disclose your PHI to operate and support business activities at River Valley Gastroenterology.  We may disclose information to review and improve quality of care and performance of staff, to obtain authorization from your insurance company for services, to perform necessary audits and medical reviews, legal services, investigations related to fraud and abuse, compliance programs and business planning and management.  Your information may be disclosed to business associates that we work with that perform services in an administrative or revenue cycle capacity for patient accounts.

Communication:

A sign-in sheet may be utilized in the registration area where you will be asked to write down your name.  Your name will be called in the waiting room once our staff has prepared to take you back for the requested service. 

Social Media:
River Valley Gastroenterology actively participates in various social media platforms; however, we do not publish any PHI without prior written consent from the patient per occurrence.  The sites will otherwise be utilized to promote operations of the clinic and health information to the community.  Individual patients who choose to disclose their PHI on River Valley Gastroenterology social media sites understand this information is being made public and is not protected by privacy laws.  Do not share anything on a social media site that you do not want to be viewed by the public. 

2- Other Uses and Disclosures Based Upon Written Authorization 

Unless otherwise permitted or required by law, other uses and disclosure of your PHI will only be made with your written approval.  You have the right to revoke your approval at any time in writing.  

3- Disclosures To Which You Have the Right To Object

Your PHI may be discussed with family or friends who accompany you to our facility.  Understand that your PHI will only be disclosed to individuals who are actively involved in your care.  PHI may be disclosed in an emergency.  PHI may be disclosed if you are unable to consent and professional judgment is used to determine that it is in the best interest of the individual to have the necessary care.  You have the right to object to any of these disclosures.

 4- Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Object

Required By Law:

As required by law, we will disclose your health information, but such disclosures are limited to relevant requirements of the law.  

Public Health:

We may and are sometimes required by law to disclose your health information to public health authorities in order to prevent / control disease, injury or disability.  Reporting child, elder, dependent abuse or neglect. Reporting domestic violence.  Reporting issues to the FDA regarding products and medications.  Reporting infectious disease or exposure.  

Health Oversight Activities:

We may and are sometimes required by law to disclose your health information to health oversight agencies during the course of audits, investigations, inspections, licensure and other proceedings.

Judicial and Administrative Proceedings:

We may be required by law to disclose your PHI in the course of any administrative or judicial proceeding to the extent expressly authorized by a court or administrative order.  We may also disclose information about you in response to a subpoena, discovery request or other lawful process if reasonable efforts have been made to notify you of the request and you have not objected, or if your objections have been resolved by a court or administrative order. 

Law Enforcement:

We are required by law to disclose your health information to law enforcement officials for certain law enforcement purposes.  

Coroners:

We can share health information with a coroner, medical examiner, or funeral director when an individual has expired.

Organ or Tissue Donation:

We can share health information about you with organ procurement organizations.

Public Safety:

We may, and sometimes are required by law to disclose your health information to appropriate personnel in order to prevent or lessen a serious and imminent threat to the health or safety of another person.

Specialized Government Functions:

We may disclose your health information for military or national security purposes or to correctional institutions, law enforcement officers that have you in their lawful custody. 

Inmates:

If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official(s).

Worker’s Compensation:

We may disclose your health information as necessary to comply with workers’ compensation laws.  We are required to report cases of occupational injury or illness to the employer or worker’s compensation insurer.

De-Identified Information:

We may remove information that identifies you from your health information so others may use it without learning who you are.

Research:

We can use or share your de-identified information for health research. 

5- Your Health Information Rights

Right to Request Confidential Communications:

You may request us to contact you in a specific way or to send mail to a different address. We will accommodate all reasonable requests submitted in writing.  We reserve the right to reject any unreasonable requests.

Right to Inspect and Copy:

You may request to view or obtain an electronic or paper copy of your PHI.  We will provide a copy or summary of your health information. We may charge a fee for printing records. Your request may be denied under certain circumstances.  If we deny your request, you will have a right to appeal against our decision.

Right to Amend or Supplement:

You may request us to correct health information that you believe is incorrect or incomplete.  Your request may be denied.  If your request is denied, you will be notified for the reason in writing. 

Right to Request Special Privacy Protections:

You may request for us not to use or disclose any portion of your PHI for the purposes of treatment, payment or healthcare operations. If you pay for a service or health care item out-of-pocket in full, you may request for us not to share that information for the purpose of payment or our operations with your insurer.

Right to an Accounting of Disclosures:

You may request a list of the times your PHI has been shared for the past 6 years prior to the date of your request, who we shared it with, and why.  We will include all the disclosures except for those regarding treatment, payment, health care operations and certain other disclosures that you may have inquired about. We will provide one accounting a year for free.  You will be charged an additional fee for accounting requests within the one-year period.  

Right to Notice of Duties and Practices:

You may request a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.  We will provide you with a paper copy.  If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, contact our Privacy Officer listed at the top of the Notice of Privacy Practices.

Right to Notice of Privacy Breach:

You will be notified if a breach occurs that may have compromised the privacy or security of your PHI.

6- Complaints

You have the right to file a complaint if you believe your privacy has been compromised. You may file a complaint with River Valley Gastroenterology Privacy Officer at 479-444-3566.  You may also file a complaint with the Secretary of Health and Human Services.  We will not retaliate against you for filing a complaint.  You will not be required to waive the right to file a complaint with HHS as a condition of to receive treatment from our facility.  

7 Information

This notice is published and effective 1/02/2024.  We reserve the right to change this notice and provide you with a revised copy of the notice.