DIX – EUREKA MEDCENTER PC
Health Insurance Portability and Accountability Act – (HIPPA) Compliancy Policy Notice
Our office is fully committed to compliance with the Health Insurance Portability and Accountability
Act (HIPAA) guidelines. Please review the following carefully.
- Our office will use and disclose the minimum necessary amount of your personal health
information (P.H.I) for purpose of treatment, meaning the provision, coordination,
management of your health care and related services. For instance, we will use and disclose
your health information to coordinate benefits with a third party payer or for consultation
between our office and a specialist if required for your care.
- Our office will use and disclose the minimum necessary amount of P.H.I. to obtain payment
for services rendered. Our office may share the information of services rendered with your
insurer for the purposes of reimbursements.
- Our office may use and disclose the minimum necessary amount of P.H.I to appropriate
Public Health or government authorities for reasons such as, but not limited to, preventing or
controlling disease, injury, or child abuse and neglect. Our office may use your minimum
necessary amount of your P.H.I to the extent necessary to inform appropriate government
authorities if we reasonably believe you to be a victim of abuse, neglect or domestic violence.
- Our office may use or disclose the minimum necessary amount of your P.H.I. to a health
oversight agency for oversight activities authorized by law, such as for, but not limited to
- Our office may use or disclose the minimum necessary amount of your P.H.I. in the course of
any judicial or administrative proceeding if required by law to do so. We may use or disclose
your minimum necessary amount of your P.H.I to law enforcement agency if required by law
to do so.
- Our office may use or disclose the minimum necessary amount of your P.H.I. to a coroner or
medical examiner for the purpose of identifying a deceased person, determining a cause of
death or another matter authorized by law, or to funeral directors to carry out their duties with
respect to the deceased.
- Our office will transfer all of your information to Corporate Health in cases of work-related
- Our office may use or disclose the minimum necessary amount of your P.H.I. for an
investigation by the United States Department of Health and Human Services Secretary to
determine if our office is in compliance with the HIPAA privacy regulation that requires us to
protect your individually identifiable health information.
- Our office will obtain written authorization from you if we would like to use your P.H.I. for
marketing purposes. You have the right to revoke and authorization as long as you do so in
- Our office will use and disclose the minimum necessary amount of your P.H.I. that is directly
relevant to involvement of a family member, other relative, or a close personal friend or
someone identified. Such uses and disclosures will be made only with your permission if you
are present, unless you are incapacitated or there is an emergency circumstance where our
office must exercise professional judgment.
- Our office will use and disclose the minimum necessary amount of your P.H.I. for health care
operations such as business planning, auditing, and development that involves conducting
cost management and planning related analysis related to managing, operating the entity
including formulary development and administration, development or improvement of
methods of payments or coverage policies. It may be done without your written authorization.
- Our office may use or disclose the minimum necessary amount of your P.H.I. if we believe
doing so is necessary to prevent or lessen a serious and imminent threat to the health or
safety of a person or the public and other specific circumstances.
You have the right to inspect or obtain a copy of the minimum necessary amount of your P.H.I.
from our office. Our office requires you to submit such requests in writing to our office management.
Our office must act on your request no later than five days after receipt of your request, unless P.H.I.
requested is not maintained or accessible to our office on site. In the latter case, our office must
respond to your request within 15 days of your request: you may be charged a processing fee of $25
Security of Records
- Our office is in compliance with HIPAA guidelines as regards to maintaining security of our
patients’ medical information and records.
- All patients’ charts and P.H.I. are kept locked after the operating hours of business and cannot
- Patient information cannot be accessed on the computer after the operating hours. During
operating hours only free healthcare provider has access to that information.
- All staff will refrain from discussing protected health information in lobby, elevators, corridors
and public spaces.
- P.H.I. will not be placed in public accessible places.
- Chart to be placed face down on counters and face up backwards in the racks.
All employees of Dix-Eureka MedCenter practice, including doctors, managers and other staff members
continually undergo training so that they may understand and comply with government rules and
regulations regarding the HIPAA with particular emphasis on “Privacy Rule.” It is our policy to
properly determine appropriate uses of P.H.I. in accordance with the government rules, laws and
Our office maintains our patients’ information and billing process in compliance with national
HIPAA standards. Our billing company is HIPAA compliant.
Correspondence & Privacy officer
Please email: firstname.lastname@example.org