Chitter Chatter, LLC

Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to the information. Please review it carefully.

If you have any questions about this Notice, please contact the Privacy Officer.
Jenna Thomas 919-609-5643

We are committed to protect the privacy of your personal health information (PHI).

This Notice of Privacy Practices (Notice) describes how we may use within our practice or network and disclose (share outside of our practice or network) your PHI to carry out treatment, payment or health care operations. We may also share your information for other purposes that are permitted or required by law. This Notice also describes your rights to access and control your PHI.

We are required by law to maintain the privacy of your PHI. We will follow the terms outlines in the Notice.

We may change our Notice, at any time. Any changes will apply to all PHI. Upon your request, we will provide you with any revised Notice by:

• Posting the new Notice in our office
• If requested, making copies of the new Notice available in our office or by mail
  
  

Uses and Disclosure of Protected Health Information

1. Treatment-Your PHI may be used and disclosed by your physician, our office staff and others outside our office that are involved in your care and treatment for the purpose of providing health care services to you. For example: Your PHI may be shared with home health agencies to provide care for you.
2. Payment-Your PHI may be used to seek payment from your health plan, from other sources of coverage, such as an automobile insurer, or from credit card companies that you may use to pay for services. For example: Your insurance company may request and receive information on dates of service, the services provided, and the medical conditions being treated.
3. Health Care Operations-Your PHI may be used as necessary to support the day-to-day activities and management of Cornerstone Pediatric and Adolescent Medicine. For example: information on the services you received may be used to support budgeting and financial reporting, and activities to evaluate and promote quality of care within our organization.
4. Law Enforcement-Your PHI may be disclosed to law enforcement agencies who support government audits and inspections, to facilitate law-enforcement investigations, and to comply with government- mandated reporting.
5. Public Health Reporting-Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the state’s public health department.
   
   

Your PHI may be used or disclosed in other ways without your permission:

• Health oversight agencies
• Legal proceedings
• Coroners, funeral directors
• Medical research
• Special government purposes
• Correctional institutions
• Workers Compensation
• Business Associates
• Health Information Exchange
• Fundraising activities
• Treatment alternatives
• Appointment reminders
  
  

We may use or disclose your PHI in the following situations UNLESS you object:

• We may share your information with friends or family members, or other persons directly identified by you at the level they are involved in your care or payment of services. If you are not present or able to agree/object, the healthcare provider using professional judgment will determine if it is in the best interest to share the information. For example, we may discuss post procedure instructions with the person who drove you to the facility unless you tell us specifically not to share the information.
• We may use or disclose protected health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition or death.
• We may use or disclose your PHI to an authorized public or private entity to assist in disaster relief efforts.
  
  

The following uses and disclosures of PHI require your written authorization:

• Marketing
• Disclosures of for any purposes which require the sale of your information
• Release of psychotherapy notes: Psychotherapy notes are notes by a mental health professional for the purpose of documenting a conversation during a private session. This session could be with an individual or with a group. These notes are kept separate from the rest of the medical record and do not include: medications and how they affect you, start and stop times of counseling sessions, types of treatments provided, results of tests, diagnosis, treatment plan symptoms, or prognosis.
  
  

All other uses and disclosures not recorded in the Notice will require a written authorization from you or your personal representative.

Written authorization simply explains how you want your information used and disclosed. Your written authorization may be revoked at any time, in writing. Except to the extent that your doctor or this practice has used or released information based on the direction provided in the authorization, no further use or disclosure will occur.

Your Privacy Rights

You have certain rights related to your protected health information. All requests to exercise your rights must be made in writing. You must request form from a staff member and submit to the Privacy Officer or Medical Records for approval.

• You have the right to see and obtain a copy of your protected health information.
• You have the right to request a restriction of your protected health information.
• You have the right to request for us to communicate in different ways or in different locations.
• You may have the right to request an amendment of your health information.
• You have the right to a list of people or organizations who have received your health information from us.
  
  

Additional Privacy Rights

• You have the right to obtain a paper copy of this notice from us, upon request. We will provide you a copy of this Notice the first day we treat you at our facility. In an emergency situation we will give you this Notice as soon as possible.
• You have a right to receive notification of any breach of your protected health information.
  
  

Complaints

If you think we have violated your rights or you have a complaint about our privacy practices you can contact:

Jenna Thomas

Chitter Chatter, LLC

4820 Studbury Hall Ct.

Wake Forest, NC 27587

You may also complain to the United States Secretary of Health and Human Services if you believe your privacy rights have been violated by us.

If you file a complaint we will not retaliate against you for filing a complaint.

This notice was updated on September 23, 2013 according to the Omnibus Regulations.