Privacy Policy

NOTICE OF PRIVACY POLICIES

USE OF YOUR PROTECTED HEALTH INFORMATION

By signing this form I understand, authorize and agree that Maryland Center for Brain Health may use and disclose my protected health information to conduct formal, or informal research, education projects and other health care operation purposes deemed appropriate by Maryland Center for Brain Health. My protected health information that may be used includes my demographic information (e.g., age, gender, weight, location, etc.), medical history (e.g., health behaviors, diagnosis, complications with prior treatment, testing results, etc.), physical examination findings and laboratory tests (e.g., blood tests, biopsy results).

We use and disclose PHI for a variety of reasons. We have a limited right to use or disclose your PHI for purposes of treatment, payment, or our health care operations. To treat your health conditions and manage special health programs, we need to use your health information. We can do this without your written or verbal permission.

We may use and disclose your medical or other private health information without your permission under federal as well as state laws for the following purpose:

1. For Treatment: We may use and disclose your PHI to nurses, doctors, social workers, including trainees, involved in your care, to provide treatment services for you health care needs. For example, our personnel will use your PHI in order to coordinate the care of services you need, such as substance abuse treatment, presciptions and medical services. If you need care from health care professionals whoa re not part of our practice, we may also need to disclose your PHI to enable them to treat you. However, they too must protect the privacy of your PHI.

2. For Payment: We may use and disclose your PHI in order to bill and collect payment for your health care services. For example, when you receive services from providers not a part of this practice, we may have an obligation to pay for these services.

3. For Health Care operations: We may use and disclose your PHI ion the course of our health care operations. For example, we may use your PHI in assessing the quality of our services, reviewing accreditation, certification and licensing: and conducting medical reviews, audits and legal services.

4. Marketing: We will not use your PHI to sell you services or supplies unrelated to your health care coverage or your health status. We will not give any other person your PHI to allow them to contact you in any way or try to sell you anything

5. Appointment Reminders: We may use and disclose your PHI to contact you regarding your appointments for treatment or other health care related services.

HIPAA POLICY

I do hereby consent and acknowledge my agreement to the terms set forth in the HIPAA INFORMATION FORM and any subsequent changes in office policy. I understand that this consent shall remain in force from this time forward.

Changes to this notice

We may change this notice and our privacy practices at any time, as long as the change is consistent with federal law. If we make an important or material change to our policies, we will promptly post a new notice at www.mdbrainhealth.com

By signing this form I understand, authorize and agree that de-identified data collected concerning me may be shared to advance science and health, education endeavors and other purposes as deemed appropriate by Maryland Center for Brain Health. I understand and agree that Maryland Center for Brain Health will remove or code any protected health information that could identify me before files and information are shared for formal or informal research, education endeavors and other research, education or health care operation purposes deemed appropriate by Maryland Center for Brain Health.