This notice describes how medical information about you may be used and disclosed and how you can get access to this information. A record is made at each office visit. The chart includes office examinations, lab results, billing information, and other items. The notice is provided to you as a requirement of the Heath Insurance and Portability Act (HIPPA). Please review it carefully.
Uses and Disclosures
Treatment. Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. For example, results of laboratory tests and procedures will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members.
Payment. Your health information may be used to seek payment form your health plan, from other sources of coverage such as an automobile insurer, or from credit card companies that you may use to pay for services. For example, your health plan may request and receive information on dates of service, the services provided, and the medical condition being treated.
Health Care Operations. Your health information may be used as necessary to support the day-to-day activities and management of Drs. Lousteau and Cecola, A.M.C. For example, information on the services you received may be used to support budgeting and financial reporting, and activities to evaluate and promote quality.
Law Enforcement/Governmental Agencies. Your health information may be disclosed to law enforcement agencies without your permission to support government audits and inspections, to facilitate law enforcement investigations, and to comply with government mandated reporting.
Public Health reporting. Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the state’s public health department.
Other uses and disclosure require your authorization. Disclosure of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing a use of disclosure of your information you may submit a written revocation of the authorization. However, your decision to revoke authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision.
Additional Uses of Information
Appointment Reminders. Your health information may be used by our staff to send you appointment reminders.
Information about treatments. Your health information may be used to send you information on the treatment and management of your medical condition that you may find to be of interest. We may also send information describing other health related goods and service that we believe might interest you.
You have certain rights under the federal privacy standards. These include:
The right to request restrictions on the use and disclosure of your protected health information.
The right to receive confidential communications concerning your medical condition and treatment.
The right to inspect and copy protected health information. Louisiana law establishes the cost of copies. You will be charged a fee of $1.00 per page for the first 25 pages, .50 per pages 26-500, and .25 per page thereafter.
The right to amend or submit corrections to your protected health information.
The right to receive an accounting of how and to whom your protected health information has been disclosed.
The right to receive a printed copy of this notice.
Drs. Lousteau and Cecola, A.M.C. Duties
We are required by law to maintain the privacy of your protected health information and to provide you with this notice of privacy practices.
We are also required to abide by the privacy policies and practices that are outlined in this notice.
Right to Revise Practice Practices. As permitted by law, we reserve the right to amend or modify our privacy practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Whatever the reason for these revisions, we will provide you with a revised notice on your next office visit. The revised policies and practices will be applied to all protected health information that we maintain.
Request to Inspect Protected Health Information. As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. You may obtain a form to request access to your records by contacting Bonnie Runnels or Robyn Marques.
Complaints. If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter to:
Privacy Officer – Yvette Harper
Drs. Lousteau and Cecola, A.M.C.
120 North Jefferson Davis Parkway
New Orleans, LA 70124
If you believe that your rights have been violated, you should call the matter to our attention by sending a letter describing the cause of your concern to the same address.