Notice of Privacy Practices
Effective Date of this Notice October 16, 2003

This Notice Describes How Health Information About You May Be Used and Disclosed and How You Can Get Access To This Information
PLEASE REVIEW IT CAREFULLY

If you have any questions about this notice, please contact our Privacy/Compliance Officer at P.O. Box 436866, Louisville, Kentucky 40253.

We are required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to protect the privacy of health information that may reveal your protected health information (PHI) and identity. We are also required by law to provide you a copy of this privacy notice and to make you aware of our legal duties and privacy practices regarding PHI. You may ask for a copy of this policy at any time.

How we use and Disclose Your Health Information
Eckman/ Freeman & Associates collects PHI in the process of providing Case Management Care and Service Coordination, as well as Payment and Health Care Operations for you. Under HIPAA, Eckman/ Freeman & Associates is not required to obtain your consent or authorization prior to using or disclosing your PHI for Case Management Care, Service Coordination, Payment or Health Care Operations. The following list gives examples of how Eckman/ Freeman & Associates may use or disclose your PHI for Case Management care, Service Coordination Payment and Health Care Operations.

  • For Case Management Care and Service Coordination
    Eckman/ Freeman & Associates discloses your PHI to health care providers involved in taking care of you, and they may in turn use that information to diagnose or treat you.

  • For Payments
    We use your health information or share it with others so that your physicians can obtain payment for the treatment they provide. For example, we may share information about you with your health insurance or worker's compensation company in order to obtain reimbursement for the services provided. We also may provide your PHI to business associates, such as billing companies, claims processing companies, and others that process our claims. Our business associates sign agreements that limit the use and disclosure of any PHI they receive from us or on our behalf.

  • For Health Care Operations
    We may use your health information or share it with others in order to conduct our normal health care operations. We may also provide PHI to our accountants, attorneys, consultants, or others to comply with laws affecting our business. These business associates are required to sign agreements restricting their use and disclosure of any PHI received from or on behalf of Eckman/ Freeman & Associates.

  • Appointment Reminders
    We may use and disclose your PHI to contact you and remind you of an appointment.

  • Treatment Options
    We may use and disclose your PHI to inform you of potential treatment options.

  • Health-Related Products and Services
    We may use and disclose your PHI to inform you of health-related products or services that may be of interest to you.

Required Uses and Disclosures for Non-Eckman/ Freeman & Associates Functions
We may also make the following disclosures without your consent or authorization for:

  • As Required By Law
    We may use or disclose your health information if we are required by law. We may also disclose your health information to the Secretary of Health and Human Services or his designee to determine our compliance with federal privacy laws.

  • Lawsuits And Disputes
    We may use and disclose your PHI in response to a court or administrative order, if you are involved in a lawsuit or similar proceeding. We also may disclose your PHI in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if an effort has been made to inform you of the request, or if an effort has been made to obtain an order protecting and limiting the use and disclosure of the information the party has requested.

  • Public Health Risks
    Our Practice may disclose your PHI to public health authorities who are authorized by law to collection information. For example, we may provide information to public health authorities that are authorized by law to collect medical information for public health investigations or to control the spread of various diseases. such as tuberculosis. We may also provide information to agencies responsible for registering vital statistics, including births and deaths. We may also provide your PHI to the proper state agencies authorized to investigate suspected victims of abuse, neglect, or domestic violence.

  • Health Oversight Activities
    We may disclose your PHI to a health oversight agency for activities authorized by law. Oversight activities can include, for example, investigations, inspections, audits, surveys, licensure, and disciplinary actions; civil, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws, and the health care system in general. We may also disclose your PHI to a government benefit program so that it can determine your eligibility under that program.

  • Law Enforcement
    Our Practice may release PHI if asked to do so by a law enforcement official. For example, if you are the victim of a gunshot wound or other type of injury that must be reported to law enforcement, we may disclose your PHI as required by law. We may also disclose your PHI to law enforcement officials if disclosure appears necessary to alert law enforcement to the commission or location of a crime, or the identity of the perpetrator. Finally, if you are the suspected victim of a crime that does not have to be reported, we may disclose your PHI to a law enforcement official who requests the information, but (a) only if you agree, or (b) if you are unavailable or incapacitated at the time, only if the law enforcement official tells us that the information is needed quickly for law enforcement activity and is not intended to be used against you. We will disclose your PHI under these circumstances only if we believe at the time that disclosure is in your best interests.

  • Deceased Patients
    We may release PHI to a medical examiner to identify the deceased or to identify the cause of death. We may also disclose PHI to the extent it is necessary for a funeral director to perform his or her duties with respect to a deceased person.

  • Military and National Security
    We may disclose your PHI if you are member of the military (including veterans) and if required by the appropriate military authorities. We may also disclose your PHI, when appropriate, for national security and intelligence purposes, and for the protection of the President of the United States or other top governmental officials.

  • Inmates
    We may disclose your PHI to correctional or law enforcement officials if you are an inmate or under the custody of a law enforcement official. Disclosure for these purposes would be necessary: (a) for the institution to provide health care services to you, (b) for the safety and security of the institution, and/or (c) to protect your health and safety or the health and safety of other incarcerated individuals.

