Kids Docs Pediatrics

Notice Of Privacy Practices


Protected Health Information (PHI), about you, is obtained as a record of your contacts/visits for healthcare services at Kids Docs Pediatrics. Specifically, “Protected Health Information” is information about you, including demographic information (i.e. Name, Address, Phone etc.) that may identify you and relates to your past, present or future physical or mental health and related health care services.

Kids Docs Pediatrics is required to follow specific rules on maintaining the confidentiality of your PHI, how our staff uses your information, and how we disclose/share this information with other healthcare professionals/entities involved in your care and treatment, obtain payment for services you receive, manage our healthcare operations and for other purposes that are permitted or required by law.

Your Rights under The Privacy Rule

Following is a statement of your Rights, under the Privacy Rule, in reference to your PHI. Please feel free to discuss any issues with our clinic.

You have a Right to Receive and are Required to provide you with a copy of this Notice of Privacy Practices

We are required to follow the terms of this notice. We reserve the Right to Change the terms of our Notice, at any time. If required, new versions of this Notice will be effective for all PHI that we maintain at that time. Upon request, we will provide you with a revised Notice of Privacy Practices, if you call our Clinic a request that a revised copy be mailed to you or ask for it at the time of your appointment.

You have the Right to Authorize other use and disclosure

This means that you have the Right to authorize or deny any other sue or disclosure of PHI not specified in this Notice. You may revoke an authorization, at any time, in writing, except to the extent that your Physician or our Office has taken an action in reliance on the use of disclosure indicated in the authorization.

You have the Right to Designate a Personal Representative

This means that you may designate a person with the delegated authority to consent to, or authorize the use or disclosure of PHI

You have the Right to Inspect and Copy your PHI

This means that you may inspect and obtain a copy of PHI about you that is contained in your patient records. In certain cases, we may deny your request.

You have the Right to Inspect a Restriction of your PHI

This means you may ask us, in writing, not to use or disclose any part of your PHI for the purpose of treatment, payment or healthcare operations. You may also request that any part of your PHI not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy. In certain cases, we may deny your request for a restriction.

You may the Right to have us amend your PHI

This means that you may request an amendment of your PHI for as long as we maintain this information. In certain cases, we may deny your request for amendment.

You have the Right to Request a Disclosure accountability

This means that you may request a listing of your PHI disclosures we have made to entities or persons outside of our clinic


You may register your complaint to the Clinic or to the Secretary of Health and Human Services, if you believe your Privacy Rights have been violated by us. You may file a complaint with us by notifying our Office Manager

How We May use/Disclose PHI

Following are some examples of uses and disclosures of your PHI that we are permitted to make

For Treatment

We may use and disclose your PHI to provide, coordinate, or manage your health care needs and any other services. This includes, the coordination or management of your health care with a 3rd Party that is involved in your care and treatment. For example, we would disclose your PHI, necessary, to a Pharmacy that would fill your prescriptions. We will also disclose PHI to other Physicians who may be involved in your care and treatment. We may also call you by name in the waiting room when your Physician is ready to see you. We may use or disclose your PHI as necessary, to contact you to remind you or your appointment. We may contact you phone, and/or other means, to provide results from exams or tests, and to provide information that describes or recommends treatment alternatives regarding your care. And, we may contact you to provide information about health-related benefits and services offered by our clinic.

For Payment

Your PHI will be used, as needed, to obtain payment(s) for your healthcare services. This includes, but is not limited to, activities that your health insurance plan may undertake before it approves or pays for the healthcare service(s) we recommend for you, such as, making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities.

For Healthcare Operations

We may use or disclose, as needed, your PHI in order to support the business activities of our practice. This includes, but is not limited to, business planning and development, quality assessments and improvement, medical reviews, legal services, and auditing functions. If also includes Education, Provider Credentialing, Certification, Underwriting, Rating, or other insurance related activities. Additionally, it includes business administration activities, such as customer service, compliance with Privacy requirements, internal grievance procedures, due diligence in connection with the sale or transfer of assets, and creating un-identifiable information.

Other Permitted and Required Uses and Disclosures

We may also use and disclose your PHI in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of your PHI

To Others Involved in your Healthcare

Unless you object, we may disclose to a member of your family, a relative, a close friend or any person you identify, your PHI that directly relates to that person’s involvement in your healthcare. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgement. We authorized), in certain conditions in response to a subpoena, discovery request or other lawful process.

As Required by Law

We may use or disclose your PHI to the extent that the use or disclosure is required by Law

For Public Health

We may disclose your PHI for public health activities and purposes, to a Public Health Authority that is permitted by Law to collect or receive this information

For Communicable Diseases

We may disclose your PHI, 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

For Health Oversight

We may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections

In Cases of Abuse and/or Neglect

We may disclose your PHI to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your PHI if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.

To the Food and Drug Administration

We may disclose your PHI to a person or company required by the FDA, to report adverse events, product defects or problems, biologic product deviations, tracking products, to enable product recalls, to make repairs or replacements, or to conduct post marketing surveillance, as required.

For Legal Proceedings

We may disclose PHI in the course of any judicial or administrative proceedings, in response to an order of a court, or administrative tribunal (to the extent such disclosure is expressly

To Law Enforcement

We may disclose PHI, so long as applicable requirements are met, for Law Enforcement Purposes

To Coroners, Funeral Directors, and Organ Donations

We may disclose PHI to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose PHI to a funeral director, as authorized by law, in order to permit the funeral director to carry out their duties. PHI may be used and disclosed for cadaveric organ, eye or tissue donation purposes

In Cases of Criminal Activity

Consistent with applicable federal and state laws, we may disclose your PHI, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose PHI if it is necessary for law enforcement authorities to identify or apprehend an individual.

For Military Activity and National Security

When the appropriate conditions apply, we may use or disclose PHI of individuals who are Armed Forces Personnel (1) for activities deemed necessary by appropriate military command authorities: (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if you are a member of that foreign military service.

For Worker’s Compensation

Your PHI may be disclosed by us as authorized to comply with worker’s compensation laws and other similar legally-established programs

When an Inmate

We may use or disclose your PHI if you are an inmate of a correctional facility and your physician created or received your PHI in the course of providing care to you

Required Uses and Disclosures

Under the law, we must make disclosures about you, as and when required, by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of the Privacy Rule