Our Privacy Policies
PedIM Healthcare™ Notice of Privacy Practices
Pediatric & Internal Medicine Specialists, P.A.
1990 N. Prospect Avenue Lecanto, FL 34461
Dr. Dacelin St.Martin, M.D., F.A.A.P. & Lilia Shammas, MD
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU MAY GET ACCESS TO THIS INFORMATION. PLEASE READ IT CAREFULLY.
PedIM Healthcare is dedicated to protecting your medical information. We are required by law to maintain the privacy of protected health information and to provide you with this Notice of our legal duties and privacy practices with respect to protected health information. PedIM Healthcare is required by law to abide by the terms of this Notice.
HOW YOUR MEDICAL INFORMATION WILL BE USED AND DISCLOSED:
The following describes how PedIM Healthcare may use your protected health information for treatment, payment or health care operations.
PedIM Healthcare may use health information about you to provide you with health care treatment or services. PedIM Healthcare may disclose health information about you to doctors, nurses, or other essential personnel who are involved in your care. For example, our office may disclose health information about you to a specialist who has been asked to provide a consultation regarding your care.
PedIM Healthcare may use and disclose health information about you to receive payment for services provided to you. For example, our office may disclose certain information to our health insurance provider in order to receive payment for services provided to you. Under Florida law we must obtain your written consent in order to submit claims for services provided to you. While we do not condition treatment on your signing of our general consent form, failure to sign may force us to decline you as a new patient or discontinue you as an active patient.
Health Care Operations:
PedIM Healthcare may use and disclose health information about you for operational purposes related to our office. These uses and disclosures are necessary to run our office and make sure that all of our patients receive quality care. For example, PedIM Healthcare may use your protected health information in our peer review activities. Such activities are confidential and are designed to assist our office in maintaining a high stand of medical care.
We may also and/or disclose your information in accordance with federal and state laws for the following purposes:
We may contact you to provide appointment reminders.
We may contact you with information about treatment alternatives or other health related benefits and services that may be of interests to you.
Disclosure to Department of Health and Human Services:
We may disclose medical information when required by the United States Department of Health and Human Services as part of an investigation or determination of our compliance with relevant laws.
Family and Friends:
Unless you object, we may disclose your medical information to immediate family members or other relatives or close personal friends as authorized by you, when the medical information is directly relevant to that person’s involvement with your care.
Unless you object, we may use or disclose your medical information to notify a family member, a personal representative, or another person responsible for your care of your location, general condition, or death.
We may disclose your medical information to a public entity, such as the American Red Cross, for the purpose or coordinating with that entity to assist in disaster relief efforts.
Health Oversight Activities:
We may disclose your medical information to a health oversight agency for oversight activities authorized by law, including audits, investigations, inspections, licensure, or disciplinary actions, administrative and/or legal proceedings.
Abuse or Neglect:
We may disclose your medical information when it concerns abuse, neglect, or violence to you in accordance with federal and state law.
Judicial and Administrative Proceedings:
We may disclose your medical information in the course of certain judicial or administrative proceedings and as required by law.
We may disclose your medical information for certain law enforcement purposes as required by law.
Specialized Government Functions:
We may disclose medical information as required by law for certain specialized government functions including: certain military and veterans activities, national security and intelligence activities, protective services for the President and others, and correctional institution and law enforcement custodial situations.
Coroners, Medical Examiner’s, and Funerals Directors:
We may disclose your medical information to a coroner, medical examiner, or a funeral director.
If you are an organ donor, we may disclose your medical information to an organ donation and procurement organization.
We may use or disclose your medical information for certain research purposes if an Institutional authorization, the review is preparatory to research or the research is on only decedent’s information.
Public Health Activities:
We may use or disclose your medical information for public health activities, including the reporting of disease, injury, vital events and the conduct of public health surveillance, investigation and/or intervention.
We may use or disclose your medical information to prevent or lessen a serious threat to the health or safety or another person or to the public.
We may disclose your medical information as authorized by laws relating to workers compensation or similar programs.
We may disclose your health information to a business with whom we contact to provide services on our behalf. To protect your health information, we require our business associates with whom we contact to provide services on our behalf. To protect your health information, we require our business associates to appropriately safeguard the health information of our patients.
