Notice of Privacy Practices
John B. Crider, M.D., L.L.C. · Family Medical Clinic, Arab, Alabama
This notice describes how medical 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 Officer, John B. Crider, M.D., at (256) 586-4127.
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment, or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. Protected health information is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health and related health care services.
We are required by law to maintain the privacy of your protected health information and to provide you with this notice of our legal duties and privacy practices. We are required to abide by the terms of this notice. We may change the terms of our notice at any time, and a new notice will be effective for all protected health information we maintain at that time. Upon your written request, we will provide you with any revised notice.
Uses and disclosures for treatment, payment, and health care operations
We use your protected health information as part of providing your care. Treatment: we use and disclose your information to provide, coordinate, or manage your health care, such as sharing information with a specialist you are referred to. Payment: we use your information as needed to obtain payment for your health care services, such as obtaining approval from your health plan. Health care operations: we use your information to support the everyday business activities of the practice, such as quality assessment, training, and contacting you with appointment reminders. We share information with third party business associates, such as billing services, only under written contracts that protect your privacy.
Uses and disclosures that allow you to object
Unless you object, we may use or disclose your protected health information in certain situations, including to family members or friends involved in your care, for notification of your location or condition, for disaster relief efforts, and in emergencies when it is in your best interest as determined by your physician's professional judgment.
Uses and disclosures that do not require your authorization
The law permits or requires us to use or disclose your protected health information without your authorization in certain situations, including:
- When required by law
- For public health activities
- For health oversight activities such as audits and inspections
- To report abuse, neglect, or domestic violence
- For Food and Drug Administration requirements
- In legal proceedings and in response to lawful court orders or subpoenas
- For law enforcement purposes when legal requirements are met
- To coroners, medical examiners, and funeral directors
- For organ, eye, or tissue donation
- For approved research
- To prevent a serious and imminent threat to health or safety
- For specified military and veterans activities
- For workers' compensation claims
- To notify a person who may have been exposed to a communicable disease
Other uses and disclosures will be made only with your written authorization, which you may revoke in writing at any time, except where we have already acted in reliance on it.
Your rights
- You may request a restriction on how your information is used or disclosed. We are not required to agree to every request.
- You may request to receive communications about your information in a confidential manner or at an alternative location.
- You have the right to inspect and copy your protected health information, subject to certain exceptions. A reasonable fee may apply for copies.
- You have the right to request an amendment to your information. We may deny the request in certain cases, and you may file a statement of disagreement.
- You have the right to receive an accounting of certain disclosures we have made.
- You have the right to obtain a paper copy of this notice upon request.
To exercise any of these rights, please contact our office in person or by phone.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. You may file a complaint with us by notifying our Privacy Contact, John B. Crider, M.D., at (256) 586-4127. We will not retaliate against you for filing a complaint.
This notice was published and became effective August 21, 1996.