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It is the policy of our practice that all physicians
and staff preserve the integrity and the confidentiality of protected health
information (PHI) pertaining to our patients. The purpose of this policy is to
ensure that our practice and its physicians and staff have the necessary
medical and PHI to provide the highest quality medical care possible while
protecting the confidentiality of the PHI of our patients to the highest degree
possible. Patients should not fear about providing information to our practice
and its physicians and staff for purposes of treatment, payment and healthcare
operations (TPO). To that end, our practice and its physicians and staff
will:
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Adhere to the standards set forth in the Notice
of Privacy Practices. |
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Collect, use and disclose PHI only in
conformance with state and federal laws and current patient covenants and/or
authorizations, as appropriate. Our practice and its physicians and staff will
not use or disclose PHI for uses outside of practice TPO, such as marketing,
employment, or life insurance applications without an authorization from the
patient. |
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Use and disclose PHI to remind patients of their
appointments only with their consent. |
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Recognize that PHI collected about patients must
be accurate, timely, complete, and available when needed. Our practice and its
physicians and staff will: ~ Implement reasonable measures to protect
the integrity of all PHI maintained about patients. |
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Recognize that patients have a right to privacy.
Our practice and its physicians and staff respect the patient's individual
dignity at all times. Our practice and its physicians and staff will respect
the patient's privacy to the extent consistent with providing the highest
quality medical care possible and with the efficient administration of the
facility. |
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Act as responsible information stewards and
treat all PHI as sensitive and confidential. Consequently, our practice and its
physicians and staff will: ~ Treat all PHI data as confidential in
accordance with professional ethics, accreditation standards, and legal
requirements. ~ Not disclose PHI data unless the patient (or his or her
authorized representative) has properly consented to or authorized the release,
or the release is otherwise authorized by law. |
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Recognize that, although our practice "owns" the
medical record, the patient has a right to inspect and obtain a copy of her
PHI. In addition, patients have a right to request an amendment to her medical
record if she believes her information is inaccurate or incomplete. Our
practice and its physicians and staff will: ~Permit patients access to
their medical records when their written requests are approved by our practice.
If we deny the patient's request, then we must inform the patient that she may
request a review of our denial. In such cases, we will have an on-site
healthcare professional review the patient's appeals. ~Provide patients an
opportunity to request the correction of inaccurate or incomplete PHI in their
medical records in accordance with the law and professional standards.
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All physicians and staff of our practice must
adhere to this policy. Our practice will not tolerate violations of this
policy. Violation of this policy is grounds for disciplinary action, up to and
including termination of employment and criminal or professional sanctions in
accordance with our practice's personnel rules and regulations. |
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Our practice may change this privacy policy in
the future. Any changes will be effective upon the release of a revised privacy
policy and will be made available to patients upon request.
Instructions: 1. Print this form, then fax or mail it. 2.
Fax (919)781-9247 3. Mail Address
North Raleigh
11001 Durant Road
Suite 100
Raleigh, NC 27614
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