Patient Health Information

Under federal law, your 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 Patient 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

with medical treatment or services For

example, nurses, physicians and other

members of your treatment team will record

information in your 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 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 payments 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.

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 by law to report gunshot wounds, suspected abuse or neglect, or similar injuries  and events.

• 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:  Subjected 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 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 for national security purposes.

• Research:  We may use or disclose information for approved medical research.

• Workers Compensation:  We may release information about you for workers compensation or similar programs providing benefits for work-related injuries or illness.

In any other situation, we will ask for your written authorization before using or disclosing any identifiable health information about you.  If

you chose 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 right with regard to your health information.  Please contact the person listed below to obtain the appropriate form for exercising these rights.

Request Restrictions:   You may request restrictions on certain uses and disclosures of your health information.  We are not required to agree to such restrictions, but if we do agree, we must abide by those restrictions.

Confidential Communications:  You may ask us to communicate with you confidentially by, for example, sending notes 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. There may be a small charge.

Amend Information:  If you believe that

information in your record is incorrect, or if

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 operations.

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 person listed below.

Complaints

If you are concerned that we have violated your

privacy rights, or if you disagree with a decision

we made about your records, you may contact

the person listed below.  You also may send a

written complaint to the U.S. Department of

Health and Human Services.  The person listed

below will provide you with the appropriate

address upon request.  You will not be penalized

in any way for filing a complaint.

Contact Person

If you have any questions, request or complaints,

please contact:

Jeff Smith

Privacy Officer

1414 Medical Center Drive

Wilmington, NC 28401

(910) 763-7363

Effective Date:  The effective date of this Notice is 4/1/2003.