Notice of Privacy Practices

Our organization is dedicated to maintaining the privacy of your individually identifiable health information. This Notice describes how medical information about you may be used and disclosed and how you may obtain access to this information. The terms of this Notice apply to all records containing your health information that are created or retained by our organization. Please review it carefully. You have the right to obtain a paper copy of this Notice upon request.

Quality of Care & Patient Rights

Capital Digestive Care is committed to providing competent and compassionate care, while respecting and safeguarding the dignity of the patient, and allowing patients access to all medical and ethical information necessary to make decisions about their care. For details on our commitment to quality of care, patient rights and responsibilities, please visit our patient rights and responsibilities page.

Patient Health Information

Under federal law, patient health information is protected and confidential. Patient health information includes information about your symptoms, test results, diagnosis, treatment, and related medical information. Your health information also includes payment, billing, and insurance information.

How We Use Your Health Information

We use health information about you for treatment, to obtain payment, and for health care operations, including administrative purposes and evaluation of the quality of care that you receive. Under some circumstances, we may be required to use or disclose the information even without your permission.

Examples of Treatment, Payment and Health Care Operations

• Treatment: We will use and disclose your health information to provide you with medical treatment or services. For example, nurses, physicians and other members of your treatment team will record and use it to determine the most appropriate course of care. We may also disclose the information to other health care providers who are participating in your treatment, to pharmacists who are filling your prescriptions, and to authorized family members who are helping with your care.
• Payment: We will use and disclose your health information for payment purposes. For example, we may need to obtain authorization from your insurance company before providing certain types of treatment. We will submit bills and maintain records of payment from your health plan.
• Health Care operations: We will use and disclose your health information to conduct our standard internal operations, including proper administration of records, evaluation of the quality of treatment and to assess the care and outcomes of your case and others like it.

Special Uses

We may use your information to contact you with appointment reminders. We may also contact you to provide information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may contact you for fundraising purposes, but you have the right to opt out of receiving such communications.

We participate in Chesapeake Regional Information Systems for our Patients (CRISP), a regional health information exchange serving Maryland and D.C. As permitted by law, your health information will be shared with this exchange in order to provide faster access, better coordination of care, and assist providers and public health officials in making more informed decisions. Refer to our Communications Notification form if you prefer to opt out of this program.

Other Uses and Disclosures

We may use or disclose identifiable health information about you for other reasons, even without your consent. Subject to certain requirements, we are permitted to give out health information without your permission for the following purposes:

• Required by Law: We may be required to report gunshot wounds, suspected abuse or neglect, or similar injuries and events.
• Research: We may use or disclose information for approved medical research.
• Public health activities: As required by law, we may disclose vital statistics, diseases, information related to recalls of dangerous products, and similar information to public health authorities.
• Health oversight: We may be required to disclose information to assist in investigations and audits, eligibility for government programs, and similar activities.
• Judicial and administrative proceedings: We may disclose information in response to an appropriate subpoena or court order.
• Law enforcement purposes: Subject to certain restrictions, we may disclose information required by law enforcement officials.
• Deaths: We may report information regarding deaths to coroners, medical examiners, funeral directors, and organ donation agencies.
• Serious threat to health or safety: We may use and disclose information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
• Military and special government functions: If you are a member of the armed forces, we may release information as required by military command authorities. We may also disclose information to correctional institutions or for national security purposes.
• Workers’ compensation: We may release information about you for workers’ compensation or similar programs providing benefits for work-related injuries or illness.
• Business associates: We may disclose your health information to business associates or third parties that we have contracted with to perform agreed upon services.

We do not engage in selling your health information, however, if we do, we will obtain your written authorization before we are permitted to sell your health information. In all other situations, including marketing activities, we will ask for your written authorization before using or disclosing any identifiable health information about you. If you choose to sign an authorization to disclose information, you can later revoke that authorization to stop any future uses and disclosures.

Individual Rights

You have the following rights with regard to your health information. Please contact the Privacy Officer at the location where you are receiving services to obtain the appropriate form for exercising these rights.

• Request restrictions: You may request restrictions on certain uses and disclosure of your health information. You have the right to restrict disclosures of your health information to your health plan for payment and health care operations purposes (and not for treatment) if the disclosure pertains to a health care item or service for which you paid out-of-pocket in full. If requesting a restriction for a health care item or service for which you paid out-of-pocket in full, we will honor your request, unless the disclosure is necessary for your treatment or is required by law. For all other restriction requests, we are not required to agree to such restrictions.
• Confidential communication: You may ask us to communicate with you confidentially by, for example, sending notices to a special address or not using postcards to remind you of appointments.
• Inspect and obtain copies: In most cases, you have the right to look at or get a copy of your health information. An administrative fee may apply
• Amend information: If you believe that information in your record is incorrect, or, important information is missing, you have the right to request that we correct the existing information or add the missing information.
• Accounting of disclosures: You may request a list of instances where we have disclosed health information about you for reasons other than treatment payment, or health care options.
• Breach notification: We are required to notify you in the event of a breach or inadvertent disclosure of your protected health information and will do so accordingly.

Our Legal Duty

We are required by law to protect and maintain the privacy of your health information, to provide this notice about our legal duties and privacy practices regarding protected health information, and to abide by the terms of the notice currently in effect.

Changes in Privacy Practices

We may change our policies at any time. Before we make a significant change in our policies, we will change our Notice and post the new Notice in the waiting area. You can also request a copy of our Notice at any time. For more information about our privacy practices, contact the Privacy Officer at the location where you are receiving services.

Complaints

If you are concerned that we have violated your privacy rights, or you disagree with a decision we made about your records, you may contact the Privacy Officer at the location where you are receiving services. You also may send a written complaint to the U.S. Department of Health and Human Services. You will not be penalized in any way for filing a complaint.

Contact Person

If you have any questions, requests, or complaints, please contact:

Capital Digestive Care
ATTN: Privacy Officer
10770 Columbia Pike, Suite 400
Silver Spring, MD 20901
Contact us on the website at CapitalDigestiveCare.com or send an email to PatientRelations@capitaldigestivecare.com