HIPAANoticeofPrivacy_1_ - Effective Date of this Notice:_...

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Effective Date of this Notice:____________ © Gates, Moore & Company 1 October 2002 Georgia Institute of Technology Health Services Notice of Privacy Covered Entities As Required by the Privacy Regulations Created as a Result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU (AS A PATIENT OF THIS COVERED ENTITY ) MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY. A. OUR COMMITMENT TO YOUR PRIVACY Our covered entity is dedicated to maintaining the privacy of your individually identifiable health information (IIHI). In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We also are required by law to provide you with this notice of our legal duties and the privacy covered entities that we maintain in our covered entity concerning your IIHI. By federal and state law, we must follow the terms of the Notice of Privacy Covered Entities that we have in effect at the time. We realize that these laws are complicated, but we must provide you with the following important information: · How we may use and disclose your IIHI · Your privacy rights in your IIHI · Our obligations concerning the use and disclosure of your IIHI The terms of this notice apply to all records containing your IIHI that are created or retained by our covered entity. We reserve the right to revise or amend this Notice of Privacy Covered Entities. Any revision or amendment to this notice will be effective for all of your records that our covered entity has created or maintained in the past, and for any of your records that we may create or maintain in the future. Our covered entity will post a copy of our current Notice in our offices in a visible location at all times, and you may request a copy of our most current Notice at any time. B. IF YOU HAVE QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT: Privacy Officer, 740 Ferst Drive Atlanta, GA 30332 404-894-0474 C. WE MAY USE AND DISCLOSE YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION (IIHI) IN THE FOLLOWING WAYS The following categories describe the different ways in which we may use and disclose your IIHI.
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Effective Date of this Notice:____________ © Gates, Moore & Company 2 October 2002 1. Treatment . Our covered entity may use your IIHI to treat you. For example, we may ask you to have laboratory tests (such as blood or urine tests), and we may use the results to help us reach a diagnosis. We might use your IIHI in order to write a prescription for you, or we might disclose your IIHI to a pharmacy when we order a prescription for you. Many of the people who work for our covered entity including, but not limited to, our doctors and nurses may use or disclose your IIHI in order to treat you or to assist others in your treatment. Additionally, we may disclose your IIHI to others who may assist in
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This note was uploaded on 02/08/2011 for the course HPS 1040 taught by Professor Surrency during the Fall '08 term at Georgia Institute of Technology.

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HIPAANoticeofPrivacy_1_ - Effective Date of this Notice:_...

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