MINIMUM NECESSARY INCIDENTAL DISCLOSURES AND SUPER CONFIDENTIAL INFORMATION
Our staff will not use or disclose your medical information unless it is necessary to perform their jobs. In other words, access to your medical information will be based on a need to know. When your medical or payment information is disclosed, only the necessary amount of medical or other information needed to accomplish the recipients lawful purpose will be disclosed. Additionally, while using or disclosing your confidential information we will take every reasonable step to prevent such information from being inadvertently disclosed. Finally, we will follow both state and federal laws related to the use and disclosure of super-confidential information such as HIV/AIDS, alcohol/substance abuse and mental health records.
AUTHORIZATIONS AND CONSENTS:
We will not use or disclose your medical information for any other purpose other than treatment, payment, or health care operations without your written authorization. Once given, you may revoke your authorization in writing at any time. To request a Revocation of Authorization form you may contact the office’s Privacy Contact, or office manager. Additionally, the time of your first office visit you will be asked to sign a general consent/records release. This consent is required under Florida law in order for our office to submit claims and other information needed to receive for services rendered to you or your family.
YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION:
You have the following rights with respect to your medial information:
- You may ask us to restrict certain uses and disclosures for your medical information. We are not required to agree to your request, but if we do we will honor it.
- You have the right to receive communications from us in a confidential manner.
- Generally, you may inspect and copy your medical information. This right is subject to certain specific exceptions, and you may be charged a reasonable fee for any copies of your records.
- You may ask us to amend your medical information. We may deny your request for certain specific reasons. If we deny request, we will provide you with a written explanation for the denial and information regarding further rights you may have at that point.
- You have the right to receive an accounting of the disclosures of your medical information made by PedIM Healthcare during the last 6 yrs. Except for disclosures for treatment, payment or healthcare operations, disclosures which you authorized and certain other specific disclosure types.
- You have the right to complain to us and/or to the United States Department of Health and Human Services if you believe that we have violated your privacy rights. If you choose to file a complaint, you will not be retaliated against in any way. To complain to us, please require at the Registration desk (you will be directed to our Privacy Officer).
To file a complaint with the U.S. Department of Health and Human Services you must submit your complaint in writing, within 180 of the alleged violation to
Region I.V, Office for Civil Rights
U.S. Department of Health and Human Services
Atlanta Federal Center, Suite 3B70
61 Forsyth Street, S.W
Atlanta, GA 30303-8909
Voice phone 404-562-7886
PedIM Healthcare Website Privacy
Thank you for visiting the PedIM Healthcare website. Your privacy is important to us. To better protect your privacy, we provide this notice explaining our online information practices and the choices you can make about the way your information is collected and used on this website.
The Information We Collect - You may express an opinion; contact us online to ask for information on our services or to sign up for the newsletter. The types of personally identifiable information that may be collected at these pages include: name, email address and telephone number.
How We Use the Information - We may use the information you provide about yourself to respond to your inquiries. We may use the non-personally identifiable information that we collect to improve the design and content of our site and to enable us to enhance your internet experience. We also may use this information in the aggregate to analyze site usage. Although we take appropriate measures to safeguard against unauthorized disclosures of information, we cannot assure you that personally identifiable information that we collect will never be disclosed in a manner that is inconsistent with this Privacy Notice. Inadvertent disclosures may result, for example, when third parties misrepresent their identities in asking the site for access to personally identifiable information about themselves for purposes of correcting possible factual errors in the data.
Privacy Options - PedIM Healthcare™ may, on occasion, combine information we receive Online with outside records to enhance our ability to market to you those products that may be of interest to you. If you prefer not to receive online marketing information from this web site, please contact us via the email or phone number provided below. Finally, PedIM Healthcare™ will not use or transfer personally identifiable information provided to us in ways unrelated to the ones described above without also providing you with an opportunity to opt out of these unrelated uses.
Collection of Information by Third-Party Sites and Sponsors - The Web site may contain links to other sites whose information practices may be different than ours. Visitors should consult the other sites’ privacy notices, as we have no control over information that is submitted to, or collected by, these third parties.
Our Commitment to Security - We have put in place appropriate physical, electronic, and managerial procedures to safeguard and help prevent unauthorized access, maintain data security, and correctly use the information we collect online.
How to Contact Us - If you have any questions or concerns about PedIM Healthcare Online Policy for this site, please contact us via email, phone, fax or at the following address: 1990 N Prospect Avenue Lecanto, FL 34461 Phone (352) 527-6888 Fax (352) 527-8818 email@example.com