Notice of
Privacy Practices
Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This Notice of Privacy Practices is adopted to ensure that the practice of Compass Neuro, “PRACTICE", fully complies with all federal and state privacy protection laws and regulations, in particular, the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Protection of patient privacy is of utmost importance to PRACTICE. PRACTICE is required by law to maintain the privacy of its patients’ protected health information and to abide by its Notice of Privacy Practices. PRACTICE must provide its patients with a copy of its Notice of Privacy Practices outlining its legal duties and privacy practices with respect to protected health information. Violations of any of these provisions will result in disciplinary action which may include termination of employment and possible referral for criminal prosecution.
This Notice of Privacy Practices shall become effective as of August 19, 2023 and shall remain in effect until it is either amended or cancelled. As a patient of PRACTICE, you have a right to receive a paper copy of this Notice of Privacy Practices. If you have any questions or comments concerning this notice, you should contact the PRACTICE by mail at Compass Neuro, 8706 Jefferson Hwy., Suite B, Baton Rouge, Louisiana 70809, or by telephone at 225-926-7500.
DEFINITIONS
For the purposes of this Notice of Privacy Practices, the following defined terms shall have the following definitions.
a. “HHS” shall mean the United States Department of Health and Human Services.
b. “Health Information” or “Protected Health Information” shall mean, certain Individually Identifiable Health Information, as defined in 45 C.F.R. § 164.501 of the Privacy Standards.
I. Information Collected
In the ordinary course of business PRACTICE may receive personal information such as:
o Patient’s name, address, and telephone number;
o Information relating to treatment, diagnosis or other medical information concerning a patient;
o Patient’s insurance information and coverage.
In addition, other information will be gathered about a patient and we will create a record of the care and/or services provided to the patient by PRACTICE. Some of the information also may be provided to us by other individuals or organizations that are part of the patient’s “circle of care”- such as referring physician, other doctors, their health plan and family members, hospitals or other health care providers.
II. How PRACTICE May Use or Disclose Your Protected Health Information
PRACTICE collects protected health information from you and stores it in a chart and on a computer. This is your medical record. The medical record is the property of PRACTICE, but the information in the medical record belongs to you. PRACTICE protects the privacy of your protected health information. It is the policy of PRACTICE, that all protected health information may not be used or disclosed unless it meets one of the following conditions:
1. The patient, who is the subject of the information, has consented to the use or disclosure and the use or disclosure is for the treatment, payment or health care operations.
a. Treatment. PRACTICE collects information from you regarding your past psychological/medical history, present psychological/medical problems and/or complaints, as well as any diagnosis and or psychological/medical treatment at PRACTICE. This information may be transmitted to the staff of PRACTICE, including but not limited to, Traci W. Olivier, PsyD; Steven Felix, MD; Emily McMann, APRN, CPNP; all medical, clinical, and/or research assistants; support staff; and business manager. PRACTICE may also transmit this information to your referring physician/provider and any other entities associated or involved in your treatment. This information may also be disclosed to your physicians/providers or your primary care physician in association with your treatment.
b. Payment. PRACTICE will collect billing information from you such as your present address, social security number, date of birth, health insurance carrier, policy number and any other related billing information. PRACTICE may disclose to your health insurance provider, Medicare and Medicaid, or any other payor of health care claims the minimum amount necessary of your patient health care information in order to process your health insurance claim (if applicable), IF PRACTICE ACCEPTS THIRD PARTY PAYORS. As of 8/19/2023, the PRACTICE does not accept insurance, Medicaid, or Medicare.
c. Regular Health Care Operations. PRACTICE may disclose your healthcare information to the following including but not limited to Traci W. Olivier, PsyD; Steven Felix, MD; Emily McMann, APRN, CPNP; all medical, clinical, and/or research assistants; support staff; and business manager; or other employees/team members involved in your healthcare treatment.
2. The patient, who is the subject of the information, through a written authorization has authorized the use or disclosure of the information. An authorization is written permission above and beyond the general consent that permits only specific disclosures. This authorization may be revoked by the patient submitting a written revocation to PRACTICE; a written authorization must be received by PRACTICE before releasing medical records.
3. PRACTICE may use or disclose your healthcare information without your consent or authorization in the following circumstances:
a. Child Abuse – If PRACTICE has cause to believe that a child’s physical or mental health or welfare as a result of abuse or neglect or that abuse or neglect was a contribution factor in a child’s death, PRACTICE must report this belief to the Louisiana Department of Social Services/Department of Child and Family Services/and/or other legal entities as required by law.
b. Adult and Domestic Abuse – If PRACTICE has cause to believe that an adult’s physical or mental health or welfare has been or may be further adversely affected by abuse, neglect, or exploitation, PRACTICE must report this belief to the appropriate authorities as required by law. Please note that the term “adult”, for the purposes of this section, means any person sixty years of age or older, any disabled person eighteen years of age or older, or an emancipated minor.
4. Voice Mail Message. It is the policy of PRACTICE that a voice mail or answering machine message may be left at a patient’s home or other number the patient provides to PRACTICE regarding appointments, billing or payment issues, or other health care operations.
5. As Required by Law. It is the policy of PRACTICE that we may use and disclose your protected health information as required by law as follows:
a. To comply with public health laws;
b. To comply with medical oversight activities such as the Louisiana State Board of Medical Examiners relevant to its disciplinary proceedings and investigations;
c. To comply with court orders or subpoenas in judicial and administrative proceedings;
d. To comply with law enforcement or judicial activities;
e. To Coroners, Medical Examiners and Funeral Directors;
f. To assist in organ donation activities;
g. Research activities that have been approved by an Institutional Review Board (IRB) or authorization signed by you;
h. To comply with public safety laws
i. To comply with specialized government functions such as the military, national security, prisoner purposes;
j. To comply with worker’s compensation laws;
k. Marketing to you directly to provide information about other treatment or health-related benefits or services.
l. Change of Ownership if PRACTICE is sold or merges with another organization, practice, or entity.
