Privacy Policy

HIPAA Policy To Protect Our Patients

The Health Insurance Portability and Accounting Act (“HIPAA”) Privacy Rule controls the use and disclosure of Protected Health Information (PHI) and protects the “individually identifiable health information” held or transmitted by an entity or its business associate, in any form or medium, whether electronic, on paper, or oral.

Implementation and Compliance with this rule in NOT OPTIONAL for our practice.

We are bound to give you the attached information and require you to read through the material thoroughly. Please read and familiarize yourself with the attached material and please feel free to print out a copy for your records.

For parents or legal guardians of patients, we require a consent form signed by you for the patient.

Use and Disclosure of Your Protected Healthcare Information

WelbyMD, may use or disclose your PHI or Protected Health Information to carry out Treatment, Payment or Healthcare Operations (TPO). Please refer to our Notice of Privacy Practices for a more complete description of such uses and disclosures.

Please feel free to review our Notice prior to acceptance. We reserve the right to revise our Notice at any time and any such Notice will be provided to you.

WelbyMD may at any time, mail to your residence any items that assist us in carrying out TPO, such as policy statements, patient statements or letters. By accepting this Notice, you are consenting to our use and disclosure of your PHI to carry out treatment, payment and healthcare operations.

Your agreement to this Notice may, at any time, be revoked in writing, except to the extent that we may have already made disclosures in credence to your prior acceptance.

HIPAA Notice of Privacy Practices (Notice)

Effective From:

This Notice describes exactly how information about you may be used and disclosed and how you can gain access to this information.

Please review the following document carefully:

This Notice describes how WelbyMD and the specialists, employees, trainees, and staff may use and disclose your medical information to carry out treatment, payment or healthcare operations and for other purposes that are described in this Notice.

We understand that the medical information about you and your health is personal and we are committed to protecting the said information about you. This Notice applies to all records of your care generated by this practice.

This Notice also describes your rights to access and control your medical information, that includes: your demographic information, that may identify you and that relates to your past, present and future, physical or mental health conditions and is related to healthcare services. Normally your medical information will include symptoms, examination and test results, diagnoses, treatment plans and plans for future care and treatment.

We are required by law to protect the privacy of your medical information and to follow the terms and conditions as aforementioned in the Notice. We may change the terms of the Notice at any time. The new Notice will then be effective for all medical information that we maintain at the said time.

We will provide you with the revised Notice if you request a revised copy to be sent to you in the mail or provided to you at your next service.

  • I. Uses and Disclosures of Protected Health Information
  • WelbyMD will ask you to illustrate your acceptance of this Notice and once you have accepted the said Notice, we will use or disclose your medical information as provided in this Notice.

    Your medical information may also be used and disclosed by WelbyMD and others that are involved in your care and treatment for the purpose of providing quality health care services to you.

    Your medical information may also be used or disclosed to pay your healthcare bills and to support the operations of WelbyMD.

    The following are examples of the different ways we use and disclose medical information. These are only examples for your information.

    • (a) Treatment:
    • We at WelbyMD use and disclose your medical information to provide, coordinate and manage your medical treatment or any other related services. This includes the coordination or management of your healthcare with a third party that has already obtained your permission to have access to your medical information.

      For example, we might disclose your medical information to a residential care facility that is taking care of you.

      We may also disclose your medical information to other physicians or doctors, who may be treating you, such as your primary physician or specialists, to ensure that all your medical data is up-to-date to diagnose or treat you.

    • (b) Payment:
    • We may use or disclose your medical information to obtain payment for the services you have received from us. We may provide your information to Medicare, Medicaid or other health insurance plans so that they can determine the eligibility of your treatment plan.

    • (c) Healthcare Operations:
    • WelbyMD may use or disclose medical information about you or your patient to support the business activities of WelbyMD. These activities include, but are not limited to, reviewing our treatment of your, employee performance reviews, licensing, marketing and fund-raising activities and conducting or arranging for other business activities.

      We may share your medical information with third party “business associates” that perform activities such as billing or transcriptions.

      Whenever an arrangement between our office and a business associate involves the use or disclosure of your medical information, we will have a written contract that contains terms that ask the “business associate” to protect your privacy. We may use or disclose your medical information to provide you with alternative treatment methods or other health-related benefits and services that we think you might be interested in.

      We may also use or disclose your medical information for other marketing activities, such as newsletters or email or letters about new services, treatment plans and offers we believe may be beneficial for you.

      You may contact us to request that these materials not be sent to you.

  • II. Permitted and Required Uses or Disclosures that may be made With your Consent, Authorization or Opportunity to Object
  • We at WelbyMD, may use and disclose your medical information in the following instances.

    You have the opportunity to agree or disagree to the use or disclosure of all or part of your medical information. If you are not present or able to agree or disagree to the use or disclosure of the medical information, then your physician may, using his/her professional judgment, determine whether the disclosure is in your best interest. In that case, only the medical information that is relevant to your immediate healthcare will be disclosed.

    • (a) Others Involved in your Healthcare:
    • Unless you disagree, we may disclose to a member of your family, a relative, guardian or close friend, your medical information that directly relates to the person’s involvement in your healthcare.

      If you disagree, then we may disclose such information that we determine, is in your best interest based on our professional judgment.

      We may also use or disclose medical information to notify or assist in notifying a family member or any other person that is responsible for your general health care or in the time of death.

      Finally, we may disclose your medical information to an entity in disaster relief efforts to coordinate the uses and disclosures to family or other individuals.

