Terms, Conditions, Privacy Statement and HIPPA
“Where we are committed to excellence in service and patient care.”
We are committed to protect the privacy of your personal health information (PHI).
This notice describes how your medical information may be used and disclosed and how you can obtain access to this information. Please review it carefully. Should you have any questions about this Notice of Privacy Practices and Policies, please contact the Privacy Officers of Georgia Pain and Spine Care:
Sarah Morgan, HR
Elizabeth Anglin, COO
This Notice of Privacy Practices (Notice) describes how we may use within our practice or network and disclose (share outside of our practice or network) your PHI to carry out treatment, payment or health care operations. We may also share your information for other purposes that are permitted or required by law. This Notice also describes your rights to access and control your PHI.
We are required by law to maintain the privacy of your PHI. We will follow the terms outlined in this Notice.
We may change our Notice, at any time. Any changes will apply to all PHI. Upon your request, we will provide you with any revised Notice by:
- Posting the new Notice in our office.
- If requested, making copies of the new Notice available in our office or by mail.
- Posting the revised Notice on our website: https://www.gapaincare.com
Uses and Disclosures of Protected Health Information
We may use or disclose (share) your PHI to provide health care treatment for you.
Your PHI may be used and disclosed by your physician, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you.
EXAMPLE: Your PHI may be provided to a physician to whom you have been referred for evaluation to ensure that the physician has the necessary information to diagnose or treat you. We may also share your PHI from time-to-time to another physician or health care provider (e.g., a specialist or laboratory) who, at the request of your physician, becomes involved in your care by providing assistance with your health care diagnosis or treatment to your physician. We may also share your PHI with people outside of our practice that may provide medical care for you such as home health agencies.
We may use and disclose your PHI to obtain payment for services. We may provide your PHI to others in order to bill or collect payment for services. There may be services for which we share information with your health plan to determine if the service will be paid for.
PHI may be shared with the following:
- Billing companies
- Insurance companies, health plans
- Government agencies in order to assist with qualification of benefits
- Collection agencies
EXAMPLE: You are seen within our practice for a procedure, we will need to provide a listing of services such as injections to your insurance company so that we can get paid for the procedure. We may at times contact your health care plan to receive approval PRIOR to performing certain procedures to ensure the services will be paid for. This requires sharing your PHI.
We may use or disclose, as-needed, your PHI in order to support the business activities of this practice which are called health care operations.
- Training students, other health care providers, or ancillary staff such as billing personnel to help them learn or improve their skills.
- Quality improvement processes which look at delivery of health care and for improvement in processes which will provide safer, more effective care for you.
- Use of information to assist in resolving problems or complaints within the practice.
We may use and disclosure your PHI in other situations without your permission:
- If required by law: The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. For example, we may be required to report gunshot wounds or suspected abuse or neglect.
- Public health activities: The disclosure will be made for the purpose of controlling disease, injury or disability and only to public health authorities permitted by law to collect or receive information. We may also notify individuals who may have been exposed to a disease or may be at risk of contracting or spreading a disease or condition.
- Health oversight agencies: We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.
- Legal proceedings: To assist in any legal proceeding or in response to a court order, in certain conditions in response to a subpoena, or other lawful process.
- Police or other law enforcement purposes: The release of PHI will meet all applicable legal requirements for release.
- Coroners, funeral directors: We may disclose protected health information 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
- Medical research: We may disclose your protected health information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.
- Special government purposes: Information may be shared for national security purposes, or if you are a member of the military, to the military under limited circumstances.
- Correctional institutions: Information may be shared if you are an inmate or under custody of law which is necessary for your health or the health and safety of other individuals.
- Workers’ Compensation: Your protected health information may be disclosed by us as authorized to comply with workers’ compensation laws and other similar legally-established programs.
Other uses and disclosures of your health information.
- Business Associates: Some services are provided through the use of contracted entities called “business associates”. We will always release only the minimum amount of PHI necessary so that the business associate can perform the identified services. We require the business associate(s) to appropriately safeguard your information. Examples of business associates include billing companies or transcription services.
