Privacy Policy

JACKSONVILLE HEART CENTER

NOTICE OF PRIVACY PRACTICES - PHI WAIVER

THIS NOTICE DESCRIBES HOW PROTECTED MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

1) The Jacksonville Heart Center (JHC) is permitted to make uses and disclosures of protected health information for treatment, payment and health care operations, as described in the following examples:

  • For treatment - Medical information including, but not limited to, physician or nursing staff documentation, diagnostic test results, patient social and family history, medication listings, and demographic and health insurance information may be disclosed or used when providing any health care service to an individual and when coordinating such care with other facilities, health care providers, ancillary health services, and health insurers when applicable for the betterment of the patient.
  • For payment - Medical information including, but not limited to, physician or nursing staff documentation, diagnostic test results, patient social and family history, medication listings, and demographic and health insurance information may be disclosed or used when processing health care claims in order to receive payment for services rendered.
  • For health care operations - Medical information including, but not limited to, physician or nursing staff documentation, diagnostic test results, patient social and family history, medication listings, and demographic and health insurance information may be disclosed or used when assisting or participating in an individual's health insurance carriers quality assurance programs, utilization management review and data analysis, benefit management activities, accreditation and administrative activities and routine claims processing.

2) The Jacksonville Heart Center (JHC) is permitted and at times required, under specific circumstances, to use or disclose protected health information without individual patient's written authorization.

3) Other uses and disclosures will be made only with the individual patient's written authorization, and individuals may revoke such authorization.

4) The Jacksonville Heart Center (JHC) may contact individual's to provide appointment reminders and information about treatment alternatives or other health related benefits and services, including billing and health care operations, that may be of interest to the individual.

5) The Jacksonville Heart Center may use public, outside, sources to obtain demographic information if not provided by the patient in a timely manner.

6) The Jacksonville Heart Center (JHC) may also disclose protected health information to group health plans or a health insurance issuer or HMO in order to facilitate the billing process and health care operations.

7) Individuals have the following rights regarding protected health information:

  • The right to request restrictions on certain uses and disclosures of protected health information. JHC is not required to agree to a requested restriction, however.
  • The right to receive confidential communications of protected health information, as applicable.
  • The right to inspect and copy, amend and receive an accounting of disclosures of protected health information, as provided in the Privacy Regulation.
  • The right to obtain a paper copy of the Privacy Notice from the Jacksonville Heart Center upon request.

8) The Jacksonville Heart Center is required by law to maintain the privacy of protected health information and to provide individuals with notice of its legal duties and Privacy practices with respect to protected health information.

9) The Jacksonville Heart Center is required to abide by the terms of the Notice currently in effect, but reserves the right to modify or change the terms of this Notice. The new Notice provisions will be effective for all protected health information that it maintains and will be posted in each office and provided to all patients via the website (www.jaxheart.com) and paper copy upon arrival for treatment or services.

10) Individuals may complain to the Jacksonville Heart Center and to the Secretary of the Department of Health and Human Services at (404) 562-7886, without fear of retaliation by JHC, if they believe their privacy rights have been violated. Complaints should be provided in writing to either the Office Administrator of the location where the complaint is derived, or to the JHC Corporate Office, ATTN: Privacy Official, 1905 Corporate Square Blvd., Jacksonville, FL 32216.

11) The Jacksonville Heart Center's contact person for matters relating to complaints is:

  • JHC Beach Location: Office Administrator, 1361 13th Ave. South, #270, Jacksonville Beach, FL 32250; #904-241-7147.
  • JHC Pavilion Location: Office Administrator, 836 Prudential Drive, Suite 1700, Jacksonville, FL 32207; #904-398-0125.
  • JHC Mandarin Location: Office Administrator, 14546 St. Augustine Road., Suite 103, Jacksonville, FL 32258; #904-338-0852.
  • JHC Sleep Location: Office Administrator, 6930 Bonneval Road, Suite 2, Jacksonville, FL 32216; #904-854-6899.
  • JHC Corporate Office: Privacy Official/Human Resources Manager, 1905 Corporate Square Blvd., Jacksonville, FL 32216; #904-720-0799.

12) This Notice is in effect on April 1, 2003.

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