Privacy and Financial Policies

This notice describes how Holland Biomedical Clinic and Holland Hyperbarics, hereafter referred to as CLINIC, protects your health information and what rights you have regarding it. CLINIC is obligated by law to give you notice of our privacy practices. Please review it carefully.

RIGHT TO NOTICE

As a patient, you have the right to adequate notice of the uses and disclosures of your protected health information. Under the Health Insurance Portability and Accessibility Act (HIPAA), CLINIC can use your protected health information for treatment, payment and health care operations.

a) Treatment – CLINIC may use or disclose your health information to a physician or other health care provider providing treatment to you.
b) Payment – CLINIC may use and disclose your health information to obtain payment for services we provide to you.
c) Health care operations – CLINIC may use and disclose your health information in connection with our healthcare operations. Healthcare operations include quality assessment and improvement activities, reviewing the competency of qualifications of health care professionals, evaluating provider performance, conducting training programs, accreditation, certification, licensing, or credentialing activities.

YOUR AUTHORIZATION

Most uses and disclosures that do not fall under treatment, payment, or health care operations will require your written authorization. Upon signing, you may revoke your authorization (in writing) through CLINIC at any time.

EMERGENCY SITUATIONS

In the event of your incapacity or an emergency situation, CLINIC will disclose health information to a family member, or other person responsible for your care, using our professional judgment. CLINIC will only disclose health care information that is directly relevant to the person’s involvement in your care.

MARKETING

CLINIC will not use your health information for marketing communications without your written authorization.

REQUIRED BY LAW

CLINIC may also use or disclose your health information when required to do so by law.

ABUSE OR NEGLECT

CLINIC may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence or the victim of other crimes. CLINIC may disclose your health information to the extent necessary to avert a serious threat to your or other people’s health and safety.

NATIONAL SECURITY

CLINIC may disclose the health information of Armed Forces personnel to military authorities under certain circumstances. CLINIC may disclose health information to authorized federal officials required for lawful intelligence, counterintelligence and other national security activities. CLINIC may disclose health information of inmates or patients to the appropriate authorities under certain circumstances.

APPOINTMENT REMINDERS

CLINIC may use or disclose your health information to provide you with appointment reminders via phone, email or letter.

YOUR RIGHTS AS A PATIENT

  • You have the right to receive confidential communications regarding your protected health care information.
  • You have the right to inspect and copy your protected health information. Requests for copies of PHI must be made in writing to our office and will be available for review within 30 days of the request.
  • You have the right to amend/update your protected health information. To provide the best care possible, it is always recommended that you keep CLINIC up-to-date on ALL of your health information/conditions.
  • You have the right to receive an account of disclosures of your protected health information. CLINIC will provide one within 30 days of a written request.
  • You have the right to a paper copy of this notice of privacy practices.

LEGAL REQUIREMENTS

CLINIC is required by law to maintain the privacy of your protected health information. CLINIC is required to abide by the terms of this notice as it is currently stated, and reserve the right to change this notice. The policies in any new notice will not be in effect until they are posted within our office.

CLINIC is required to make a copy of a photo I.D. to confirm identity and treatment of the correct patient listed in patient chart.

COMPLAINTS

It is always our goal to treat our patients with care and respect. If, however, you have complaints regarding the way that your protected health information is handled, you may submit a complaint to CLINIC.

CONTACT INFORMATION

For further information about my privacy policies, please contact us at Holland Biomedical Clinic or Holland Hyperbaric, 319 Barry Ave S, Suite 105, Wayzata, MN, 55391 or by phone at 952-215-3767.

EIN: Holland Center Inc 87-0721580