III. Other Policies, Uses and Disclosures
1. Notice of Privacy Practices. It is the policy of PRACTICE that privacy practices must be published and that all uses and disclosures of protected health information are done in accordance with PRACTICE’s privacy policy.
2. Deceased Individuals. It is the policy of PRACTICE that privacy protections extend to information concerning deceased individuals.
3. Restriction Requests. It is the policy of PRACTICE that serious consideration must be given to all requests for restrictions on uses and disclosures of protected health information as published in this privacy policy. You have the right to request restrictions on certain uses and disclosures of your protected health information. PRACTICE is not required to agree to the restriction that you requested. If a particular restriction is agreed to, PRACTICE is bound by that restriction.
4. Minimum Necessary Disclosure. It is the policy of PRACTICE that it shall make reasonable efforts to limit the disclosure to the minimum amount of information needed to accomplish the purpose of the disclosure. It is also the policy of PRACTICE that all requests for protected health information must be limited to the minimum amount of information needed to accomplish the purpose of the request.
5. Access to Information. It is the policy of PRACTICE that you have the right to inspect and copy your protected health information. It is PRACTICE’s policy that access to protected health information must be granted to a patient when such access is requested. Such request shall be submitted in writing by completing PRACTICE’s request form entitled “Request for Inspection and/or Copy of Protected Health Information”. Costs associated with the copying of any protected health information shall be in accordance with applicable state and federal law.
6. Designation of Personal Representative. It is the policy of PRACTICE that access to protected health information must be granted to your designated personal representative as specified by you when such access is requested. This designation of a personal representative must be made in writing by completing PRACTICE’s form entitled “Designation of Personal Representative.”
7. Confidential Communications Channels. It is the policy of PRACTICE that you have the right to receive your protected health information through a reasonable alternative means or at an alternative location. Confidential communication channels can be used within the reasonable capability of PRACTICE, (i.e. do not call me at work, call me at home) as requested by you. Such request shall be made in writing by completing PRACTICE’s form entitled “Confidential Channel Communication Request.”
8. Amendment of Incomplete or Incorrect Protected Health Information. It is the policy of PRACTICE that you have a right to request that PRACTICE amend your protected health information that is incorrect or incomplete. PRACTICE is not required to change your protected health information and will provide you with information about PRACTICE denial and how you can disagree with the denial. A request to amend your protected health information shall be made in writing by completing PRACTICE’s form entitled “Request for Amendment of Health Information.”
9. Accounting of Disclosures. It is the policy of PRACTICE that an accounting of disclosures of protected health information made by PRACTICE is given to you whenever such an accounting is requested in writing. You have a right to receive an accounting of disclosures of your protected health information made by PRACTICE. Such written request for an accounting shall be made by completing PRACTICE’s form entitled “Request for Accounting of Disclosures”.
10. Complaints. It is the policy of PRACTICE that all complaints by employees, patients, providers or other entities relating to protected health information be investigated and resolved in a timely fashion. Complaints about this Notice of Privacy Practices or how PRACTICE handles your protected health information should be directed to:
Compass Neuro
ATTN: Business Manager
8706 Jefferson Hwy., Suite B
Baton Rouge, Louisiana 70809
Ph: 225-926-7500 | Fax: 225-924-0188
If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to:
Department of Health and Human Services, Office of Civil Rights, Hubert H. Humphrey Bldg.
200 Independence Avenue, S.W., Room 509F HHH Building, Washington, DC 20201
11. Prohibited Activities. It is the policy of PRACTICE that no employee may engage in any intimidating or retaliatory acts or actions against any person who files a complaint or otherwise exercises their rights under HIPAA regulations. It is also the policy of PRACTICE that no disclosure of protected health care information will be withheld as a condition for payment for services from the patient or from an entity.
12. Responsibility. It is the policy of PRACTICE that the responsibility for designing and implementing procedures related to this policy lies with the Chief Privacy Officer.
13. Mitigation. It is the policy of PRACTICE that the effects of any unauthorized use or disclosure of protected health information be mitigated (to decrease the damage caused by the action) to the extent possible.
14. Business Associates. It is the policy of PRACTICE that business associates must be contractually bound to protect your protected health information to the same degree as set forth in this policy.
15. Preemption of State Law. It is the policy of PRACTICE that the federal privacy regulations are the minimum standard to be used regarding the privacy of a patient’s protected health care information. If the laws of the State of Louisiana are more stringent in certain areas, the state laws in these areas shall prevail. In all other areas, the federal privacy regulations shall prevail.
16. Cooperation with Privacy Oversight Authorities. It is the policy of PRACTICE that oversight agencies such as the Office for Civil Rights of the Department of Health and Human Services be given full support and cooperation in their efforts to ensure the protection of protected health information within this organization. It is also the policy of PRACTICE that all personnel cooperate fully with all privacy compliance review and investigations.
If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, contact the Chief Privacy Office of PRACTICE.
IV. Changes to this Notice of Privacy Practices
PRACTICE reserves the right to amend this Notice of Privacy Practices at any time in the future and will provide a copy of such amendment to you upon request or upon your next visit. Until such amendment is made, PRACTICE is required by law to comply with this Notice.