It has always been the policy of
Eastern Carolina Ear, Nose & Throat - Head & Neck
Surgery to protect the privacy/confidentiality
of every patient. The protection of patient
information is not only a requirement under applicable
laws, but it is also an ethical and clinical
obligation of every physician and employee of
EC-ENT. The practice will comply with all federal
and state laws related to the privacy and security
of patient information.
A recent federal law requires medical practices,
and other covered entities, to provide patients
with a written NOTICE OF PRIVACY PRACTICES that
outlines how protected health information we maintain
may be used or disclosed to others. We are required
to abide by the terms of the current notice; however,
we reserve the right to change privacy practices
when we deem it necessary. A copy of the current
notice is available to you upon request, and also
it appears on our website - www.easterncarolinaent.com.
This notice describes how medical information
about you may be used and disclosed, and bow you
can get access to this information. Please review
If you consent, EC-ENT is permitted by federal
law to make uses and disclosures of your health
information for purposes of treatment, payment,
and health care operations. Protected health information
is the information we create and obtain in providing
our services to you. Such information may include
demographics, documenting your symptoms, examination
and test results, diagnosis, treatment, and applying
for future care or treatment. It also includes
billing documents for those services.
Examples of uses of your health information for
treatment purposes are:
It is essential that EC- ENT physicians and staff
who are involved in your care have necessary information
to diagnose, treat, and provide health care services
to you. We may use and disclose protected health
information to provide, coordinate, or manage your
health care and related services. We may disclose
your health information to other physicians involved
in your care, as well as hospitals, laboratories,
diagnostic centers, home health agencies, or other
health care providers that may be involved in your
Examples of uses of your health information for
payment purposes are:
Your protected health information may be used
to file health insurance claims and billing statements
for health care services provided to you, to check
insurance eligibility and coordination of benefits,
to obtain authorizations for services, or to collect
unpaid accounts as needed to obtain payment for
your health care services.
Examples for uses of your information for health
care operations are:
We obtain services from insurers or other business
associates, such as quality assessment, quality
improvement, outcome evaluation, case management
and care coordination, protocol and clinical guidelines
development, training programs, credentialing,
medical review, legal
services, and insurance. We will share information
about you with such insurers and other business
associates as necessary to obtain these services.
We may use or disclose protected health information
to send appointment reminders or to reschedule
appointments (such as voicemail messages, postcards,
or letters), to phone in prescriptions to your
pharmacist, and to train employees and medical
In addition, we may use a sign-in sheet at the
registration desk where you will he asked to sign
your name and indicate your physician. We may also
call you by name in the waiting room when your
physician is ready to see you.
Whenever protected health information is provided
to certain Business Associates - such as billing
services, medical record transcription services,
computer vendors, business consultants, collection
agencies, etc.; we are required to obtain contractual
assurances that the Business Associate will take
appropriate steps to protect your health care information.
We do not, however, have direct control over Business
Associates beyond these contractual assurances.
Uses and Disclosures of Protected Health Information
Based Upon Your Written Authorization
Other disclosures of your protected health information
will be made only with your authorization, unless
otherwise permitted or required by law. You may
revoke this authorization at any time, in writing,
except to the extent that your physician or the
physician's practice has taken action indicated
in the authorization. If you are not present or
able to agree or object to the use of disclosure
of the protected health information, then your
physician may, using professional judgment, determine
whether the disclosure is in your best interest.
In this case, only the protected health information
that is relevant to your health care will be disclosed.
Disclosures Without Consent
Notification: Unless you object, we may use or
disclose your protected health information to notify,
or assist in notifying a family member, personal
representative, or other person responsible for
your care, about your location, and about your
general condition, or your death.
Communication with Family: Using our best judgment,
we may disclose to a family member, other relative,
close personal friend, or any other person you
identify, health information relevant to that person's
involvement in your care or in payment for such
care if you do not object, or in an emergency.
In an emergency situation, if your physician is
unable to obtain your consent he or she may still
use or disclose your protected health information
to treat you.
Research - We may
disclose information to researchers when their
research has been approved by an institutional
review board which has reviewed the research proposal,
and established protocols to ensure the privacy
of your protected health information.
Disaster Relief - We may use and disclose your
protected health information to assist in disaster
Funeral Directors or Coroners - We may disclose
your protected health information to funeral directors
or coroners consistent with applicable law to allow
them to carry out their duties.
Organ Procurement Organizations - Consistent with
applicable law, we may disclose your protected
health information to organ procurement organizations,
or other entities engaged in the procurement, banking,
or transplantation of organs for the purpose of
tissue donation and transplant.
Marketing - We may contact you to provide you
with appointment reminders, with information about
treatment alternatives, or with information about
other health-related benefits and services that
may be of interest to you.
Fund-Raising - We may contact you as a part of
a fund-raising effort.
Food and Drug Administration
(FDA) - If you are
seeking compensation through Workers' Compensation,
we may disclose your protected health information
to the extent necessary to comply with laws relating
to Workers' Compensation.
Public Health - As required by law, we may disclose
your protected health information to public health
or legal authorities charged with preventing or
controlling disease, injury, or disability.
Abuse & Neglect - We may disclose your protected
health information to public authorities as allowed
by law to report abuse or neglect.
Correctional Institutions - If you are an inmate
of a correctional institution, we may disclose
to the institution or its agents the protected
health information necessary for your health and
the health and safety of other individuals.
