Our Pledge Regarding Your Medical Information
Your medical information is personal, and Leap Pediatrics is committed to keeping this information confidential. Maintaining a record of the care and services you receive enables us to provide you with quality care and comply with certain legal requirements.
There may be instances where Leap Pediatrics will share your protected health information with members of our Organized Health Care Arrangement as allowed under HIPAA regulations and as necessary to carry out treatment, payment or health care operations. These members include all staff, employees, volunteers, trainees, students and other personnel providing services as employed by Leap Pediatrics
This notice details the ways in which we may use and disclose medical information about you, describes your rights and explains certain obligations we have regarding the use and disclosure of your medical information. All other uses and disclosures of your medical information may only occur with your permission, which you have a right to revoke at any time. Additionally, if your doctor is not a member of the physician practice that is owned by Ochsner Clinic Foundation, he or she may have different policies about how to handle your information and a separate notice.
We are required by law to:
- Make sure that medical information that identifies you is kept private;
- Give you this notice of our legal duties and privacy practices with respect to your medical information; and
- Follow the terms of the notice that is currently in effect.
How Leap Pediatrics May Use and Disclose Your Medical Information
The following categories describe the different ways we may use your health information within the hospital or clinic and how we will release your health information to persons outside the Health System. We have not listed every use or release of information within the categories, but all permitted uses will fall within one of the following categories:
Treatment. Leap Pediatrics may use your medical information to provide treatment or services. We may disclose your medical information to doctors, nurses, technicians, medical students or other hospital/clinic personnel who are involved in your care.
Payment. Leap Pediatrics may use and disclose your medical information to bill for the treatment and services you receive at our facilities and to collect payments from an insurance company, a third party or you
Individuals Involved in Your Care. Leap Pediatrics may discuss medical information about you with a guardian or family member who is involved in your medical care.
Required By Law. Leap Pediatrics will disclose medical information about you when required to do so by federal, state or local law.
To Avert a Serious Threat to Health or Safety. Leap Pediatrics may use and disclose your medical information to prevent a serious threat to your health and safety or to the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
Military and Veterans. If you are a member of the armed forces, Leap Pediatrics may release your medical information as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.
Public Health Risks. Leap Pediatrics may disclose your medical information for public health activities. These activities generally include the following:
- To prevent or control disease, injury or disability;
- To report births and deaths;
- To report reactions to medications or problems with products;
- To notify people of recalls of products they may be using;
- To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
- To report to appropriate government authorities adverse events related to food, medications or products; and
- To notify the appropriate government authority if we believe a patient has been the victim of child or elder abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
Health Oversight Activities. Leap Pediatrics may disclose your medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections and licensure. These activities are necessary for the government to monitor the healthcare system, government programs and compliance with civil rights laws.
Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, Leap Pediatrics may disclose your medical information in response to a court or administrative order or in the defense of a malpractice claim arising out of care provided by us. We may disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute.
Coroner, Medical Examiners and Funeral Directors. We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients of the hospital to funeral directors as necessary to enable them to carry out their duties.
Law Enforcement. Leap Pediatrics may release your medical information if asked by a law enforcement official for the following reasons:
- In response to a court order, subpoena, warrant, summons or similar process;
- Limited information to identify or locate a suspect, fugitive, material witness or missing person;
- About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement;
- About a death we believe may be the result of criminal conduct;
- About criminal conduct at the hospital or clinic; and
- In emergency circumstances to report a crime, the location of the crime or victims or the identity, description or location of the person who committed the crime.
Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, Leap Pediatrics may release your medical information to the correctional institution or law enforcement official. This information would be released for the following uses: (1) to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) to ensure the safety and security of the correctional institution.
Situations that Require Your Written Authorization
Marketing. Leap Pediatrics may ask you to sign an authorization to use you likeness as part of a marketing effort..
Disclosure of Psychotherapy Notes. Disclosure of Psychotherapy Notes will be done in accordance with Louisiana state law. In most cases this will require an authorization signed by you.
Your Rights Regarding Medical Information About You
The HIPAA Privacy Rule provides individuals with rights in regards to their protected health information. If you have any questions regarding your patient rights or wish to make a patient rights request, notify the office manager for a copy at 504-569-5327 or firstname.lastname@example.org
Right to Inspect and Copy. You have the right to inspect and request copies of medical information that may be used to make decisions about your care. Usually, this includes medical and billing records but does not include psychotherapy notes.
To inspect and receive copies of medical information that may be used to make decisions about your care, you must submit your request to Leap Pediatrics. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. If you request a copy in electronic format, we must provide the information in an electronic format. If there are any fees for the costs of creating this format, we may charge you for them.
Right to Request Amendment or Addendum. If you feel that medical information we have in your record is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the facility.
To request an amendment, your request must be made in writing and you must provide a reason that supports your request.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. If we deny your request, we will explain why. In addition, we may deny your request if you ask us to amend information:
- Not created by us;
- Not part of the medical information kept by or for the clinic;
- Not part of the information which you would be permitted to inspect and copy; or
- That is accurate and complete.
If we deny your request to amend, you may be permitted to provide a statement that you disagree with a specific part of the record.
Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of the disclosures Leap Pediatrics made of your medical information.
This list may not include disclosures made:
- To carry out treatment, payment or health care operations;
- To you or your personal representative;
- Incident to another permitted use or disclosure;
- To parties you authorize to receive your medical information;
- To those who request your information through the hospital directory;
- To your family members, other relatives or friends who are involved in your care, or who otherwise need to be notified of your location, general condition, or death;
- For national security or law enforcement purposes.
The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved, and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information Ochsner uses or discloses about you for treatment, payment or hospital/clinic operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, such as a family member or friend. For example, you could ask that we not disclose information about a surgery you had.
We are not required to agree to your request, unless your request is for a restriction on health information sent to your health plan for payment or health care operations where you have paid the full cost of the service to which the information related. If we do agree to your request, our agreement must be in writing, and we will comply unless the information is needed to provide you with emergency treatment or required by law.
To request restrictions, you must make your request in writing to Patient Relations at the Ochsner facility where you receive your care. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) what you want to limit: for example, disclosure to your spouse. In cases of services paid in full, the request for a restriction must occur prior to the service being provided and proof of payment in full for the service must be submitted with the request.
Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
To request confidential communications, you must make your request in writing to 2439 Manhattan Blvd ste 501, Harvey LA 70058. We will not ask you the reason for your request. Leap Pediatrics will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Right to Notification of a Breach of Unsecured Protected Health Information. Under certain circumstances, you have the right to or will receive notifications of breaches of your unsecured protected health information.
Right to a Paper Copy of this Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of the notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy.
You may review this notice at our website, www.leapclinics.org. To obtain a paper copy of this notice, contact Leap Pediatrics directly 2439 Manhattan Blvd ste 501, Harvey LA 70058; 504-569-5327.