- Health Information Exchange: We may make your health information available electronically to other healthcare providers outside of our facility who are involved in your care.
- Fundraising activities: We may contact you in an effort to raise money. You may opt out of receiving such communications.
- Treatment alternatives: We may provide you notice of treatment options or other health related services that may improve your overall health.
- Appointment reminders: We may contact you as a reminder about upcoming appointments or treatment.
We may use or disclose your PHI in the following situations UNLESS you object.
- We may share your information with friends or family members, or other persons directly identified by you at the level they are involved in your care or payment of services. If you are not present or able to agree/object, the healthcare provider using professional judgment will determine if it is in your best interest to share the information. For example, we may discuss post procedure instructions with the person who drove you to the facility unless you tell us specifically not to share the information.
- We may use or disclose protected health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition or death.
- We may use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts.
The following uses and disclosures of PHI require your written authorization:
- Disclosures of for any purposes which require the sale of your information
- Release of psychotherapy notes: Psychotherapy notes are notes by a mental health professional for the purpose of documenting a conversation during a private session. This session could be with an individual or with a group. These notes are kept separate from the rest of the medical record and do not include: medications and how they affect you, start and stop time of counseling sessions, types of treatments provided, results of tests, diagnosis, treatment plan, symptoms, prognosis.
All other uses and disclosures not recorded in this Notice will require a written authorization from you or your personal representative.
Written authorization simply explains how you want your information used and disclosed. Your written authorization may be revoked at any time, in writing. Except to the extent that your doctor or this practice has used or released information based on the direction provided in the authorization, no further use or disclosure will occur.
Your Privacy Rights
You have certain rights related to your protected health information. All requests to exercise your rights must be made in writing. You may direct your concerns and requests in writing and address your letter to be mailed to:
Georgia Pain and Spine Care – Privacy Officer
1665 Hwy 34 East, Suite 100
Newnan, Ga 30265
You have the right to see and obtain a copy of your protected health information.
This means you may inspect and obtain a copy of protected health information about you that is contained in a designated record set for as long as we maintain the protected health information. If requested we will provide you a copy of your records in an electronic format. There are some exceptions to records which may be copied and the request may be denied. We may charge you a reasonable cost based fee for a copy of the records.
You have the right to request a restriction of your protected health information.
You may request for this practice not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. We are not required to agree with these requests. If we agree to a restriction request we will honor the restriction request unless the information is needed to provide emergency treatment.
There is one exception: we must accept a restriction request to restrict disclosure of information to a health plan if you pay out of pocket in full for a service or product unless it is otherwise required by law.
You have the right to request for us to communicate in different ways or in different locations.
We will agree to reasonable requests. We may also request alternative address or other method of
contact such as mailing information to a post office box. We will not ask for an explanation from you about the request.
You may have the right to request an amendment of your health information.
You may request an amendment of your health information if you feel that the information is not correct along with an explanation of the reason for the request. In certain cases, we may deny your request for an amendment at which time you will have an opportunity to disagree.
You have the right to a list of people or organizations who have received your health information from us.
This right applies to disclosures for purposes other than treatment, payment or healthcare operations. You have the right to obtain a listing of these disclosures that occurred after April 14, 2003. You may request them for the previous six years or a shorter timeframe. If you request more than one list within a 12 month period you may be charged a reasonable fee.
Additional Privacy Rights
- You have the right to obtain a paper copy of this notice from us, upon request. We will provide you a copy of this Notice the first day we treat you at our facility. In an emergency situation we will give you this Notice as soon as possible.
- You have a right to receive notification of any breach of your protected health information.