Law Enforcement - We may disclose your protected
health information for law enforcement purposes
as required by law, such as when required by a
court order, or in eases involving felony prosecutions,
or to the extent an individual is in the custody
of law enforcement.
Health Oversight - Federal law allows us to release
your protected health information to appropriate
health oversight agencies, or for health oversight
Proceedings - We may disclose
your protected health information in the course
of any judicial or administrative proceeding as
allowed or required by law, with your consent,
or as directed by a proper court order.
Serious Threat to Health
or Safety - To avert
a serious threat to health or safety, we may disclose
your protected health information consistent with
applicable law to prevent or lessen a serious,
imminent threat to the health or safety of a person
or the public.
For Specialized Governmental
Functions - We may
disclose your protected health information for
specialized government functions authorized by
law, such as to Armed Forces personnel, for national
security purposes, or to public assistance program
Other Uses - Other
uses and disclosures besides those identified in
this notice will be made only as otherwise authorized
by law, or with your written authorization. You
may revoke the authorization as previously provided.
Website - We maintain a website that provides
information about our entity. This Notice of Privacy
Practices is available on our website:
Effective Date: April 14, 2003
Following is a statement of your rights with respect
to your protected health information and a brief
description of how you may exercise these rights.
The health and billing records we maintain are
the physical property of EC-ENT. The information
in it, however, belongs to you.
You have the right to request a restriction of
your protected health information. This means you
may ask us not to use or disclose any part of your
protected health information for the purposes of
treatment, payment or health care operations. EC-ENT
is not required to agree to a restriction that
you may request. We will consider your request
to determine if there are reasonable ways to meet
your needs or concerns. You may be asked to make
special payment arrangements if requesting restrictions
on release of information for payment purposes,
such as filing insurance claims. If EC-ENT does
agree to the requested restriction, we may not
use or disclose your protected health information
in violation of that restriction, unless it is
needed to provide emergency treatment. You may
request a restriction by sending a certified letter
explaining your request and to whom you want the
restriction to apply to our privacy officer.
You may obtain a paper copy of the Notice of Privacy
Practices for Protected Health Information by making
a request at our office.
You have the right to inspect and copy your protected
health information. This means you may inspect
and obtain a copy of protected health information
about you that is contained in a designated record
set, for as long as the protected health information
is maintained in the designated record set. Under
federal law, the right to request access does not
apply to psychotherapy notes, protected health
information compiled in anticipation of, or for
use in, a civil, criminal, or administrative action
or proceeding, and certain types of protected health
information that is subject to law that prohibits
access to protected health information. You may
exercise this right by delivering the request in
writing to our office, using the form we provide
to you upon request. We will respond to your request
within 30 days, if such information is maintained
onsite or is accessible onsite. If such information
is offsite, we will respond to your request within
60 days. We may charge you a fee for the costs
of copying, mailing or other costs incurred by
us in complying with your request.
You have the right to appeal a denial of access
to your protected health information, except in
You may request that your health care record be
amended to correct incomplete or incorrect information
by a written request and providing a reason to
support the request. The physician may deny your
request for an amendment. If we deny your request
for an amendment, you have the right to file a
statement of disagreement, and require that the
request for amendment and any denial be attached
to all future disclosures of your protected health
You have the right to receive an accounting of
certain disclosures we have made, if any, of your
protected health information, by delivering a written
request to our office. An accounting will not include
internal uses of information for treatment, payment,
operations, disclosures made to you or made at
your request, disclosures made to family members
or friends involved in your care, or for notification
purposes. You have the right to receive specific
information regarding these disclosures that occurred
after April 14, 2003. The right to receive this
information is subject to certain exceptions, restrictions,
You may request the right to receive communications
about your records in a confidential manner by
alternative means, or at an alternative location
by delivering this request in writing.
You may revoke authorizations that you made previously
to use or disclose information, except to the extent
information or action has already been taken by
delivering a written request to our office.
You have the right to review this Notice before
signing the consent authorizing use and disclosure
of your protected health information for treatment,
payment, and health care operations purposes.
If you want to exercise any of the above rights,
please contact our privacy officer in person or
in writing, during normal working hours. They will
provide you with assistance on the steps to take
to exercise your right.
The Office is Required to:
Maintain the privacy of your health information
as required by law.
Provide you with a notice of our duties and privacy
practices as to the information we collect and
maintain about you.
Abide by the terms of this Notice.
Notify you if we cannot accommodate a requested
restriction or request.
Accommodate your reasonable requests regarding
methods to communicate health information with
To Request Information or File a Complaint:
If you have questions, would like additional information,
or want to report a problem regarding the handling
of your information, you may contact our privacy
Additionally, if you believe your privacy rights
have been violated, you may file a written complaint
at our office by delivering the written complaint
to the privacy officer. You may also file a complaint
by mailing it or e-mailing it to the Secretary
of Health and Human Services. Contact us for the
address of the Department of Health and Human Services.
We cannot, and will not, retaliate against you
for filing a complaint with the Secretary of Health
and Human Services.
Contact Our Office
Paul S. Camnitz, M.D.
Eastern Carolina ENT - Head & Neck Surgery,
850 Johns Hopkins Drive
Greenville, NC 27834
*This notice was published and becomes effective
on April 14, 2003