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The Country Doctor, Ltd. acts to maintain the privacy of protected health information (PHI) and provide individuals with The Country Doctor, Ltd.'s Privacy Policy (CDLPP) of the practice's legal duties and privacy practices with respect to PHI and abide by the terms of the documents currently in effect. The Country Doctor provides the CDLPP to every patient with whom it has a direct treatment relationship, starting April 13, 2003. The CDLPP also is available to any member of the public to enable prospective patients to evaluate the practice's privacy policies. When a direct patient receives the CDLPP from the practice, The Country Doctor, Ltd. asks the patient to sign its "Receipt of the CDLPP" form, which is filed with the patient's medical record. If the patient refuses to sign the form, it is noted in the medical record that the patient refused to sign the form.
The Country Doctor, Ltd. reserves the right to revise the CDLPP whenever there is a material change to the uses or disclosures, the individual's rights, the covered entity's legal duties, or other privacy practices stated in the notice. If the CDLPP is revised, The Country Doctor, Ltd. makes the revised CDLPP available upon request beginning on the revision's effective date to all patients, including those who have received a previous notice. Upon receipt of a revised notice, the patient is asked to acknowledge receipt of the notice.
The Country Doctor, Ltd. allows all patients and their agents to file complaints with The Country Doctor, Ltd. and with the Secretary of the federal Department of Health and Human Services (DHHS), whenever a patient or his or her agent believes that The Country Doctor, Ltd. has violated a patient's privacy rights. Complaints to The Country Doctor, Ltd. must be in writing, must describe the acts or omissions that are the subject of the complaint, and must be filed within 180 days of the time the patient became aware or should have become aware of the violation. Complaints and privacy questions must be addressed to the privacy officer, Dr. David Mitchell, at The Country Doctor, Ltd, 2310 Country Road, Shiloh, IL 62221-2570. The Country Doctor, Ltd. investigates each complaint and may, at its discretion, reply to the patient or the patient's agent. Complaints to the Secretary of the DHHS must be in writing, must name the practice, must describe the acts or omissions that are the subject of the complaint, and must be filed within 180 days of the time the patient became aware or should have become aware of the violation. The Country Doctor, Ltd. does not take any adverse action against any patient who files a complaint, either directly or through an agent, against the practice.
The Country Doctor, Ltd. reasonably ensures that the PHI it requests, uses, and discloses for any purpose is the minimum amount of PHI necessary for that purpose. The Country Doctor, Ltd. treats all qualified individuals as personal representatives of patients and usually allows individuals to act as personal representatives of patients, with the general exceptions to allowing individuals to act as personal representatives related to unemancipated minors and abuse, neglect, or endangerment situations. In addition, The Country Doctor, Ltd. makes reasonable efforts to ensure that PHI is only used by and disclosed to individuals that have a right to the PHI. Toward that end, the practice makes reasonable efforts to verify the identity of those using or receiving PHI.
The Country Doctor, Ltd. uses and discloses PHI for payment, treatment, health care operations, and to those involved in a patient's care when the patient approves or, when the patient is not present or not able to approve, when such disclosure is deemed appropriate in the professional judgment of the practice. Treatment includes those activities related to providing services to the patient, including releasing information to other health care providers involved in the patient's care. Payment relates to all activities associated with reimbursement for services provided, including submission of claims to insurance companies and any additional information requested by the insurance company so that they can determine if they should pay the claim. Health care operations includes a number of areas, such as quality assurance and peer review activities. When the patient is not present, The Country Doctor, Ltd. determines whether the disclosure of the patient's PHI is authorized by law and if so, discloses only the information directly relevant to the person's involvement with the patient's health care.
The Country Doctor, Ltd. uses and discloses PHI to appropriate individuals as required by law and in emergency situations. As required by law, in emergency situations, or as agreed to by the individual, The Country Doctor, Ltd. discloses PHI to public health officials, including for reporting of communicable diseases and other conditions, sexually transmitted diseases, lead poisoning, Reyes Syndrome, and mandated reports of injury, medical conditions or procedures, or food-borne illness including but not limited to adverse reactions to immunizations, cancer, adverse pregnancy outcomes, death, birth, victims of child abuse or neglect, elderly victims of neglect, victims of domestic violence, information about a minor, disabled adult information, or person over 60 years of age who may be a victim of abuse or neglect. In addition, The Country Doctor, Ltd. discloses PHI for judicial and administrative proceedings in response to an order of a court or an administrative tribunal; in response to a subpoena, discovery request or other lawful process, not accompanied by a court order or an ordered administrative tribunal; for law enforcement purposes to law enforcement officials; to a coroner or medical examiner and funeral directors as required by law, including to sign a death certificate; to facilitate organ, eye or tissue donations; to public health and other authorities as required by law to avert a serious threat to health or safety, including for military and veterans activities, national security and intelligence activities, and other activities as required by law; for health oversight activities, such as when the information may be used and released for audits, investigations, licensure issues, and other health oversight activities, including, but limited to hospital peer review, managed care peer review, or Medicaid or Medicare peer review; and to provide treatment in emergency situations. In instances where The Country Doctor, Ltd. has not previously provided its CDLPP to a patient who receives direct treatment in an emergency situation, The Country Doctor, Ltd. provides the CDLPP to the individual as soon as practicable after the emergency treatment.