If you believe that we have violated your rights or you have a complaint about our privacy practices and policies, you may contact:
Georgia Pain and Spine Care – Privacy Officers
1665 Hwy 34 E, Suite 100
Newnan, Ga 30265
Or you may contact the Privacy Officers of Georgia Pain and Spine Care via phone:
Sarah Morgan, HR – 678-671-4801
Elizabeth Anglin, COO – 678-671-4807
You may also file a formal complaint to the United States Secretary of Health and Human Services if you believe your privacy rights have been violated by us.
Should you file a complaint we will not retaliate against you in any way for filing a complaint.
This notice of privacy practices and policies was revised, published and becomes effective on August 17, 2016.
Georgia Pain and Spine Care Disclaimer Statement for Website.
- Medical Information
No medical information on the website is provided to further general consumer understanding, awareness and knowledge of pain. All information provided on this website is for general information purposes only. The information provided by the website is not intended nor implied to be a substitute for professional medical advice from health care providers.
- Inaccurate or Incomplete Information
The information available on this website should not be considered complete or exhaustive and may not reflect the most current information on pain. While Georgia Pain and Spine Care attempts to make sure the information included in this website is accurate and as current as possible, there may be delays, omissions, or inaccuracies in the content provided on this website. As a result, Georgia Pain and Spine Care does not represent that the information contained herein is complete, accurate and up to date in every case.
- No Warranty
The information contained in this website and in any other website accessed via links from this website is provided as is or as available without representation or warranty of any kind, express or implied. All such representations and warranties are hereby disclaimed, including without limitation, the implied warranties of merchantability and fitness for a particular purpose. Georgia Pain and Spine Care does not warrant or represent the timeliness, content, sequence, accuracy, or completeness of any information or data furnished hereunder.
- Liability Limitation
In no event shall Georgia Pain and Spine Care be liable for any direct, indirect, incidental, special, exemplary, punitive, or any other monetary or other damages, fees, fines, penalties or liabilities arising out of or relating in any way to use of this website or websites accessed through links and/or information contained in this website. In no event shall Georgia Pain and Spine Care be liable for any lost profits, lost data or business arising out of or relating in any way to use of this website or websites accessed through such links and/or information.
- No Guarantee against Errors, Delays, Losses
Georgia Pain and Spine Care cannot guarantee and does not warrant against human and/or machine errors, omissions, delays, interruptions or losses of information or data, infringing material, or defamation. Georgia Pain and Spine Care cannot and does not guarantee or warrant that files available for downloading on this website will be free of infection or viruses, worms, Trojan horses or other codes that manifest contaminating or destructive properties.
- No Guarantee about Linked Websites
Georgia Pain and Spine Care not endorse and is not responsible or liable for the materials contained in or through, or products available through the materials contained in other websites accessed via links from this website. Linking to such websites is done at the user’s own risk. Georgia Pain and Spine Care cannot guarantee and does not warrant the availability of such linked websites. Georgia Pain and Spine Care cannot guarantee and does not assume responsibility for any damage incurred from accessing such linked websites nor from use, browsing or downloading information from such linked websites.
- Information You Give Us
The information we learn from customers helps us personalize and continually improve your experience at our website.
The following are forms of information we gather:
We receive and store any information you enter on our web site or give us in any other way. We do not sell or rent your personal information to others without your consent. We use the information we collect only for the purposes of sending promotional information, enhancing the operation of our site, serving advertisements, for statistical purposes and to administer our systems. We currently use a SSL (Secure Sockets Layer) Certified third party to host our online forms such as the new patient packet and survey in order to protect your privacy. We do not use third parties to provide customer service, to serve site content, to serve the advertisements you see on our site to help administer promotional emails, or to administer drawings or contests, but reserve the right to do so in the future without advance notice. Our computer system protects personal information using advanced firewall technology.
- Information from Other Sources
For reasons such as improving personalization of our service, we might receive information about you from other sources and add it to our account information. Your input is vital to our success and we reserve the right to use any feedback you provide us to better Georgia Pain and Spine Care, for educational or training purposes within our facility and for our personal record.
This disclaimer for Georgia Pain and Spine Care’s website has been revised, published and becomes effective on August 2016.