    • (b) Emergencies:
    • We at WelbyMD, may use or disclose your medical information for emergency treatment as well. If this happens, then WelbyMD shall obtain your consent as soon as reasonable time has passed after the delivery of treatment. If the practice is required by law to treat you and has attempted to obtain your consent but is unable to, then the practice may still use or disclose your medical information to treat you.

    • (c) Communication Barriers:
    • In case we try to obtain consent from you but cannot due to substantial communication barriers and in our professional judgment we determine that you will consent to it or agree to disclose it, then we may use or disclose your medical information.

    • (d) Patient Index:
    • Your PHI or Protected Healthcare Information may be updated in a patient index with details such as name, address, general information, and health issues may be mentioned. These may be disclosed during emergencies or natural calamities to ensure that quality healthcare is provided.

  • III. Permitted and Required Uses or Disclosures that may be made Without your Consent, Authorization or Opportunity to Object
  • We may use or disclose your medical information in the following situations without your consent or authorization.

    • (a) As Required by Law:
    • We may use or disclose your medical information where federal, state or local law asks us for the information. If such disclosure occurs we assure our patients that we will inform them of such disclosure and will try to keep the information to the bare minimum.

    • (b) As Required by Public Health:
    • We may disclose your medical details for public health activities and to a public health authority that is permitted by state or central law to collect or receive the information. This disclosure will be made for the purpose of controlling any disease, injury or disability.

    • (c) As Required by the CDC:
    • We may disclose your medical information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

    • (d) Health Oversight:
    • We may disclose your medical information to a health oversight agency for any activity that is authorized by law, such as audits, investigations, inspections and licensure. These activities are necessary for the government agencies to oversee the country’s healthcare system, to adjust the government benefit programs, other government regulatory programs and civil rights laws.

    • (e) Abuse or Neglect:
    • We may disclose your medical information to a governmental entity authorized by federal or state laws to receive such information if we believe that you have been a victim of abuse, neglect or domestic violence.

    • (f) As Required by Food and Drug Administration:
    • We may disclose your medical information to a person or company as required by the Food and Drug Administration to report adverse events, product defects or problems, biological product deviations, to help enable product recalls, to make repairs or replacement, or to conduct post marketing surveillance, as required.

    • (g) As Required during Legal Proceedings:
    • We may disclose any or all medical information in the course of any judicial or administrative proceeding when required by court order or administrative tribunal, and in certain conditions, in response to a subpoena, request or any other lawful process.

    • (h) As Required by Law Enforcement:
    • We may disclose medical information, to meet legal requirements, so long as they are applicable, for law enforcement purposes. The law enforcement purposes include: (i) in response to a court order, subpoena, warrant, summons or otherwise as required by law; (ii) to identify or locate a suspect, fugitive, material witness or missing persons; (iii) pertaining to victims of a crime; (iv) suspicion that death has occurred as a result of criminal conduct; (v) in the event that a crime occurs on the premises of the practice; (vi) medical emergency (not on the practice’s premises) where it is likely a crime has occurred.

    • (i) As Required by Coroners, Funeral Directors and Organ Donors:
    • We may disclose your medical details to a coroner or medical examiner for identification purposes, or to determine the cause of death or for the coroner or medical examiner to perform other duties as authorized by law. We may also disclose certain medical details to funeral directors as may be required.

      For organ donors, we may release medical information to the organizations that handle organ procurement or transplant or to an organ donation bank, as necessary to facilitate the proper harvesting of the organ or tissue.

    • (j) As Required for Research:
    • We may disclose your medical information to researchers where an institutional review board has reviewed the research proposal and established clear protocols to ensure the protection of your medical information.

    • (k) Required Uses and Disclosures:
    • Under the law, we must make disclosures to you and when required, to the Secretary of the Department of Health and Human Services, to investigate or determine our compliance with the requirements of Section 164.500.

    • IV. The following are statements of your Rights with Respect to your Medical Information and details of how you may Exercise these Rights:
      • (a) You have the right to request a restriction of use or disclosure of your PHI:
      • You have the right to ask us not to use or disclose your medical information for the purpose of treatment, payment or healthcare options. You may also request that certain parts of your medical information not be disclosed to family members or friends who may be involved in your care or for notification purposes as prescribed in this Notice.

        But you must state in writing the specific restriction requested and to whom you want the restriction to apply.

      • (b) You have the right to inspect and copy your medical information:
      • You may inspect or obtain a copy of medical information about you that has originated in our practice. You may be charged a reasonable fee for copying and mailing records. After you have made a written request to inspect or copy, our privacy officer will have 30 days to satisfy your request. If we deny your request, we will provide you with a written explanation for the denial.

      • (c) You have the right to request to receive confidential communications from us at a location other than your primary address:
      • You have the right to request that we send all our communication in regard to your medical information in a certain way or to a certain address. Please make sure to send all such requests to our Privacy Officer, and we will try our best to accommodate your request.

      • (d) You have the right to have your medical information amended:
      • If you feel that the medical information we have about you is incorrect or incomplete, you may request that we amend the same.

        If you wish to make an amendment, please contact our privacy contact in writing about the necessary changes.

      • (e) You have the right to receive an accounting of disclosures we have made, if any, of your medical information:
      • You have the right to request any other uses and disclosures of your medical information, not covered by this Notice or as required by law, can be made only with your written authorization. You may revoke this authorization at any time, except to the extent that our practice has taken any action in reliance to the use or disclosure as indicated by prior authorization.

      • (f) Complaints:
      • You may send your complaints to us or to the Secretary of Health and Human Services if you believe that your privacy rights have been violated by us. You may file a complaint with us by notifying our Privacy Officer.

        We will not retaliate against you for filing a complaint.

        Please indicate your acceptance of this Notice below. WelbyMD cannot provide services to you unless such acceptance is provided.