Notice of Privacy Practices

This notice describes how medical information about Children’s Clinics patients may be used and disclosed and how you can get access to this information. Please review it carefully.

If you have any questions about this Notice please contact our Privacy Officer.

What Is "Protected Health Information"?

"Protected health information" is any health and/or personal information that could identify a patient or that concerns the patient’s past, present, or future health care.

This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information.
We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice, at any time. The new notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices. You can receive this information by calling the Privacy Officer and request a revised copy be sent to you in the mail or you may request a copy at the time of your next appointment.

Uses And Disclosures Of Protected Health Information That Don’T Require Separate Consent Or Authorization From You

Every year you will be asked to sign a Medical Consent form to provide care. The Medical Consent form also covers the use and disclosure of Protected Health Information for routine treatment, payment, and healthcare operations and for other situations that may be required by law. Your protected health information may be used and disclosed by your physician, clinic staff and others outside of the clinic that are involved in your care and treatment for the purpose of providing health care services to you. Your protected health information may also be used and disclosed to pay your health care bills and to support the operation of the clinic.

Routine Uses And Disclosures

This section gives examples of the ways Protected Health Information may be routinely used and disclosed for Treatment, Payment, and HealthCare Operations. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by the clinic without consent.
Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party that has access to your protected health information. Examples of persons involved in the patient’s care include:

• The primary care physician and the staff of the primary care physician.
• Medical specialists, therapists, technicians, audiologists, nutritionists, pharmacists, or others who need protected health information to diagnose or treat the patient.
• Suppliers contracted and authorized to provide medical supplies and medical equipment to our patients.
• Nursing, therapy, and other students who receive a formal part of professional training at Children’s Clinics.
• Service coordinators from the Division of Developmental Disabilities, AHCCCS programs, or other agencies involved in the patient’s care.
• Family members, friends, or others who may accompany the patient for care at the Children’s Clinics, or who are involved in carrying out recommendations.

• CRS, AHCCCS or any government-sponsored program paying for the patient’s health care.
• Private commercial insurers who need the information to approve services, authorize payments for services, or determine eligibility for insurance benefits.
• Family members, friends, private organizations, or others who help to pay for the patient’s care. Healthcare Operations: We may use or disclose, as-needed, your protected health information in order to support the business activities of the clinic. For example, we may use protected health information to:
• Assess the quality of health care provided by our physicians, therapists, nurses, and training of medical students.
• For licensing, auditing, or legal professionals who advise us in our health care operations.
• Plan and conduct quality improvement efforts.
• We may use or disclose your protected health information, as necessary to remind you of your appointment.
• We will share your protected health information with third party "business associates" that perform various activities (e.g., wheelchair services, orthotics) for the clinic.
• We may use or disclose your protected health information, as needed, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you.
• Your name or address may be used to send you a newsletter about the clinic and the services we offer.

• Government Agencies who monitor health care, such as the Arizona Department of Health Services, the Board of Medical Examiners, or professional licensing boards.
• Government benefit programs such as AHCCCS, DES, SSI.
• Other government regulatory programs and civil rights laws.

• Public health authority, such as state or local departments of health that are permitted by law to collect and receive the information. The disclosure will be made for the purpose of controlling disease, injury or disability.
• We may disclose your protected health information, if required by law, to a person who may have been exposed to a communicable disease or may be at risk of contracting or spreading the disease.
• The Food and Drug Administration if there is a problem with medications, medical products, or medical equipment, or a recall of any of those.
• State agencies such as Child Protective Services, if there is evidence of abuse, neglect, or domestic violence to a patient or family member.

• If a crime has occurred on the premises.
• To report medical emergencies (not on the clinics premises) and it is likely that a crime has occurred.
• Suspicion that death has occurred as a result of criminal conduct.
• Limited requests for location and identification purposes.
• If we believe the disclosure is necessary to prevent or control a serious threat to the public health and safety.