Effective March, 2002;
Revised January 2013
This policy describes how your medical information may be used and
disclosed. Please review the information
carefully which describes how Brazos Valley Pathology (BVP) and its business
associates may use and disclose your protected health information (PHI) in
order to carry out payment, treatment, healthcare operations and other purposes
required by law.
Our legal duty is to
safeguard your PHI. BVP is required to
protect the privacy of your healthcare billing information. The PHI includes information provided to us
by your treating physician and/or facility where services were performed. We may not use or disclose any more of your
PHI than is necessary to accomplish the purpose of its use. We strive to legally follow the privacy
practices that are herein described. BVP
reserves the right to change our privacy practices and the terms of this information
at any time and make such changes effective for the PHI that we possess at the
time of change as well as any information received thereafter.
Your PHI May Be Used and/or Disclosed
We may disclose your PHI without your consent or
authorization for the following reasons:
Treatment your PHI may be disclosed to
physicians, nurses and other healthcare personnel who provide treatment or are
involved in your care; this includes disclosure related to workers
compensation insurance and treatment.
Payment we may use and disclose your PHI to
bill and collect payment for the services provided to you. Our pathology group may provide portions of
your information to our billing company, ProMedX Billing Solutions and to your
health plan in efforts to obtain payment for our services.
Operations BVP may also disclose your PHI
to organizations that evaluate the quality of healthcare services provided to
you. We may also be requested to share
your information with accountants, attorneys, consultants and others to confirm
that we are complying with the laws that affect our physician group.
Administrative we may use and disclose your
information when required by state, federal and/or local laws, judicial or
administrative proceedings or law enforcement.
In addition, public health activities and guidelines require us to
report certain information to state agencies for disease monitoring or
investigations/inspections of a healthcare provider or organization.
Organ donation upon request of our
hospitals facility(ies), our pathology group may notify organ procurement
organizations to assist in orderingeye or tissue donation and transplants.
Research in certain studies, upon request
of the attending physician, we may provide your PHI to research groups.
Law enforcement we may provide PHI to law
enforcement personnel in efforts to lessen or prevent harm or serious threat to
Military certain PHI of military personnel
and veterans may require disclosure to federal agencies.
You may object to disclosure of your PHI in the following
may share your PHI with a family member, friend or other person that you
indicate is involved in your care or the payment for your healthcare, unless
you object in whole or in part. The opportunity to authorize may be obtained
retroactively in emergency situations.
You must provide prior written approval to release you
any other situation not described above.
you authorize us to use or disclose your PHI, you may later revoke that
authorization in writing at any time. If you revoke your authorization, we will
no longer use or disclose your PHI for any of the reasons that may have been
covered by your written authorization; however, you understand that we are
unable to take back any disclosures which may already have been made with your
You have the following rights with respect to your PHI:
§ You have the right to
request that we restrict or limit how we use and disclose your PHI. Your
request must be in writing and must explain what information you want to limit
and to whom the limits are to apply. You may not however limit the uses and
disclosures that we are legally required or allowed to make. We will consider
your request, but we are not required to agree to such requests. If we do
agree, we will comply with the requested limits except in emergency situations.
have the right to choose how we send PHI to you. You have the right to ask that
we send information to you in a certain way or at a certain location. For
example, you may want us to send information to you at your work address
instead of your home address. Your request must be made in writing, and we will
agree to it as long as we can easily provide it in the manner you requested.
have the right to inspect and obtain copies of your PHI. In most cases, you
have the right to inspect or obtain copies of your PHI that are in our
possession, but you must make this request in writing. If we do not have your
PHI, but we know who does, we will inform you of the manner in which to obtain
it. We will respond to you within 60 days after receiving your written request.
In certain situations, we may deny your request. If we do, we will inform you,
in writing, of our reasons for the denial and explain your right to have the
denial reviewed. If you request copies of your PHI, we may charge you. Instead
of providing the PHI you requested, we might provide you with a summary or
explanation of the PHI as long as you agree to that and to the actual cost in
have the right to obtain an accounting of the disclosures we have made. You
have the right to obtain an accounting of instances in which we have disclosed
your PHI. Your request must be made in writing and should state a specific time
period to be covered (the time period requested may not be more than six (6)
years and may not include dates prior to April 2002). We will respond within 60
days of receiving your written request. The list we provide may not include
uses or disclosures associated with treatment, payment or healthcare operations
or those made directly to you or to your family. The list also may not include
uses and disclosures for which a signed authorization has been received; those
made for national security purposes; or those made to corrections or law
enforcement personnel. The list will include the date of the disclosure, to
whom the PHI was disclosed, a description of the information disclosed and the
reason for the disclosure. We will generally provide the list to you at no
charge, except that if you make more than one request in the same calendar
year, we may charge you for the cost of providing each additional request.
have the right to amend your PHI. If you believe that there is a mistake in
your PHI or that a piece of important information is missing, you have the
right to request that we correct the existing information or add the missing
information. You must provide the request and your reason for the request in
writing. We will respond within 60 days of receiving your request. We may deny
your request if it is not made in writing or does not include a reason to
support the request, or if: 1) we believe that the information is correct and
complete; 2) the information was not created by us; 3) you do not have the
right to the information; or 4) the information is not part of our records. If
we deny your request, our written response will state the reasons for the
denial and explain your rights to file a written statement of disagreement with
the denial. If we approve your request, we will make the change as requested
and advise you in writing that we have done it, and we will make reasonable
efforts inform others of the changes on a need-to-know basis.
have the right to obtain a paper copy of this notice or by email. You have the
right to obtain a copy of this notice at any time. We can send it to you
electronically via email, or you may prefer to have us mail you a paper copy.
More Information or To Report a Problem:
you have any questions or complaints about our privacy practices in general or
our handling of your PHI, or if you want to submit a written request to BVP as
required in any of the previous sections of the Notice, please write us at the
address provided below. If you believe that your privacy rights have been
violated, you may also file a written complaint with the Secretary of the
Department of Health and Human Services. BVP will not take any retaliatory
action against you for filing a complaint about our privacy practices. We
understand that information about you and your health is personal, we respect
your right to privacy, and we are committed to protecting your health
information against any unlawful or otherwise improper use or disclosure.
Brazos Valley Pathology
PO Box 163567
Austin, TX 78716-3567