  • Workers' Compensation
    We may release your PHI for workers' compensation and similar programs as authorized by such programs.

  • Research
    We may use and disclose your PHI for research purposes in certain limited circumstances. For example, we may disclose PHI to a researcher, whose project has met the safeguards and requirements of a research approval board after it has considered the need for patient privacy, as long as the information will be protected and not be used for any other purpose.

  • Serious and Imminent Threats of Harm
    We may disclose your PHI if we believe, in good faith, that such disclosure will prevent or lessen a serious and imminent threat of harm to the health and safety of a person or the general public. For example, if you have a medical condition that poses a serious threat to your health or to the health of another, we may disclose relevant information to someone who can help prevent that threat.

  • Organ or Tissue Donations
    If you are an organ or tissue donor, we may disclose your PHI to organ procurement agencies in order to help with the donation process.

Potential Impact of State Law
In some situations, the federal privacy laws do not preempt (or take precedence over) state privacy laws that give you greater privacy protections. As a result, the privacy laws of a particular state might impose a privacy standard under which we will be required to operate.

Personal Representative or Authorization
If a personal representative has been appointed or authorized by you to act on your behalf, we may provide your PHI to that personal representative.

If you become incapacitated or incompetent, your PHI will be treated the same way it was treated when you were capable and competent. For example, if an Authorization is required, your personal representative or surrogate health care decision-maker will be treated in the same manner as you would be treated.
Your health information will remain protected even after your death. If an Authorization is required for the release of your PHI after your death, the executor or administrator of your estate must sign the Authorization.

Other Uses and Disclosures
In situations not described above or otherwise permitted or required by law, we will generally ask for written authorization before using or disclosing your PHI. If you choose to sign an authorization form to disclose your PHI, you may later revoke that authorization in writing.

Uses and Disclosures of your PHI that Frequently Require Your Authorization
The law specially protects certain types of PHI. Except when the law expressly provides otherwise, certain information cannot be used and/or disclosed without a valid written Authorization signed by you. This information includes (a) psychotherapy notes, (b) records related to human immunodeficiency virus (HIV), and (c) records relating to mental health treatment, or treatment for drug or alcohol abuse.

Your Rights to Access and Control of your PHI
We want you to know that you have the following rights to access and control you health information.

  • Right To See and Receive Copies of your PHI
    When allowed by applicable state and federal law, you have the right to receive a copy of the PHI Eckman/ Freeman & Associates maintains for you after making a requesting writing for this information. We will review and respond to your request within 30 days.

  • Right To Correct or Update your PHI
    If you believe that the health information we have about you contains a mistake, you may request in writing, that we correct the information. To request an amendment, please write to Eckman/ Freeman & Associates, Attn: Privacy/ Compliance Officer, P.O. Box 436866, Louisville, Kentucky. Your request should include the reasons why you think we should make the changes. We will respond to your request within 60 days. If your request is denied, we will provide an explanation of the reasoning and give you an opportunity to appeal.

  • Right To An Accounting Of Disclosures
    You have a right to receive a list of certain instances in which we have disclosed your PHI. This list will not include disclosures of PHI for treatment, payment, healthcare operations, or disclosures made based on your authorization. We will respond to your request within 60 days of receipt and may apply a reasonable charge.

  • Right To How We Communicate PHI
    You have the right to request that our Practice communicate with you about your health related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home rather than work. Our Practice will accommodate reasonable requests. You do not need to give a reason for your request.

  • Right to Request Limits to Uses and Disclosures of your PHI
    You have the right to request that we limit how we use and disclose your PHI, except where we are legally required to disclose information. We will consider your request, but we are not required to agree to it.

  • Right to Obtain a Copy of this Notice
    You have the right to request and receive a copy of this notice by email or by paper copy.

  • Right to Complain
    If you think we may have violated your privacy rights, you may file a complaint with our Privacy/ Compliance Officer at Eckman/ Freeman & Associates, Attn: Privacy/ Compliance Officer, P.O. Box 436866, Louisville, Kentucky 40253. You also may send a written complaint to the Secretary of the Department of Health and Human Services. We will take no retaliatory action against you if you file a complaint about our privacy practices.

Changes to Eckman/ Freeman & Associates Privacy Notice
We reserve the right to make changes to this notice and our privacy policies. Changes adopted will apply to PHI we maintain relating to you. When changes are made, we will promptly update this notice and post it on our website. You may obtain a copy of this notice by contacting our Privacy/Compliance Officer.

Other Uses and Disclosures of Your PHI
We have provided you with many examples of how your PHI may be used and disclosed by our Practice, either with or without your Authorization. It is not possible for us to list every possible use and disclosure of your PHI, however. Therefore, if you have any questions about specific uses or disclosures, please contact our Compliance Officer at the address listed below.

IF YOU HAVE ANY QUESTIONS REGARDING OUR NOTICE OF PRIVACY PRACTICES, OR NEED TO EXERCISE YOUR RIGHTS AS DESCRIBED ABOVE, PLEASE CONTACT:

Eckman/ Freeman & Associates
Privacy/ Compliance Officer
P.O. Box 436866
Louisville, Kentucky 40253
Phone: 800-509-6277