The Country Doctor, Ltd. does not use or disclose any PHI for marketing purposes, research activities, employers, or health plan sponsors. The Country Doctor, Ltd. does not engage in communications about products and services that encourages a recipient of the communication to purchase or use the product or service for treatment, to direct or recommend alternative treatments, therapies, health care providers, or settings of care to the individual.
The Country Doctor, Ltd. informs the individual of the reporting of PHI unless the practice, in the exercise of professional judgment, believes informing the individual would place the individual at risk of serious harm or The Country Doctor, Ltd. would be informing a personal representative, and The Country Doctor, Ltd. believes the personal representative is responsible for the abuse, neglect, or other injury with the risk that informing such person would not be in the best interests of the individual. If an individual wants The Country Doctor, Ltd. to release his or her PHI to employers or health plan sponsors, for underwriting and related purposes, for facility directories, or to brokers and agents, then he or she can contact The Country Doctor, Ltd. and complete an appropriate written authorization.
A patient may request copies of a medical record, a privacy disclosure list and an amendment to PHI in the medical records. The Country Doctor, Ltd. tracks all disclosures of a patient's PHI that occur for other than the purposes of treatment, payment, and health care operations, that are not made to the individual or to a person involved in the patient's care, that are not made as a result of a patient authorization, and that are not made for national security or intelligence purposes or to correctional institutions or law enforcement officials. An individual can request an accounting of disclosures for a period of up to six years prior to the date of the request, and an individual can request to inspect and copy PHI of the medical record. Amendments to the PHI may be requested by the patient. Patients may only request an accounting of disclosures or an amendment to the medical records dated after April 13, 2003. The Country Doctor, Ltd. responds to all requests for an accounting of disclosures, medical records copying, and/or amendments to PHI within 60 days of receipt of the request. If The Country Doctor, Ltd. intends to provide the accounting for disclosures, the medical records copies, or allows amendments to the PHI, and cannot do so within 60 days, then The Country Doctor, Ltd. informs the requester of such and provides a date that the request is expected to be fulfilled, with up to one 30-day extension permitted. A request for an accounting for disclosures or for medical records must be made in writing and sent to the practice. It should be marked "Attention: Privacy Officer."
The Country Doctor, Ltd. allows individuals to inspect and copy their PHI, documents all requests, responds to those requests in a timely fashion, informs individuals of their appeal rights when a request is rejected in whole or in part, and charges a reasonable fee for the copying of records and health disclosure information documents. Each request will be accepted or denied, with the requester notified. If a request is denied, the requester is informed if the denial is "reviewable" or not. The requester has the right to have any denial reviewed by a licensed health care professional who is designated by The Country Doctor, Ltd. as a reviewing official and who did not participate in the original decision to deny. The Country Doctor, Ltd. informs the requester of the decision of the reviewing official and adheres to the decision. The Country Doctor, Ltd. charges reasonable fees based on actual cost of fulfilling the request and based on the Illinois State Mandated Medical Records Copying Fees, with the appropriate charge for providing the requested documents stated to the requester in advance of providing the documents. If the requester agrees to pay the fee in advance, the records will be provided. Otherwise, the records will not be provided, unless the Privacy Officer determines that the charge is burdensome to the requester.
The Country Doctor, Ltd. accommodates all reasonable requests to keep communications confidential and to restrict disclosure of PHI. The Country Doctor, Ltd. determines the reasonableness based on the administrative difficulty of complying with the request. A request for confidential communications or restriction of PHI must be in writing, must specify an alternative address or other method of contact, and must provide information about how payment will be handled. The request must be addressed to the practice's privacy officer at The Country Doctor. No reason for the request needs to be stated. The Country Doctor, Ltd. will reject a request due to administrative difficulty: if no independently verifiable method of communication such as a mailing address or published telephone number is provided for communications, including billing; or if the requester has not provided information as to how payment will be handled. The Country Doctor, Ltd. will not refuse a request: if the requester indicates that the communication will cause endangerment; or based on any perception of the merits of the requestor's request.
At the first visit, The Country Doctor, Ltd. obtains a written authorization from a patient or the patient's representative for the use or disclosure of PHI for use for treatment, payment, or health care operations, but The Country Doctor, Ltd. will not get an authorization for the use or disclosure of PHI specifically allowed under the Privacy Rule in the absence of an authorization. The Country Doctor, Ltd. will provide a patient upon request a copy of any authorization initiated by The Country Doctor, Ltd. (as opposed to requested by the patient) and signed by the patient. The Country Doctor, Ltd. does not condition treatment of a patient on the signing of an authorization, except disclosure necessary to determine payment of a billing claim (excluding authorization for use or disclosure of psychotherapy notes); or provision of health care solely for purpose of creating PHI for disclosure to a third party (e.g., pre-employment or life insurance physicals). In Illinois, a specific written authorization is required to disclose or release of mental health treatment, alcoholism treatment, drug abuse treatment or HIV/Acquired Immune Deficiency Syndrome (AIDS) information. The Country Doctor, Ltd. allows an individual to revoke an authorization at any time, with the .revocation in writing and to be sent to the attention of the practice's privacy officer. The Country Doctor, Ltd. will be able to use or disclose the PHI to the extent practice has taken action in reliance on the authorization. The Country Doctor, Ltd. never requires an individual to waive any of his or her individual rights as a condition for the provision of treatment, except under very limited circumstances allowed under law.
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